Children with a history of acute leukemia may experience some deficits in their cognitive functions in the late period (Hewitt et al. Childhood Cancer Survivorship 2003).These deficits negatively affect their quality of life by impairing their academic, social and psychological functioning (Jacola et al. Lancet Psychiatry 2016; 3-10-965-972).

The aim of this study was to compare the cognitive functions of children with a history of leukemia compared to their healthy peers.

Our study was conducted with 42 cases with a history of leukemia who were followed up in the Pediatric Hematology outpatient clinic of Dokuz Eylül University Faculty of Medicine and 41 healthy controls who were admitted to the Child and Adolescent Psychiatry outpatient clinic of Dokuz Eylül University Faculty of Medicine.After obtaining informed consent from both parents and participants, the Wisconsin Card Sorting Test (WCST), Stroop Test-TBAG form, Trail Making Test (TMT) A and B forms were administered to all participants.The parents of all participants were given a sociodemographic data form and the Childhood Behavior Checklist (CBCL) and asked to complete it.The teachers of all participants were given the Conner’s Teacher’s Rating Scale-Revised Long form (CTRS-RL) and asked to complete it.

All sub-dimension CBCL scores of the case group were significantly higher than the control group (p<0.05).All sub-dimension CTRS scores of the case group were found to be significantly higher than the control group.The case group performed worse than healthy controls in WCST, Stroop-TBAG and Trail-Making Test. The mean Stroop2-time score was higher in the group that received cranial radiotherapy, whereas the Trail-Making-B-error score was higher in the group that did not.The group receiving the medium-high risk chemotherapy protocol performed worse overall on the Stroop test.Women in the case group performed worse on the WCST than men.Stroop5-error scores were higher in the group with a history of sequelae.It can be said that there is a negative correlation between age at diagnosis, age at the end of treatment and time elapsed after treatment and cognitive test performances.There was a moderate positive correlation between the duration of the treatment and the CBCL-attention problems score (r=0.348, p=0.024) and the CTRS-attention problems score (r=0.432, p=0.04).

In conclusion, it can be said that leukemia treatment may cause deficits in areas such as attention, memory, learning, processing speed, executive function and problem solving in the late period (Montour-Proulx et al. J Child Neurol 2005; 20 2 129-133).The difference in the severity of deficits in these areas between individuals can be explained by many biological, social and psychological factors (Duffner et al. J Pediatr Hematol Oncol 2014; 36 1 8-15).

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Adverse childhood experiences (ACEs) describe an array of stressful exposures that occur during childhood/ adolescence, including types of abuse and neglect. As ACEs occur during a critical period of human development, they have been associated with a range of chronic diseases in adulthood.

We aimed to systematically analyze the prevalence of ACEs in studies in two different disease severity populations, including primary headache and cancer. The objectives of this study are to examine,

The prevalence of ACEs hypothesized to impact chronic disease

The pooled association of the presence of “disease”, which consists for this study only primary headache and/or cancer, with ACEs

The inclusion criteria for the studies in the systematic reviews/meta-analyses included observational studies with a comparator group, ACE(s) occurrence at ≤18 years of age, and disease diagnosis at ≥21 years of age. Searches were conducted up to Mar 16, 2023. Two review authors independently screened articles, extracted data, assessed risk of bias using QUIPS, and conducted GRADE assessment as part of the systematic reviews. In this study, we calculated the prevalence and the odds of experiencing ACEs among those with disease compared to those without disease.

Of the total 39,658 articles screened, 44 studies were eligible for synthesis of 437,852 participants from 22 countries across five continents. Among included studies, the most commonly examined ACEs were physical abuse (82% of studies), sexual abuse (77%), household substance or alcohol abuse (52%), witnessing or threat of violence (50%), having a household member with a mental illness (45%), and emotional abuse (43%).

Of the 437,852 participants in the synthesis, an estimated total of 196,587 participants (45%) reported experiencing at least one ACE. Among participants with primary headache and/or cancer, 51% (29,838/58,580) reported experiencing at least one ACE, compared to 44% (166,749/379,272) of participants without primary headache and/or cancer (crude odds ratio = 1.32, 95% confidence interval: 1.30, 1.35).

The prevalence of ACEs is high when hypothesized to be associated with diseases, independent of the risk for mortality (i.e., primary headache low mortality, cancer high mortality). Abuse ACEs are more commonly considered in studies than neglect ACEs, and therefore, more consistent and comprehensive reporting of ACEs is needed. There is untapped opportunity for the expertise of psychiatrists to collaborate with clinicians and researchers of adult chronic disease studies.

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Five medications have been approved for the treatment of bipolar depression, though no medication has been approved for the treatment of depression with mixed features. Post-hoc analyses of the bipolar depression trials examined efficacy in depressed patients with and without mixed features. Each study also examined the emergence of manic symptoms as a possible negative outcome, and each found that the frequency of emergent manic symptoms was more frequent in the patients treated with placebo than with medication though in no study was the difference statistically significant. However, the studies were not powered to detect a significant difference in treatment emergent (hypo)manic episodes thereby prompting the current pooled analysis.

The goal of the present pooled analysis was to examine whether second-generation antipsychotics that have been found effective in treating depression with mixed features protect against the emergence of (hypo)manic episodes in depressed patients with concurrent manic symptoms.

Five placebo-controlled studies of the effectiveness of second-generation antipsychotics in the treatment of depressed patients with mixed features reported information on the emergence of manic symptoms.

The 5 studies included 1,829 depressed patients with mixed features—1,620 with bipolar disorder and 209 with major depressive disorder. In each study, the frequency of treatment-emergent manic episodes was higher in the group treated with placebo, though in no study was this difference significant. Summed across studies, the frequency of treatment emergent (hypo)manic episodes was higher in the patients receiving placebo (4.0% vs. 2.4%, X2=3.66, p=.056). Excluding the patients treated with olanzapine, which has not been found to be effective in treating bipolar depression, the frequency of emergent (hypo)manic episodes was significantly higher in the patients receiving placebo, (4.0% vs. 1.8%, X2=7.31, p=.007).

The results of the present analysis suggest that the second-generation antipsychotics that are effective in treating bipolar depression also protect against a (hypo)manic switch in depressed patients with mixed features.

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Depression is commonly treated with psychotherapy or antidepressants, but predicting which intervention will work best for a given patient remains a challenge. This pilot trial compared the feasibility, acceptability, and effectiveness of psychotherapy based on behavioral activation (Healthy Activity Program, HAP) and antidepressant medication (fluoxetine) in a primary care setting in India.

The trial had three key objectives: (1) assess the feasibility and acceptability of a randomized pilot trial comparing HAP and fluoxetine; (2) collect outcome data to refine study instruments and the baseline assessment; and (3) evaluate the preliminary comparative effectiveness of psychotherapy versus medication.

The pilot trial was conducted at eight primary health care centres in Madhya Pradesh (India) from August 2023 to February 2024. Eligible participants (aged 18+, PHQ-9 score ≥10) with moderate to severe depression were randomized to receive either HAP or fluoxetine. Feasibility was assessed by recruitment, retention, and adherence to study procedures. Acceptability was measured by adherence to interventions. Preliminary efficacy, as a secondary outcome, was assessed through changes in depressive symptoms (PHQ-9) from baseline to the 3-month follow-up.

76 participants were randomized, with primary endpoint data available for 63 (83%). Retention rates and study assessment completion were acceptable across both arms. Intervention adherence was high, with 79% (30/38 in HAP and ADM groups) completing the treatment per protocol (≥6 HAP sessions or 70% medication adherence). PHQ-9 scores improved significantly, with an average reduction from 15.02 at baseline to 6.73 at the 3-month follow-up, with no statistically significant differences between treatments. Full remission (PHQ-9 < 5) was achieved by 45.16% (28/62) of participants. Additionally, the pilot study identified logistical challenges and facilitators that will help refine the protocol for the larger trial.

This pilot trial successfully demonstrated the feasibility and acceptability of the study design, procedures, and interventions. The preliminary data suggest that both HAP and Fluoxetine are viable treatments for moderate to severe depression in primary care settings in India. The findings will be instrumental in informing the design and implementation of a larger precision trial.

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Safe and effective handovers are crucial for patient safety in psychiatric hospitals and a digital record helps to prevent information loss and allow auditing. Trainees at our institution raised concerns about the lack of a reliable, traceable digital record for out-of-hours handovers. The pre-existing system of handwritten notes and emails was error-prone, cumbersome and untraceable. Therefore, a more efficient digital system was needed to match the demands of a busy in-patient psychiatric hospital.

To improve the safety and quality of medical handovers in our hospital.

A baseline survey was sent to resident doctors at The Maudsley Hospital, London, to gather feedback on handover practices. The Microsoft Planner application within Teams was introduced, providing a secure, live digital handover record accessible with two-factor authentication. It allows multiple users to edit tasks simultaneously and tracks all updates with clinician specific time stamps. Changes were communicated and feedback gathered through monthly meetings, emails, and encrypted messaging apps. After 12 weeks, we sent a follow-up survey and made further adjustments based on the feedback.

Nine doctors responded to the baseline survey, giving an average score of 2.5 out of 5 for quality and 2.4 out of 5 for safety. Forty-six percent struggled to prioritize tasks during on-call shifts, 54.6% found it hard to track task progress, and 18.2% reported frequent task delays or omissions. After the changes, nine doctors responded with improved scores of 4.6 out of 5 for quality and 4.2 out of 5 for safety. Seventy-eight percent rarely had difficulty prioritizing tasks, 66.7% found it easy to track progress, and 87.5% reported that tasks were rarely or never missed. Feedback highlighted that use of the platform varied amongst clinicians and access issues for emergency locum doctors, leading to the creation of a trust-wide protocol to standardise the use of this technology and respond to access issues.

A web-based task management platform was introduced in a large in-patient psychiatric hospital with significant improvements seen in clinician-rated quality and safety of medical handovers. This application is now commonly used across South London and Maudsley NHS Trust, the largest mental health trust in the United Kingdom. Over 450 NHS organizations have access to the Microsoft 365 and could therefore use this innovative technology to improve their clinical handovers. Given Microsoft’s global use, this could very likely be used throughout European mental health organisations.

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The rapid change a variety of the clinical picture in case of autoimmune encephalitis remain a diagnostic challenge.

Diagnostics and therapeutic process as of the atypical psychosis.

A 40-year-old woman, since 2 weeks she expressed catastrophic delusions and dysphoria. Next she revealed tinnitus, psychosensory disturbances, disorganization of thinking and behavior and the first grand mal seizure occurred. In the neurology ward were described psychogenic disorders and she was referred to the psychiatric ward, where catatonic schizophrenia was diagnosed. She was disoriented, with periodic episodes of arousal and freezing, negativism and command automatism. She was hallucinating visually, auditorily, olfactorily, and cenesthetically, expressed delusions of catastrophe, influence, and persecution. Despite modifications of treatment (aripiprazole, haloperidol, olanzapine, quetiapine, clozapine, valproate) she didn’t improve. In the 4th week of hospitalization, an episode of fever of unknown etiology occurred and she was transferred to a higher referral psychiatric ward. Next fluctuating disturbances of consciousness, myoclonus, bilateral palmomental and Babinski’s sign and swallowing disorders were observed. Due to the lack of therapeutic effect tiapride was administer with slight improvement.

Laboratory tests: CRP, VDRL, anti-HIV antibodies - absent, ceruloplasmin, ANA, anti-TPO, anti-TSHR antibodies, tumor markers – normal range.

No changes in contrast-enhanced MRI head. In EEG moderate-grade, extensive changes in the fronto-central and frontotemporal leads bilateral.

CSF examination – normal range, negative result for 14-3–3 protein

In a panel for antibodies typical of autoimmune encephalitis - presence of anti-NMDA antibodies. Then autoimmune encephalitis was diagnosed. She was initially treated with immunoglobulins, with slight effects. Subsequently, effective immunosuppressive treatment with mycophenolate mofetil and methylprednisolone was administered. Further, the psychosis resolved, with the normalization of the neurological signs. The patient’s in stable mental and somatic condition was discharged without further psychopharmacology.

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In anti NMDA receptor encephalitis affective symptoms, psychosis, catatonia, consciousness disorders, as well as neurological symptoms occurred. In majority of cases no changes are observed in brain imaging. EEG examination shows non-specific changes in 90% of cases. About 80% of patients recover without functional impairment, but in 7% disease is lethal. Crucial is to determine the etiology of atypical symptoms in order to implement adequate therapy as soon as possible.

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This knowledge exchange program was designed to enhance the clinical training of a Cambodian psychiatrist in general psychiatry and addiction care. Conducted between July 1, 2024, and August 30, 2024, the program involved immersive clinical experiences in the Netherlands and South Africa. The exchange facilitated engagement with leading mental health institutions, offering valuable insights into advanced psychiatric practices and addiction care models.

The primary objectives of the program were to improve clinical competencies in diagnosing and managing psychiatric and addiction disorders, to gain exposure to multidisciplinary and community-based care models, and to develop cultural competence in adapting psychiatric practices to low-resource settings like Cambodia. These goals were pursued through a combination of clinical visits and participatory learning activities.

The psychiatrist participated in clinical visits and hands-on learning at Radboud University Medical Center and Pro Persona in the Netherlands, as well as Rustenburg Addiction Care in South Africa. These experiences included observing advanced treatments and participating in community-based psychiatric care programs. The program’s structure combined hands-on training and multidisciplinary teamwork to provide a comprehensive learning experience.

The program yielded significant improvements in the psychiatrist’s ability to manage complex addiction cases and implement community-based care. Additionally, the experience fostered greater cultural competence, enabling the application of psychiatric practices suited to the Cambodian context. The collaboration also promoted potential future psychiatric training initiatives and international partnerships.

The knowledge exchange program was successful in enhancing the psychiatrist’s clinical skills and cultural awareness. It underscored the importance of international collaboration in psychiatry and addiction care, providing a model for how mental health professionals from low-income countries can benefit from exposure to global best practices and community-based care strategies.

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Anxiety is a common and often debilitating condition in individuals with Multiple Sclerosis (MS), significantly affecting their quality of life. The challenges associated with managing MS symptoms and the potential for disability can contribute to increased levels of psychological distress.

The aim of our study was to determine the prevalence of anxiety and identify the its associated factors.

A cross-sectional study was conducted in the neurology department of Razi University Hospital (Tunisia) between October 2023 and June 2024. Patients with a diagnosis of MS based on the 2017 McDonald criteria were recruited, excluding those with active disease relapses. Participants completed questionnaires covering sociodemographic data, medical history, clinical and radiological characteristics, disability status, and psychological symptoms. Depression, anxiety and stress were assessed using the DASS-21 scale. Insomnia was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed using SPSS version 26.

A total of 83 patients with MS were recruited, with ages ranging from 19 to 66 years. The study population had a predominantly female sex ratio of 3.4. The majority of participants (75.9%) were from urban areas, and 74.7% had a university-level education. Moreover, 49.1% were married, and 60.2% were employed. Regarding medical history, 40.3% had a comorbid condition, and 30.1% had a psychiatric history. The mean age at disease onset was 26 ± 10 years, and the most common clinical presentations were sensory and pyramidal symptoms.

The median time since the last relapse in our sample was 24 months. In our sample, first-line treatments (interferon, glatiramer acetate, teriflunomide, dimethyl fumarate) were prescribed to 27.7% of patients. Second-line treatments (natalizumab, ocrelizumab, fingolimod) were prescribed to 69.9% of patients

In our study, the prevalence of anxiety was 55.4%. In our population. 26.5% of the patients had severe anxiety. A significant association was found between anxiety and female gender (p=0.02), stress (p<0.001), and insomnia (p=0.003).

The findings indicate that anxiety is a considerable concern for individuals with MS. Addressing this mental health issue is essential for healthcare providers to offer effective support. By prioritizing mental health, we can enhance the overall well-being of individuals living with MS and improve their quality of life.

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This study represents the first effort in North Macedonia to examine the contextual attributes that may influence the effectiveness and acceptability of a novel digital intervention, DIALOG+, within the mental health care system. The intervention aims to enhance mental health outcomes through a structured approach, but its success depends on understanding the specific characteristics of the local health context.

The primary objective of this research is to identify the key contextual attributes within the mental health care system of North Macedonia that are relevant to the successful implementation of DIALOG+. This includes examining factors that could impact both the effectiveness of the intervention and its acceptance by various stakeholders, including patients, clinicians, carers, and policymakers.

Data for this study were drawn from a variety of sources, including the National Mental Health Strategy 2018-2025, relevant documents from the World Health Organization, and other action plans. In addition, interviews were conducted with key stakeholders—patients, carers, clinicians, and policymakers—to gather perspectives on the anticipated introduction of DIALOG+ and assess the readiness of the mental health centers for its implementation. The data were subsequently mapped to a framework developed by the Ottawa Implementation Group, which outlines 14 key contextual attributes influencing health interventions.

The findings were categorized into two subgroups, identifying both facilitators and barriers to the implementation of DIALOG+ in North Macedonia’s mental health system. The intervention’s characteristics as a broadly applicable psychosocial tool align well with modern approaches to psychosocial rehabilitation, particularly for individuals diagnosed with psychosis.

DIALOG+ presents a valuable tool for mental health professionals in North Macedonia, offering structured support for monitoring patient progress and achieving institutional objectives. The intervention has the potential to facilitate patients’ reintegration into society, enhance their independence, and enable them to reach their full potential in the pursuit of a healthy and functional life.

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We present the case of a 61-year-old retired woman with hypothyroidism and rheumatoid arthritis who was diagnosed with bipolar disorder in 2006 after a manic episode. Her initial treatment included venlafaxine, valproic acid, quetiapine, zolpidem, and lormetazepam. She had several manic episodes over the years, some requiring hospitalization. In 2017, venlafaxine was replaced with vortioxetine, which she now introduces when detecting depressive phases, under psychiatric supervision but with some autonomy. She has remained stable, with occasional manic or hypomanic episodes triggered by stress, but none requiring hospitalization.

Figures 1 and 2 illustrate the patient’s self-perception changes with vortioxetine treatment. Figure 1 shows her as unhappy during the depressive phase (top) and happy after recovery (bottom). Figure 2 depicts her self-image during the depressive phase (left) and after recovery (right).

• - To assess the effectiveness, safety and risk of mood swings of vortioxetine in a patient with bipolar disorder during depressive phases.

• - To determine if effective psychoeducation allows patients to manage some of their medications safely under specialist supervision.

The patient mantains treatment with vortioxetine 20 mg daily, valproic acid 500 mg every 12 hours, quetiapine extended release 400 mg at dinner, zolpidem 15 mg, and lormetazepam 2 mg at bedtime during depressive phases. In manic episodes, quetiapine 300 mg is added, vortioxetine is discontinued, and the dosage of hypnotics is doubled. Intensive psychological support has improved her disease awareness and treatment adherence, allowing her to adjust vortioxetine (but not other medications) as needed under medical supervision. She has not reported any adverse effects from vortioxetine.

Vortioxetine 20 mg could effectively treat depressive phases without causing mania. Though research on its use in bipolar disorder is limited, it shows potential when combined with a mood stabilizer, with a response time of about nine weeks and a low risk of hypomania/mania. It may also help with cognitive decline and brain inflammation related to bipolar disorder, improving cognitive performance and reducing inflammatory markers. Vortioxetine is noted for its effectiveness, tolerability, and low dropout rate.

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Vortioxetine 20 mg may be effective for treating depressive phases in bipolar disorder with a lower risk of manic episodes compared to other antidepressants. Its procognitive and potentially anti-inflammatory effects could also support stability in non-psychiatric comorbidities. For this patient, good psychoeducation has facilitated a degree of independence in managing the medication, which is aided by vortioxetine’s safety and ease of use for both professionals and patients.

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ChatGPT is a language model based on artificial intelligence (AI) that is designed to generate human-like text. It offers potential applications in automating and simplification of clinical documentation tasks, addressing the increasing administrative burden that contributes to high rates of burnout in psychiatry. As discharge summaries are typically structured and repetitive, the use of ChatGPT to automate this task could offer significant benefits, such as reducing clinical workload, improving summary quality, and preventing delays in patient discharges. However, concerns about reliability, accuracy, and ethical considerations persist.

Explore the feasibility and implications of using ChatGPT to assist in writing discharge summaries in psychiatric settings.

A narrative review was conducted by searching PubMed and Google Scholar with the keywords “ChatGPT”, “discharge” and “psychiatry”. Relevant articles, including empirical studies, case reports, reviews, and expert opinions were selected.

We found only one empirical study that evaluated psychiatric discharge summaries generated with ChatGPT-4: human-written discharge summaries were rated significantly higher in quality than those generated by ChatGPT; the ChatGPT summaries fell short, particularly in coherence and specificity of formulations, though they performed reasonably well in summarizing relevant case information. Most of the literature consisted of theoretical discussions and expert opinions related to the broader use of AI in psychiatry. Despite this, the potential benefits, such as improving the efficiency and consistency of documentation, were frequently highlighted. However, concerns related to accuracy, the need for clinician oversight, and ethical implications were consistently noted.

ChatGPT shows promise in assisting with the generation of psychiatric discharge summaries, potentially alleviating the documentation burden faced by clinicians. However, further refinement of the model, integration with electronic health records, and the establishment of clear ethical safeguards are necessary for its safe and effective use. The current lack of empirical evidence highlights the need for targeted research that should also address challenges related to data governance, patient acceptance, and error management. Additionally, studies should evaluate the direct impact on clinician workload and compare the quality of AI-generated summaries with those written by psychiatrists and residents. Such research will be essential to facilitate the broader integration of ChatGPT in real-world psychiatric practice.

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Individuals with first-episode bipolar disorder (FEBD) may have language abnormalities and sub-threshold formal thought disorder (FTD). Natural language processing (NLP) methods that have been shown to assess FTD in psychosis can be used in the early stages of bipolar disorder (BD).

The purpose of this study was to examine the differences between FEBD and healthy controls (HC) utilizing NLP methods.

Speech samples were collected from 20 FEBD and 20 HC while describing eight Thematic Apperception Test images. The manually transcribed text was then processed using word2vec to generate vectors. The semantic similarity between words was computed utilizing a moving window method to windows ranging in size from 5 to 10. Finally, the average, variance, maximum, and minimum of these similarities were calculated.

All mean similarities (windows of 5 to 10) were significantly higher in FEBD (p< .001, p=0.001, p=0.002, p=0.002, p=0.003, and p=0.004, respectively). Additionally, all variances of similarities were highly significant and were increased in FEBD (all p values< .001). Regarding maximum values, except for the window of 5, all of the remaining windows were significantly higher in FEBD (all p values <.05.).

Our findings indicate that semantic similarity increased in the FEBD group compared to HC. Overall, NLP methods offer an easily applicable approach for assessing FTD in FEBD and discriminating between FEBD and HC.

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There is growing awareness of the need for Police Officers to develop skills to assist those who have Autism. The development of skills is essential for a positive outcome, be it managing an emergency call out, making an arrest or interviewing a victim of crime. This is being championed by the development of co-responder teams which consist of a Police Officer and a Mental Health Professional who are dedicated to responding to emergency calls that may have a mental health component. These teams report a high rate of call outs involving those with Autism and frequently request further training in the area.

To develop a training pilot study in Ireland which could be expanded to an international cohort of Police Officers and co-responder teams in the United States.

We were invited to train a small group of Irish Police Officers. We used the opportunity to obtain feedback which we then used to identify common training needs and used to improve the presentation. This was then delivered to the Framingham Police, Boston, USA and a group of co responder trainees. Feedback was again sought and used to improve the presentation to better address the needs of the group. A presentation was delivered to a conference for those who co-ordinate co-responder teams in Law Enforcement, Universities and Colleges in the United States and feedback sought.

In the initial training to Irish Police Officers, feedback demonstrated improvement with significant p-values in all domains examined with questions e.g. ‘I understand the common difficulties those with Autism experience’ and ‘This training will help me in my day to day work’. The feedback from the conference demonstrated significant interest and engagement in the training with questions e.g. ‘The program maintained my interest’ and ‘The presenters responded to the questions and needs of the attendees’.

There is growing recognition of the need for Police Officers to have the skills to recognise, communicate with and support those with Autism. Our program has demonstrated a need and interest of Police Officers and co-responder teams for training in this area. We have also demonstrated effectiveness of the training using feedback from the attendees.

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Well-being enables people to cope with life’s stressors and to contribute well to community life. It is associated with better productivity in the workplace.

Our study aims to assess well-being and its determinants among university staff.

We conducted a descriptive, analytical and cross-sectional survey to assess well-being and its determinants among university staff. The survey was carried out during a one-day training session on mental health promotion using a two-part questionnaire. The first part assessed socio-professional characteristics. The work ability was assessed using the Work Ability Score (WAS) questionnaire. Perceived physical workload was assessed by the Borg score. The second part assessed participants’ well-being using the Mental Health Continum Short Form (MHC-SF) questionnaire.

Our population comprised 65 participants, 67.7% of whom were female. The mean of perceived physical workload was 4.7±1.5. The job satisfaction mean was 3.8±1.3. We found that 56.9% of our participants (n=37) had good to excellent work ability and 43.1% rated their work ability as poor to moderate. The mean MHC-SF score was 41.2±16.1. The mean scores for emotional, psychological and social well-being were 8.4±4.2, 19.9±7.2 and 12.8±6.3 respectively. Sixty percent of participants reported languishing to moderate mental health and 40% were flourishing. Bivariate analysis showed that participants’ wellbeing was associated with high work ability and high perceived physical workload.

Well-being among university staff deserves to be studied given its impact on work performance. Actions to promote well-being among these staff are urgently needed not only to improve the well-being and productivity of this population but also to prevent a negative influence on students.

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This research addresses the significant mental health challenges faced by women in Pakistan, where gynecological/obstetrical issues are prevalent, and mental health awareness is often lacking due to cultural stigmatization and misconceptions. Women with conditions such as infertility, and breast and ovarian cancer are at higher risk of psychiatric disorders, and there is a clear correlation between infertility and psychological comorbidity. Cultural beliefs and regional variations further complicate the perception and understanding of mental health in Pakistan.

The primary objective of this research is to dispel myths and misconceptions surrounding mental health by providing group psychoeducation on major psychiatric illnesses. The goal is to raise awareness and promote psychiatric and psychological help-seeking behavior among women with gynecological issues.

This study employs a quantitative approach with a quasi-experimental design. A sample of 55 married female participants from the Gynecology Department of Services Hospital Lahore, underwent pre- and post- psychoeducation assessments. Only married females seeking treatment for gynecological conditions were included, while those already diagnosed or seeking treatment for mental disorders before the onset of gynecological issues were excluded. To assess the participants’ knowledge and beliefs regarding mental illnesses, a self-developed Women Mental Health Checklist was used for pre-and post-assessment. A panel of mental health experts validated the content for the checklist. Psychoeducation material was developed based on established resources, and a panel of experts examined its content validity. A pre-psychoeducation assessment was conducted, followed by psychoeducation sessions that included information about mental disorders associated with gynecological issues. Post-assessment was conducted at a one-month follow-up. SPSS 21 was used to analyze the data.

The repeated measure t-test analysis revealed a statistically significant difference in post-assessment (t (49) = 14.6, p = 0.00) which indicated a strong impact of psychoeducation on post-assessment.

These findings highlight the importance of psychoeducation in promoting help-seeking behavior. However, it is important to understand the study limitations and that future research should explore psychoeducation’s role on a broader level. This research aims to bridge the gap in mental health awareness and help-seeking behavior among women in Pakistan facing gynecological and obstetrical issues, ultimately contributing to improved mental well-being and overall quality of life.

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Electroconvulsive therapy (ECT) has gained increasing attention as a therapeutic option for managing aggressive behavior in psychiatric patients. Aggression is a common symptom in several psychiatric disorders, such as schizophrenia, bipolar disorder, and severe depression, which can be resistant to conventional pharmacological treatments.

This literature review examines the efficacy and safety of ECT in reducing aggression across various psychiatric populations.

We have conducted a web resurch on Pubmed for articles published in the last ten years about the topic using key words like “agression”, “ECT”.

Evidence suggests that ECT can be particularly effective in cases where patients do not respond to medications or display dangerous behaviors. Significant reductions in aggression have been reported post-ECT, along with improvements in mood and overall functioning.

Although ECT remains controversial due to concerns about cognitive side effects, advancements in its application have enhanced its safety. This review emphasizes the need for further.

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Psychiatric emergencies are a global challenge requiring timely, effective interventions. Traditional intra-hospital approaches often struggle to address the complexity of these crises in a patient-centered and family-inclusive manner. Trento’s Mental Health Service has implemented a community-based, multidisciplinary approach to manage psychiatric emergencies, emphasizing the socio-familial context of each crisis.

This study aims to evaluate the effectiveness of the Trento Crisis Team in managing psychiatric emergencies outside of hospital settings, reducing hospital admissions, and enhancing patient and family engagement in the recovery process. Additionally, we assess the impact of the crisis service on public stigma related to mental health crises.

The study reviews the structure and organization of the Trento Crisis Team, which operates within the Mental Health Centre. The team includes 3 psychiatrists, 5 nurses, 5 educators/psychiatric rehabilitation technicians (TERP), and 5 Peer Support Specialists (“ESP” in Italian). Data were collected from emergency intervention records, hospital admission rates, and user satisfaction surveys. Comparisons were made between territorial and intra-hospital crisis management outcomes, with statistical analysis on key performance indicators such as the number of hospital admissions and compulsory health treatments.

Preliminary results indicate a reduction in hospital admissions (Image 1) and a significant decrease in the number of compulsory interventions (Image 2) since the establishment of the dedicated Crisis Team. While overall user numbers have increased (Image 3), the availability of peer support and home-based interventions has improved patient satisfaction and engagement. However, the system still faces challenges in reducing hospital admissions due to the increasing volume of psychiatric emergency cases.

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The community-based crisis management model adopted by the Trento Crisis Team offers a promising alternative to traditional hospital-based interventions. By focusing on the individual’s socio-familial environment and engaging Peer Support Specialists, the service has demonstrated a capacity to humanize mental health crises and reduce public stigma. Continued efforts are necessary to address resource constraints and further integrate crisis management into community mental health pathways.

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Intravenous (IV) ketamine has garnered increasing attention as a rapid-acting treatment for severe psychiatric conditions such as major depressive disorder (MDD) and suicidal ideation, particularly in treatment-resistant cases. Unlike traditional antidepressants, which often take weeks to exhibit therapeutic effects, IV ketamine can provide relief within hours. While the nasal spray form of ketamine has been approved for clinical use, it remains costly and may not be accessible to all patients. Developing a standardized, cost-effective protocol for the outpatient administration of IV ketamine could enhance treatment accessibility while maintaining safety and efficacy.

To develop and evaluate a protocol for the outpatient administration of IV ketamine that ensures patient safety, maximizes clinical effectiveness, and reduces costs compared to alternative ketamine formulations, while maintaining practical outpatient management without requiring inpatient monitoring.

This study enrolled 46 patients diagnosed with treatment-resistant MDD. Each patient received an initial IV ketamine infusion at a dose of 0.2 mg/kg, followed by 0.5 mg/kg in subsequent sessions, administered over 45 minutes in a 100 mL saline solution. Treatments were performed in an outpatient setting with close monitoring during the infusion and for one hour post-infusion. Symptom improvement was evaluated using standardized psychiatric assessment tools, such as the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HAM-D). The protocol also outlined strategies for managing side effects, including transient dissociation, nausea, and hypertension.

The outpatient ketamine protocol demonstrated rapid and significant symptom relief in the majority of patients, with most reporting improvement after the first or second session. Adverse effects were generally mild, with the most common being transient dissociation and elevated blood pressure, both of which resolved without requiring additional intervention. Importantly, the need for expensive inpatient care or nasal spray formulations was minimized, making the treatment more accessible. The cost savings compared to other ketamine delivery methods were notable, making this protocol a viable option for outpatient psychiatric care.

This study establishes that IV ketamine can be safely and effectively administered in an outpatient setting, offering rapid symptom relief for treatment-resistant MDD while minimizing side effects and reducing overall treatment costs. The protocol presents a practical, cost-effective alternative to more expensive ketamine formulations, providing a feasible solution for broader clinical use in psychiatric outpatient settings. Further research is recommended to validate these findings across larger patient populations and explore long-term outcomes.

None Declared

Depression is commonly comorbid with post-traumatic stress disorder (PTSD) symptoms. There is a lack of studies evaluating trauma-informed interventions for people with depression and PTSD symptoms.

We examined whether an online, easily accessible, trauma psychoeducation program would be helpful for people with both depressive and PTSD symptoms.

Participants with depression (PHQ-9 ≥ 10) and co-occurring PTSD symptoms were recruited online and randomly assigned to the intervention group (i.e., a 10-session online program based on Be a Teammate With Yourself) or the control group. Outcome measures included the Brief-COPE, a subscale of the Endorsed and Anticipated Stigma Inventory, and the Post-traumatic Maladaptive Beliefs Scale. These outcomes were assessed at baseline, posttest, and 2-month follow-up. Qualitative feedback was also obtained from the participants.

35 participants were randomly assigned to the intervention group, and 34 to the control group. With only email reminders, 9 participants in the intervention group and 14 in the control group completed posttest and follow-up surveys. Completers-only analyses were conducted. One-way repeated measures ANOVA showed that the intervention group had significant reductions in post-traumatic maladaptive beliefs, with a large effect size (F = 4.152, p = .035, Partial Eta Squared = 0.342). The control group did not have such changes. Both groups did not have significant changes in coping and self-stigma. Of 12 participants who provided feedback, 100% agreed that the program could help them remain hopeful for recovery, and 91.6% agreed that they were satisfied with the program. The qualitative feedback also supported the usefulness and acceptability of the programme.

Participation in this program was associated with significant decreases in post-traumatic maladaptive beliefs. Completers were satisfied with the program. Given a small sample with a high dropout rate (66.6%), the results should be interpreted with caution.

None Declared