Numerous studies indicate that caregivers of patients with schizophrenia experience significant burden and exhibit depressive symptoms as measured by the CES-D scale. Specific psychoeducational programs like the multifamilal CBT based Profamille program may help alleviate these symptoms. However, it is yet to be established the extent to which these caregivers meet the criteria for clinical depression as defined by the DSM-5, as well as whether the interventions employed in this program can effectively reduce the prevalence of depressive disorder among caregivers.

Assess the prevalence of major depressive disorder among caregivers at the start and end of the Profamille psychoeducational multifamily program.

Caregivers were referred to the program by family organizations, welfare services or healthcare providers, or found out about the program through the local press.

A group consists of twelve caregivers of approximately ten patients, participating in 14 structured weekly sessions of Profamille program version V3.2, each lasting 4 hours. These sessions provide information about schizophrenia, develop coping strategies for caregivers, and employ behavioral and cognitive techniques to address depressive symptoms.

Mood was assessed using the PHQ-9, a self-report questionnaire consisting of nine items aligned with diagnostic criteria for major depressive disorder. Responses were analysed using an algorithm based on DSM-5 criteria to classify participants as having or not having major depressive disorder.

Given the paired nominal data, McNemar’s test was employed for analysis

A total of 507 caregivers were recruited, including 349 women. The average age of the participants was 58.0 years (SD = 9.0). At the beginning 14.6% of participants had a diagnosis of major depressive disorder. Fourteen sessions later this rate decreased to 5.7% (McNemar’s test, p-value < 0.00001)

The annual prevalence of depression in the general population is approximately 5%, indicating a threefold over-representation among caregivers participating in the program. This rate of over-representation is consistent with other studies utilizing the CES-D, which also captures subclinical depression. Given the implications of depression for participants’ physical health, this underscores the need for systematic investigations aimed at providing support. The Profamille program, which employed specific cognitive behavioral techniques in a group setting, resulted in a significant reduction in depression rates over 14 sessions, bringing the final rates more in line with those of the general population. These findings suggest that the program effectively normalized the prevalence of depression. However, the absence of a control group limits our ability to assess the natural progression of depressive symptoms without program participation

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Mental health reform represents one of the most transformative changes in the field of healthcare, as it not only changes the forms of services, but also the nature of services offered. While many countries have successfully implemented such reforms, others, including Georgia, have struggled with a protracted and inconsistent process. Despite decades of advocacy by professionals for deinstitutionalization psychiatric hospital treatment continues to dominate in Georgia’s mental healthcare system.

The purpose of the review is to explore the concept of deinstitutionalization within the mental health landscape and assess its status in the context of Georgia. It aims to study the lessons learned from successful deinstitutionalization and illuminate achievements and challenges surrounding deinstitutionalization in Georgia’s reality.

A qualitative analysis including desk review, in-depth interviews and focus group discussions was conducted. Proceeding from the research objectives we analyzed the existing legislation, strategic documents and clinical practices concerning individuals with mental disorders; Interviews were also conducted with key informants on the shortcomings and problems in deinstitutionalization practices

The review findings reveal, that despite recent progress such as the development of community mobile teams and increased funding allocated for community services within mental health budget, a number of issues still remain a problem: there is no agreement among stakeholders on how to restructure existing hospital beds and financial provisions remains unresolved. The field of mental health in Georgia suffers from a lack of human resources. Attracting new personnel, ensuring regional distribution, and enhancing qualifications are necessary components of deinstitutionalization that require the involvement of all stakeholders, coordinated and time-planned action. The current mental healthcare system in Georgia is characterized by a lack of coordination and collaboration among its various components. Establishing patient care pathways between services with clear referral criteria is crucial for improving the efficiency of mental health services.

This research highlights that successful deinstitutionalization requires additional funds, time, and trained people. Institutions should have a long-term (3-5) year development plan, detailing the source of funding, activities to be implemented, and expected outcomes. In the absence of such a plan, progress remains sporadic, intermittent, uncoordinated, and less effective.

By addressing identified challenges and promoting coordination among mental health components, Georgia can guide a more effective course toward a community-based, patient-centered mental healthcare system.

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Alzheimer’s disease, necessitates continuous, long-term care primarily provided by family members. As the disease progresses, caregivers experience increasing stress and burden. Research indicates that caregivers of Alzheimer’s patients are at higher risk for depression, social isolation, and health problems. In order to help the caregivers, multi-component support programs, which integrate approaches such as education, psychoeducation, and social support, have shown more positive outcomes. However, systematic reviews and meta-analyses examining the impact of these programs remain limited.

This systematic review and meta-analysis aimed to evaluate the effectiveness of multi-component support programs on the caregiver burden of individuals caring for Alzheimer’s patients.

The research was conducted through searches in five databases (CENTRAL, CINAHL, PsycINFO, PubMed, WOS), focusing on randomized controlled trials that met the inclusion criteria. Two researchers independently evaluated the full texts, assessing risk of bias with the Cochrane ‘Risk of Bias-2’ tool and evidence quality using the GRADE tool. Participants included individuals aged 18 and older who were the primary caregivers for those diagnosed with Alzheimer’s disease and had provided care for at least three months. The intervention included at least two types of support, such as skill training, education, counseling, or therapy. The primary outcome was caregiver burden.

The review included 8 studies overall. Among the 1147 participants, only one study was web-based, while the other seven interventions were conducted face-to-face. The components of the interventions were mainly educational, supportive, and skill-building, with only one intervention including respite care. Overall risk of bias assessment recorded one study with high risk, four with unclear risk, and one with low risk. The effect sizes of the interventions were calculated based on the means and standard deviations of caregiver burden scores before and after the intervention, as well as follow-up measurements. The multi-component intervention programs were found to have an uncertain short-term effect (Cohen’s d = 0.12; 95% CI: -0.06 - 0.29; p = 0.39) but were effective in the long term (Cohen’s d = 0.21; 95% CI: 0.03 - 0.38; p = 0.02). The certainty of evidence for caregiver burden outcomes was determined to be low before the intervention and follow-up, and very low from pre-intervention to post-intervention measurements. The data is current as of 12/12/2023.

Image 1:

Multi-component support programs are effective in reducing caregiver burden for Alzheimer’s caregivers in the long term; however, more high-quality studies are needed to confirm this effectiveness.

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Artifical Intelligecne is sold as a magic solution, and yet its inscrutability poses a major problem. Who is the source of the knowledge? Who is accountable? Who is responsible? Who can edit or train it? Has it been trained on copyrighted material? If so, have the owners been compensated? If not, is it culturally relevant? Has the ‘black box’ aspect been addressed? Whether a provider of knowledge, a clinical decison aid or a decsion maker, troubling issues arise that as yet have not been solved by legisaltion or the market. We shall explore potential benefits, solutions, and actual problems with real world cases that shed light on where AI may take us, and where we may need constarints that lie beyond medical ethics.

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Climate change refers to any change in climate over time, whether due to natural variability or human activity. It is estimated that between 2030 and 2050, climate change will cause an additional 250,000 deaths annually. Therefore, climate change has emerged as one of the most pressing global challenges of the 21st century, with far-reaching environmental, social, and economic consequences. Beyond its direct physical impacts, growing evidence links climate change to adverse mental health outcomes.

This review aims to synthesize current research on the impact of climate change on mental health, identifying key mental health disorders associated with climate-related stressors and highlighting vulnerable populations.

We performed a narrative literature review by searching PubMed, Google Scholar, and ScienceDirect articles published in English in the last ten years.

Climate change significantly affects mental health, with literature suggesting that for every one-degree Celsius increase in temperature, the incidence of mental health problems rises by approximately 0.9%. Extreme weather events like hurricanes, floods, and wildfires linked to climate change can negatively impact mental health, particularly by contributing to higher rates of depression and post-traumatic stress disorder. Additionally, more gradual shifts in climatic conditions, such as rising temperatures and declining air quality, have also been found to harm mental well-being, contributing to “eco-anxiety” and feelings of helplessness. Vulnerable populations, such as children, the elderly, the mentally ill, and marginalized communities, are at greater risk because of their limited coping resources and increased exposure to the impacts of climate change.

The effects of climate change can be direct or indirect, short-term or long-term, with a growing body of evidence showing its contribution to a wide range of psychological disorders. Policymakers and mental health professionals must consider mental health in climate adaptation strategies and create support systems for affected populations. The European Psychiatric Association (EPA) has recently published a position paper urging the inclusion of mental health considerations in climate strategies. Nevertheless, more research is needed to document the extent of these impacts and the best options for mitigating and treating them.

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There is growing concern that the internet may have a detrimental effect on users, leading to addiction and cognitive decline. One well-known empirical study, conducted by Sparrow, Liu, and Wegner (2011), presented two types of the so-called Google effect (intentional and mnemonic) as evidence. In this study, participants answered either difficult or easy yes/no trivia questions, followed by a Stroop task involving internet-related and neutral words displayed in different colors. The reaction times were slower for internet-related words, but only after the difficult trivia questions, which was interpreted as evidence of automatic internet priming in challenging situations. However, subsequent replication attempts were unsuccessful. We hypothesized that the Stroop paradigm may not be valid due to the lack of semantic interference and that the antisaccade task would be more sensitive.

To investigate the intentional Google effect using the antisaccade eye-tracking paradigm.

A pilot study was conducted (N=37). Participants answered a series of difficult or easy yes/no trivia questions, followed by the appearance of either an internet-related or neutral image on the left or right side of the screen. The task required participants to look in the opposite direction of the stimulus, with oculomotor activity recorded by the SMI Hi-Speed system (1250 Hz). Reaction time and the number of errors were measured.

Logistic regression and ANOVA results did not show a significant influence of question difficulty, stimulus type, or their interaction on error probability (B = -0.22, SE = 0.22, z = -0.94, p = 0.35) or reaction time (F = 0.31, p = 0.58).

These preliminary results do not support the hypothesis for the intentional Google effect, further research and discussion in the context of internet-addiction are needed.

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Schizotypy is seen as subclinical part of the psychosis liability continuum. While several studies have attempted to confirm the relationship between schizotypal traits and genetic predisposition to schizophrenia using polygenic risk scores (SZ-PRS), the association of SZ-PRS with other features of schizotypal individuals resembling schizophrenia symptoms remains unexplored.

This study aimed to assess the contribution of SZ-PRS and PRS for other relevant traits to cognitive functioning in schizotypy.

Healthy subjects (n=1468) were divided into low, negative, positive, and high mixed schizotypy groups based on a cluster analysis of the Schizotypal Personality Questionnaire data. Of them, 247 individuals had genome-wide information and completed a comprehensive cognitive battery, from which a cognitive index (CogI) was derived. PRS for schizophrenia, bipolar disorder, educational attainment, intelligence (IQ), neuroticism, and risk-taking were calculated with LDpred2-auto tool. The association of the CogI with PRSs was examined with stepwise multiple linear regression controlling for age and two ancestry-related principal components.

The groups differed in the CogI (p=0.015). The high schizotypy individuals (n=49) had a lower CogI than the low (n=73, p=0.01), negative (n=54, p=0.08), and positive (n=64, p=0.09) ones. SZ-PRS (β=-0.16, p=0.012) and IQ-PRS (β=0.13, p=0.014) predicted CogI in low schizotypy; IQ-PRS (β=0.42, p<0.001) in negative schizotypy; risk-taking PRS (β=-0.27, p<0.001) in positive schizotypy; and none of the PRSs predicted cognition in high schizotypy.

We did not find traits whose PRS might explain the lower cognitive performance in high schizotypy. Thus, nongenetic factors deserve more attention in future research.

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Mental health can affect the quality of life and productivity of healthcare workers (HCWs). It is important to determine the effect of mental health on work ability among these workers to implement adequate interventions.

Our study aims to assess the relationship between work ability and mental health among HCWs.

We conducted a descriptive, analytical and cross-sectional survey among HCWs using a self-administrated questionnaire. We collected socio-professional data. We assessed work ability using the work ability index (WAI) and mental health using the depression anxiety and stress scale (DASS 21).

Our population comprised 200 HCWs, 71% of whom were female. The mean age of participants was 42.9 years. The mean of the tenure of job was 14.2 ±10.1 years. We found that 5.5% presented mild to moderate stress, 3% severe to extremely severe stress, 4.5% presented severe to extremely severe depression, 7.7% presented severe to extremely severe anxiety and 2.5% presented severe to extremely severe depression. Using the WAI, we found that 63% of participants perceived poor to moderate work ability and 37% perceived good to excellent work ability. Work ability was negatively correlated with stress (p = 0.005, r = -0.19), depression (p = 0.003, r = -0.2) and anxiety (p = 0.003, r = -0.2).

Our findings highlight a correlation between HCWs’ altered mental health and poor work ability. Therefore, actions to promote mental health among these workers are urgently needed not only to improve the work ability and productivity of this population.

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Mental illnesses are more common in women than men, and common illnesses such as anxiety and depression often begin in youth. Young women are disadvantaged both in terms of developing mental illnesses and in terms of gender-based discrimination. In this respect, protective, preventive, and empowering interventions targeting young women can be a good investment in terms of protecting their mental health. The youth period is the focus of protective and preventive interventions due to its nature as the initial period of frequently seen mental illnesses. Empowerment can reduce vulnerability during this period.

This study aimed to examine quantitatively and qualitatively whether the self-efficacy and attachment dimensions of the participating young women changed as a result of an empowerment-themed psychodrama group therapy.

The study has a longitudinal design with mix methods. After the local ethics committee approval, an announcement was made online, and the participants were included in the study after face-to-face meetings. Young women between 18 and 25 years who do not have a current psychiatric diagnosis, without suicide attempts and alcohol or substance use disorder, were recruited. Seventeen psychodrama sessions, each lasting three hours, were conducted. Role reversal, pairing, and mirror techniques were mainly used in the sessions. Warm-up games and group games were selected following the theme of empowerment. The General Self-Efficacy Scale (GSS) and Experiences in Close Relationships- Revised (ECR-R) were applied to the group members before starting the psychodrama sessions and after the sessions ended. In addition, the group members’ processes were investigated using qualitative methods after the sessions had ended.

Thirteen young women completed the psychodrama group sessions without more than 20% absence. Statistically significant increases were observed in the initiation (z=-2.310 p=0.021), resilience (z=-1.973 p=0.049), maintenance effort sub-dimensions (z=-2.355 p=0.019), and GSS total score (z=-2.357 p=0.018) of general self-efficacy after the intervention. When the sub-dimensions of ECR-R were evaluated, statistically significant decreases were observed in both avoidant attachment (z=-2.831 p=0.005) and anxious attachment (z=-2.864 p=0.004). Qualitative analysis showed themes of self-confidence, modeling, and universality.

Psychodrama group psychotherapy is suitable for developing self-efficacy and increasing secure attachment in young women as a preventive psychiatric intervention.

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Recently it was highlighted that individuals not only vary in their beliefs but also in the manner of their thinking, and this diversity can significantly predict various crucial psychological outcomes.

This research addresses the underexplored relationship between cognitive styles and psychosocial factors like hope, subjective well-being, coping and social support, specifically in Kosovo. These variables have not been investigated in Kosovo before, making this study the first of its kind.

Its cross-sectional study. The sample consisted of 490 students aged 15 to 23 (Mage=19.06; SD=4.17). Participants completed the instruments below: Adult Hope Scale ; Brief COPE Scale ; Oslo 3-item Social Support Scale; WHO-5 Well-Being Index ; Rosenberg Self-Esteem Scale and Cognitive Reflection Test . Data processing was done with SPSS 27.0 and Microsoft Excel 2019.

Significant negative correlations were observed between Cognitive Reflection Test scores and gender (r = -.197, p < 0.00), Adult Hope Scale score (r = -.173, p < 0.00), WHO-5 Well-being Index (r = -.098, p < 0.04) and Emotion–Focused Coping (r = -.125, p < 0.01). However, no significant correlations were found with Social Support, Problem-Focused-Coping, or Dysfunctional Coping (all p > 0.05). The correlational analysis, suggested that individuals with higher analytical thinking tendencies are more likely to be male, have lower levels of hope, employ less emotion-focused coping strategies and reported lower subjective well-being.

The study emphasized that psychosocial factors are intricate, influenced by diverse elements. While cognitive abilities, as measured by the Cognitive Reflection Test, played a role in some aspects of these factors, they didn’t fully explain their complexity. Therefore, the research suggests that further investigation is needed to grasp the underlying mechanisms and implications of these correlations in a Kosovo context.

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There is strong clinical evidence that patients with depression have high probabilities to present a cardiovascular disease and vice versa. Thus, it is important to accurately identify these patients in order to provide the optimal management of the comorbid conditions.

To identify patients who have depression and cardiovascular disease using social and molecular biomarkers which are routinely collected in the clinical practice.

Data from 502,379 participants in the UK Biobank were utilized in this work. A subset of the participants has a mental assessment using questionnaires about the presence of depression. CVD assessment was also available for the majority of the patients. In total, 126,033 participants had clinical assessment of both depression and CVD. From these, 8,925 patients had both comorbid conditions. An automated medical data curation tool described in a previous study was utilized to detect and mitigate data inconsistencies and elevate the input data integrity and usability. Hybrid boosting ensembles, including the XGBoost algorithm with a customized hybrid loss function was trained on the curated data, to reduce training and testing loss and to avoid overfitting effects. Dropout rates from deep learning theory were used in the hybrid loss function to further reduce biases during the decision-making process by controlling for the shape of the loss function. Random downsampling with replacement was also applied to match the control and target populations due to the increased class imbalance (ratio?) and with respect to the pre-defined set of confound factors. Additional classifiers including bagging classifiers were used for comparison purposes. The classification performance was assessed based on stratified 10-fold cross validation, where various metrics like the accuracy, sensitivity, specificity and area under the ROC curve scores were estimated. Advanced feature selection methods from coalition game theory, including the Shapley additive explanation (SHAP) exploratory analysis was utilized to identify predictors with positive or negative impact to have both the comorbid conditions These explanations were based on the classification outcomes from specific training and testing instances.

The XGBoost classifier had the best performance among all tested classifiers. The results were 0.85, 0.88, 0.81 and 0.92 for the accuracy, sensitivity, specificity and AUC, respectively. The figure 1, presents the explainability analysis for the selected biomarkers. As shown, there are simple social questions, but also some blood biomarkers which can be used for the identification of the patients with both the comorbid conditions of depression and CVD.

Image 1:

We developed an AI-based approach which can diagnose depression and CVD to patients in a cost effective way with accuracy of 85% and AUC equal to 0.92.

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Preclinical stages of Alzheimer’s disease (AD) are characterized by structural and neurochemical abnormalities in temporal lobe and temporoparietal junction (T-TPJ; Popuri et al. Hum Brain Mapp 2020; 41 4127-4147; Jagust. Nat Rev Neurosci 2018; 19 687-700). However, the role of functional characteristics of T-TPJ in conversion to AD is understudied.

Our aim was to clarify whether any patterns of functional connectivity (FC) within T-TPJ differentiate patients with amnestic mild cognitive impairment (aMCI) and future conversion to AD from stable aMCI and healthy controls.

Patients with aMCI and future conversion to dementia due to AD (converters, n = 15; mean age 74.31 ± 7.86), patients with stable aMCI (non-converters, n = 12; mean age 66.77 ± 9.54), and healthy individuals without cognitive deficits (n = 29; mean age 64.17 ± 11.30) underwent resting-state fMRI (3T Philips Ingenia scanner). Eighteen T-TPJ cortical ROIs in each hemisphere were defined according to Harvard-Oxford atlas (Desikan et al. Neuroimage 2006; 31 968-980). FC between these ROIs was compared between groups separately for each hemisphere (one-way ANCOVA with connection threshold p[FDR] < 0.05 and post hoc between-group comparisons). Age, sex, and number of outlier scans due to motion were included into the models as covariates of no interest. The analyses were implemented via CONN (RRID:SCR_009550; www.nitrc.org/projects/conn).

FC between the posterior parts of left middle and inferior temporal gyri was different between converters, non-converters, and healthy individuals (p[FDR] = .0256). Converters demonstrated an increased FC between these regions compared to other groups (p = .0003 for both tests). We also observed a trend for inverse correlation between this FC and delayed recall of words (MoCA) in the entire sample (p = .055).

An increased FC between the temporal brain regions may reflect either pathological processes that have already started, or compensatory mechanisms, or both in future converters to AD. The posterior part of left middle temporal gyrus is critical for auditory verbal memory, whereas the posterior inferior temporal cortex in the left hemisphere stores visual images associated with a word. The observed trend-like correlation might indicate that patients with worse auditory verbal memory rely on visual images associated with a word, however, this assumption should be supported in further studies.

The study was supported by RSF grant 24-15-00220.

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Chimeric antigen receptor–engineered T-cell (CAR-T) therapy is a newly approved treatment that has shown high remission rates among patients with acute lymphoblastic leukaemia. However, its neuropsychological impact remains largely unknown. To our knowledge, this is the first study to examine the neurocognitive effects of CAR-T therapy in children.

To analyse attentional and executive functioning outcomes in paediatric patients with acute lymphoblastic leukaemia after CAR-T therapy.

This study was conducted at the Child Neuropsychology Unit of La Paz University Hospital in Madrid, Spain. Thirteen paediatric patients aged 7–16 years (mean age = 12 years and 1 month; 75% male) were assessed. Neurocognitive assessments were performed at an average of 1 year and 4 months after CAR-T therapy (ranging from 3 months to 3 years and 4 months). Neurocognitive measures included the Symbol Digit Modalities Test (SDMT), the Omission score from the Continuous Performance Test Third Edition (CPT 3), the Test of Nonverbal Intelligence Fourth Edition (TONI-4), and the Verbal Fluency Test (FAS). Descriptive analyses were conducted, including median, minimum and maximum scores for age- and sex-adjusted z-scores, with significant impairment defined as z < -1.5.

Findings revealed that 58.3% of the children scored significantly below norms on non-verbal abstract reasoning (TONI-4: Median = -1.53; Min = -3.27; Max = 1.27), 53.9% displayed significant sustained attentional deficits (Omission CPT 3: Median = -3.1; Min = -4.0; Max = 0.70), and 41.7% showed relevant impairments in both processing speed (SDMT: Median = -1.5; Min = -5.7; Max = 1.9) and phonological verbal fluency (FAS: Median = -0.7; Min = -2.9; Max = 1.5).

Paediatric acute lymphoblastic leukaemia survivors treated with CAR-T therapy show deficits in processing speed, sustained attention, abstract reasoning, and phonological verbal fluency. These findings underscore the need for both short- and long-term neuropsychological monitoring, and tailored interventions targeting attentional and executive functioning deficits in this population. Future studies should replicate these analyses by using larger sample sizes.

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Herpes Simplex Encephalitis (HSE) and anti-NMDA receptor autoimmune encephalitis (ANMDARE) are severe neurological conditions that can lead to significant psychiatric symptoms. While these conditions commonly cause cognitive and behavioral disturbances, mania with psychotic symptoms is an uncommon manifestation. Understanding this rare presentation is crucial for accurate diagnosis and management.

To describe a case of mania with psychotic symptoms in a 33-year-old woman approximately one month after Herpes Simplex Encephalitis (HSE), further complicated by anti-NMDA receptor autoimmune encephalitis.

We conducted a detailed review of the clinical process and heteroanamnesis from family reports. A non-systematic literature review was performed using the terms “encephalitis,” “mania,” “psychosis,” “herpes simplex,” and “anti-NMDA” in the PubMed®/MEDLINE® database.

A 33-year-old woman, seven months postpartum with no prior psychiatric history, presented with psychomotor agitation, distractibility, elevated mood, verbose speech, tachypsychia, impulsivity, verbal perseveration, insomnia, and mystical and persecutory delusions, including auditory-verbal hallucinations, starting 15 days after discharge from hospitalization for HSE. Her subsequent hospitalization revealed severe and fluctuating behavioral changes, significant memory deficits, and spatial-temporal disorientation. Neuroimaging showed atrophy of the left temporal lobe, ipsilateral insula, and notable involvement of the left hippocampus. Cerebrospinal fluid analysis detected anti-NMDA receptor antibodies, leading to treatment with corticosteroids and immunoglobulins. The patient was stabilized on clozapine 150 mg/day, valproate 1000 mg/day, clonazepam 1 mg/day, and monthly injectable risperidone 100 mg.

HSE is a major cause of death in sporadic encephalitis cases, with a 12% relapse rate linked to viral reactivation and the development of anti-NMDA receptor encephalitis. ANMDARE, caused by anti-NMDA receptor IgG antibodies targeting the NR1 subunit, affects about 25% of HSE patients within three months. Psychiatric affective syndromes have been described both as possible initial symptoms of HSE and as long-term sequelae, but the underlying mechanisms remain not fully understood.

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It is indisputable that against the background of the popularity of various chemical addictions among patients with schizophrenia, it is relevant to study the joint clinical and pathomorphological deformation of two nosological phenomena of paranoid schizophrenia and dependence on modern, increasingly popular drugs, synthetic cannabinoids in various ethno-territorial groups. It is important to consider issues of mutual deformation of mental disorders, their progression, behavioral characteristics and adaptation.

to study the ethno-territorial features of paranoid schizophrenia comorbid with abuse of synthetic cannabinoids, clinical dynamics, behavior and adaptations.

follow-up, clinical-psychopathological methods (PANS, SANS, CGI, MMPI, CGI, STAI, LSI, TPA, ICD-10), statistical (Python 3.11.0).

193 men (aged 18 to 35 years) were examined: 142 patients with paranoid schizophrenia dependent on synthetic cannabinoids F20.xx+F12.2xx and 51 - F20.xx without drug addiction. The study took place from 2018 to 2024 on the basis of psychiatric institutions in Russia - Tomsk Region, St. Petersburg, Noyabrsk and Nizhnevartovsk. The phenomenon of abuse of synthetic cannabinoids leads to the development of diseases. Persistent exogenous visual and delirious disorders are included in the complex of symptoms of exacerbation of schizophrenia; A new symptom of pseudohallucinoids appears - thought disorders of an associative (fantasy) disease that arose against the background of long-term exogenous (toxic) effects of the drug on the subject type, usually against the background of a primary endogenous schizophrenic process.

The leading position among patients with schizophrenia who use synthetic cannabinoids in the temperate continental climate zone of Russia was occupied by the following ethnic groups, taking into account the hierarchy: Russians, Tatars; Uzbeks; Germans; Azerbaijanis and Armenians.

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Cognitive distortion is a central feature of depression, encompassing dysfunctional personality styles and attitudes, and negative thinking. One of the cognitive schemas characteristics of depressed individuals is the tendency to overestimate causal responsibility for negative events, but not for positive ones. Total sleep deprivation (TSD) has been shown to cause rapid and sustained antidepressant effects in depressed patients and to revert the biased self description present in these patients.

The aim of the study was to investigate if TSD treatment would change cognitive distortion in a sample of patients diagnosed with major depressive disorder (MDD).

Seven patients with MDD (all females), completed the Cognition Questionnaire (CQ) to assess cognitive distortions and were assessed before and after TSD treatment. TSD protocol involved three cycle of sleep deprivation, each one lasted 36 hours and was followed by a night of recovery sleep. Light therapy was administered for 30 minutes at 3 am during waking nights and in the morning after the recovery sleep.

A significant reduction of the depressive symptomatology was observed at both objective (Hamilton depression rating scale -HDRS F=9.85, p=0.008) and subjective (Beck depression Inventory – BDI F=54.73, p<0.001) measures. Investigating the 5 dimensions assessed through the CQ, we observed that the reduction of the dimension “attribution of causality” ( r=-7707, p=0.043) and the total CQ score (r=-.8865, p=0.008) after TSD were significantly associated with the reduction of depressive symptomatology as measured by the BDI.

This is a preliminary study on the effect of TSD treatment on cognitive distortion in MDD. TSD treatment improved not only clinical symptoms but also cognitive distortion. Our preliminary findings suggest that TSD could be added to antidepressant treatment to rapidly improve the depressive symptomatology and cognitive distortion which may hamper the compliance with pharmacologic treatments and consequently the reduce the possibilities of a favouble outcome of pharmachologic interventions.

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Body dysmorphic disorder is a diagnostic entity within the somatoform disorders of the obsessive-compulsive spectrum according to the DSM-V. Its prevalence is between 0.7% and 2.5%, being more frequent in men and usually beginning in adolescence or early adulthood. Its central symptom is cognitive distortions regarding appearance, with concern about imaginary physical defects, slight or even invisible to others and in some cases close to a delusional condition.

To delve deeper into the clinical aspects and nosological conditions through the description of a clinical case.

This is a 16-year-old patient who was admitted three times to the Acute Psychiatric Unit of the Puerta de Hierro Hospital due to behavioral disorders in the context of dysmorphophobia with intense concern about the shape of his nose. The patient gradually abandoned his daily routines, stopped attending classes at school and isolated himself from his social circle.

He is the youngest of two sisters. He lives with his parents and sister. He had good academic results until the time of diagnosis.

The patient’s concern about his nose began at about age 15, coinciding with the diagnosis of leukemia of his mother, who was undergoing chemotherapy treatment. The patient reports that the symptoms have increased until causing significant functional limitation.

He says that his nose is very large and he doesn’t allow anyone to see it. He leaves the house wearing a mask, performs rituals of checking it for hours in front of the mirror and has even manipulated his nose with objects to try to deform it. He appears to have a delusional component with significant emotional and behavioural repercussions.

Several pharmacological treatments were started, including SSRIs (sertraline) and various antipsychotics (risperidone, pimozide and olanzapine), with little response in all cases. Psychotherapeutic treatment was carried out in a day hospital for adolescents, but this was also unsuccessful. Finally, he was involuntarily transferred to a Medium Stay Unit given the significant impact of the symptoms on his life, showing progressive improvement after several months of treatment.

The nosology of TDC has evolved: the DSM IV specified a delusional variant within the psychotic spectrum and a non-delusional one within the somatoform spectrum. The DSM V integrates it within the obsessive-compulsive spectrum. In order to assess a correct treatment, a continuum could be established between TDC and eating disorders. Both present similar symptoms: dissatisfaction and distortion with body image, need for continuous checking and concern about imperfections in perceived appearance. Given the chronicity of TDC and the tendency to abandon treatment in the first months, long-term follow-up by a multidisciplinary team is necessary, as well as psychoeducation and the establishment of a solid therapeutic alliance.

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Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops when a person is exposed to death, perceives a threat to their safety, or witnesses a traumatic event, either personally or vicariously. It is a condition that affects over 70% of adults who have experienced trauma at least once in their lives. What happens in the case of individuals who have attempted suicide? Do they also frequently develop PTSD?

To determine if individuals who have attempted suicide are at risk of developing PTSD as a result of their suicide attempt. If such a connection is proven, what therapeutic measures could be proposed to prevent the onset of this disorder?

This is a descriptive study using a survey of patients at the Department of Psychiatry D at RAZI Hospital, who have made one or more suicide attempts during the year 2023.

20 patients (80%) exhibited a moderate to severe depressive episode at the time of their suicide attempt. The average number of suicide attempts was 1.53. The methods used for the suicide attempts included medication ingestion, observed in 15 patients (60%), phlebotomy in 4 (16%), jumping from a height in 2 (8%), hanging in 2 (8%), and ingestion of toxins in 2 (8%). 14 patients (56%) required hospitalization in a medical unit following the suicide attempt. 9 out of 25 patients (36%) developed PTSD according to DSM-5 criteria.

A significant proportion of suicide attempt survivors may develop PTSD related to the suicide attempt. PTSD related to a suicide attempt could serve as a viable target for assessment and intervention to improve quality of life and reduce the risk of future suicide among individuals who have attempted suicide. However, more studies are needed to evaluate the risk of PTSD in this population.

None Declared