A systems approach to understanding late-onset depression points to its association with cardiovascular disease, cerebrovascular disease, tissue and organ trophic disorders, cognitive impairment, anergy, and decreased lifespan. These features are consistent with progressive aging

literature analysis

general scientific method

Cellular senescence is characterized by irreversible cell growth arrest. Characteristic features of senescent cells include increased cell size, accumulation of β-galactosidase and lipofuscin in the cytoplasm, accumulation of DNA damage foci, condensed heterochromatin regions, shortened telomeres, and increased expression of cell cycle regulatory markers. Telomere attrition has been linked to depression. Individuals with MDD have shorter white blood cell length compared to subjects without a history of depression. Telomere attrition is also associated with more unstable IL-6 levels and oxidative stress markers in major depressive disorder. Postmortem studies of the brain have revealed that severe depression leads to depletion of various areas of the cerebral cortex and oligodendrocytes. According to the authors, there is a link between severe depressive disorders and cellular aging of the brain. Mitochondrial dysfunction. Mitochondrial dysfunction in depression and aging includes genomic instability, defects in biogenesis, electron transport chain and mitochondrial scavenging, nutrient regulation mechanisms, proteostasis. In late depression, the number of mitochondrial DNA copies decreases. Increased production of ROS is a marker of mitochondrial dysfunction. In contrast, depressed individuals have elevated lipid peroxidation markers and an imbalance between oxidative stress and antioxidant stress markers. MtDNA oxidation and fragmentation are consequences of elevated OS, with high levels of fragmented mtDNA being associated with more severe depressive episodes and also a biomarker of aging and tissue damage. In patients with late-onset depression, ccf mtDNA has been found to correlate with chronic levels of IL-6, a master regulator of inflammation and a major component of SASP.

Total scores assess indicators of mitochondrial dysfunction, telomere length, cognitive tests, and structural changes on MRI in women with late depression higher than in elderly men.

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Prevention is key to maintain a healthy lifestyle and to ensure a positive outcome of any given condition, especially in such a vulnerable one, as is pregnancy. The progress made in prenatal care in the last century is astounding and professionals nowadays are able to provide state of the art investigations and inventions throughout pregnancy and even before, but there is a dire need to address the mental health approach of the soon-to-be mothers. Since studies have shown the link between mother’s emotions and the child’s well-being, providing support in order to maintain a good mental health status should be part of the prenatal care programmes.

The initial hypothesis is that pregnancy is a delicate period for the mother to be, therefore anxiety levels can be high or prenatal depressive episodes can occur in the absence of good psychological support. We aim to prove that integrating psychotherapy as part of the prenatal care programmes has benefits for both mothers and child and can significantly reduce the struggle of battling these symptoms on one’s own.

We launched an online questionnaire on groups and sites that targeted pregnant women or women who have just given birth. The questions were designed to address the anxiety and/or depressive symptoms throughout the pregnancy, the support they received from the health care providers and the impact these had on how they handled the pregnancy period. Anxiety symptoms were assessed using the HAM-A scale, meanwhile for depressive symptoms we used PHQ9 questionnaire. The study was conducted anonymously and was approved by the local ethics committee.

We received 200 answered questionnaire, from which 189 were valid and relevant to the study.

The results showed that the majority of pregnant women (83%) have struggled with anxiety and/or panic attack throughout the pregnancy and the prenatal care appointments proved insufficient to alleviate their concerns. Most of them (94%) turned to the internet for answers, which was an aggravating factor for the symptoms. The impact these symptoms had on their pregnancy varied from tensions between them and their partners, insomnia, feelings of worthlessness and irritability to moderate depressive episodes. Almost all the respondents (91%) have answers affirmatively to the proposal to undergo a few therapy sessions to manage these symptoms, if they were to be part of the prenatal care programme.

Pregnant women are at risk for various mental health issues which can be prevented with proper care, thus addressing further risk for both the mother and the baby. The need for integrating therapy in prenatal care programmes could have a great impact on the outcome of the pregnancy and even in women desire to bear children.

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Non-invasive brain stimulation (NIBS) is emerging as a promising option for the treatment of psychiatric diseases, including major depressive disorder (MDD). In this context intermittent white light at a specified frequency holds high promise. We have previously shown that 60Hz stimulation in mice induces selective brain entrainment associated with microglia-mediated remodeling of the perineuronal nets (Venturino et al., Cell Reports 2021).

Here, we extend our previous findings with 60Hz stimulation to assess behavioral effects in mice and EEG response in healthy volunteers.

For the preclinical data, we exposed C57Bl6/J mice to a battery of behavioral tests to assess anxiety level, learning capability, and response to various stress paradigms after 60Hz light (2h per day/5 days) compared to constant light. Weight change, water and food intake were recorded. For human studies, a cohort of 12 healthy volunteers (6M, 6F) was recruited; their EEG response was investigated with an 8-channel EEG setup following acute (same day), short (5 days), and intermediate (3 weeks) stimulation with 60Hz entrainment (n=6) or sham light (n=6).

Preliminary data from the preclinical behavior studies indicate that 60Hz treatment improves the social interaction of socially defeated mice compared to sham light stimulation. Furthermore, the animals showed less anxiety-related behavior when exposed to the elevated plus maze. No differences were noticed in weight change, water and food intake following 60Hz stimulation.

In healthy volunteers, we observed robust and widespread entrainment at 60Hz after acute 60Hz stimulation; the entrainment spread beyond the visual cortex and reached the frontal cortex. The normalized power of the 60Hz component slightly declined over time but remained significant as compared to sham stimulation at three weeks, indicating sustained EEG response. The stimulation was very well tolerated overall, without major side effects.

60Hz intermittent light induces strong and sustained neuronal response in mice and humans, is well tolerated, and ameliorates depressive-like symptoms in the social defeat model in mice. 60Hz might represent a novel NIBS for the treatment of psychiatric disorders, including MMD.

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Metabolic syndrome (MS) is a prevalent condition in individuals with bipolar disorder (BD) and may influence the expression of psychiatric symptoms. Factors contributing to this association include limited access to physical healthcare, lifestyle influences related to psychiatric symptoms, and adverse effects of psychotropic medications.

To compare the clinical characteristics of patients with Bipolar Disorder Type 1 (BD-1) with and without metabolic syndrome (MS).

This was a cross-sectional descriptive study conducted over a three-month period from August to October 2023 at the Psychiatric Service D of Razi Hospital in Tunisia. Patients diagnosed with Bipolar Disorder Type 1 according to the diagnostic criteria of the DSM-5, aged 18 years or older, and in a euthymic phase (confirmed by Hamilton Depression Rating Scale (HDRS) score <8 and Young Mania Rating Scale score <13) were included. Sociodemographic data, clinical features, and treatment information were initially collected from medical records and then verified and completed through direct interviews using a predefined information sheet and psychometric assessments. Metabolic syndrome was diagnosed according to the criteria of the International Diabetes Federation.

All participants provided informed consent before enrollment, and confidentiality of their personal and medical information was strictly maintained. The study protocol was approved by the Institutional Review Board (IRB) of Razi Hospital, ensuring that the research was conducted in accordance with ethical guidelines and principles of patient autonomy, beneficence, and non-maleficence. Participants were informed about the voluntary nature of their participation and their right to withdraw at any time without consequences. Data collection and storage adhered to strict privacy regulations to protect participants’ rights and ensure data security.

Forty patients were included in the study, of whom 28 had MS and 12 did not. The mean age of patients was 34.5 ± 8.2 years in the MS group and 32.1 ± 6.5 years in the non-MS group. Participants with MS had a significantly younger mean age of disorder onset (22.6 ± 8.25 years) compared to those without MS (27.9 ± 4.86 years) (p = 0.02). We found that the mean number of suicide attempts was significantly higher in the MS group (2.8) compared to the non-MS group (1.6) (p = 0.001). Anxiety comorbidity was significantly higher in patients with MS compared to those without MS (57% vs 35%, p < 10^-3).

Our study underscore the importance of addressing metabolic syndrome in the management of patients with BD-1. Given the higher prevalence of metabolic syndrome in this population and its impact on clinical outcomes, interventions aimed at preventing and managing metabolic syndrome components such as obesity, diabetes, and dyslipidemia are crucial.

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Schizophrenia remains a complex psychiatric disorder characterized by varying symptoms and levels of insight. The Frankfurt Complaint Scale (FBS) and the “My thoughts and feelings” questionnaire provide quantitative measures of symptom severity and insight, respectively. Previous literature has emphasized the importance of these tools in both clinical assessment and therapeutic planning.

Exploring the Relationship Between Schizophrenia Symptom Severity and Insight based on the Frankfurt Scale and the “My thoughts and feelings” Questionnaire.

The study utilized data extracted from an Excel dataset comprising demographic information and specific scores from the FBS and the Insight questionnaire. The sample was divided into four subgroups based on their FBS scores, and the average Insight score for each subgroup was calculated.

The study found the following average Insight scores across FBS-defined subgroups: Mild symptoms: 9.67, Moderate symptoms: 8.25, Severe symptoms: 8.22, Very severe symptoms: 9.29. The correlation analysis revealed a weak and non-significant correlation between FBS scores and Insight scores (r = -0.017, p = 0.925). The demographic analysis showed a prevalence of male patients (n=20), with the most common age group being 36-45 (n=11). Most participants resided in large cities (n=16), with the highest educational attainment being a Bachelor’s/Master’s degree (n=12), and the majority were single (n=21). The study group displayed diverse demographic characteristics,

with a significant male predominance and a concentration in urban environments. This demographic distribution may influence the generalizability of the findings and provides a context for interpreting the varied experiences and perceptions of illness within the group.

This study underscores the complexity of schizophrenia, where symptom severity does not straightforwardly correlate with insight into the illness. It highlights the importance of using a range of assessment tools to fully capture the multifaceted nature of patient experiences. Future studies should explore these relationships further to refine the tools used for assessments and to tailor intervention strategies effectively.

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Vaginismus is characterized by phobic avoidance, involuntary pelvic muscle contraction, anticipation, fear, and experience of pain during vaginal penetration. In addition to anxiety and fear, vaginismus-specific cognitive and metacognitive beliefs are thought to play a role in the etiology of vaginismus. Impaired sexual functions and decreased sexual satisfaction in women with vaginismus are claimed to be associated with anxiety and depressive symptoms. However, in clinical practice, it is observed that women who do not exhibit anxiety and depressive symptoms also experience sexual dysfunction and reduced sexual satisfaction, but it is noteworthy that the causes of this deterioration have not been sufficiently investigated.

The purpose of this study is to assess the impact of metacognitive beliefs on sexual functions and satisfaction in women with vaginismus.

A total of 64 women with vaginismus and 30 healthy controls were examined through Sociodemographic Data Form (including age, education status, duration of marriage, etc), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Arizona Sexual Experiences Scale (ASEX), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Metacognition Questionnaire-30 (MCQ-30).

The mean ASEX, GRISS, and MCQ-30 scores were significantly higher in the vaginismus group than the healthy controls. No significant difference were found between groups in terms of BDI and BAI scores. Hierarchical Regression Analysis revealed that 13% of ASEX total scores in the vaginismus group were predicted by BDI and BAI scores (F=4.59, p< 0.05), and the predictability increased significantly to 32% by the addition of MCQ-30 scores to the model (F=3.79, p<0.01). However, GRISS-Total scores were not statistically significantly predicted by BDI and BAI scores (F=1.76, p>0.05), but the predictability of variance increased significantly to %26 (F=2.87, p<0.05) with the addition of MCQ-30 scores to the model. Moreover, the metacognitive dimension of uncontrollability and danger of thoughts, and cognitive self-consciousness were found to be significant factors in predicting both ASEX (b=0.52, p=0.004 and b=-0.49, p=0.003, respectively) and GRISS (b=0.58, p=0.002 and b=-0.40, p=0.017, respectively) scores in vaginismus.

The current findings of the study indicate that metacognitive beliefs, especially dimensions of uncontrollability and danger of thoughts and cognitive self-consciousness, predict sexual functioning and sexual satisfaction in women with vaginismus. Understanding the metacognitive characteristics accompanying vaginismus and including metacognitive interventions in sexual therapy for both cognitive self-consciousness and negative beliefs about the uncontrollability of thoughts and danger, may result in increased treatment success, improved sexual functioning, and sexual satisfaction in women with vaginismus.

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Preclinical Alzheimer’s disease (AD) is characterized by subtle cognitive changes that precede the onset of clinical symptoms. Neuropsychiatric symptoms such as anxiety have been increasingly recognized for their potential role in accelerating disease progression. Although various theories have been proposed, anxiety may exacerbate cognitive decline through mechanisms involving stress-induced neurochemical dysregulation, affecting brain regions vulnerable to AD pathology.

This study examines the neural correlates of preclinical AD in individuals with low anxiety scores, employing MRI to explore potential early biomarkers and elucidate the complex role of anxiety in the progression of AD.

A total of 172 participants from the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE) were categorized into three groups: Healthy Controls (HC, n=59), Subjective Cognitive Decline (SCD, n=77), and Mild Cognitive Impairment (MCI, n=36). Anxiety levels were assessed using the Geriatric Anxiety Inventory-Short Form (GAI-SF), and neural responses to novelty were examined using 3-Tesla MRI. Statistical models were adjusted for relevant covariates, including age, education and study site. The differences of the three groups were analysed by one-way ANOVA contrasts and post-hoc analyses were performed with two sample t-tests.

Significant neural differences were observed across groups, particularly in the precuneus, right angular gyrus, and right cerebellum exterior (p < 0.001, p = 0.001, and p = 0.002 respectively). The SCD group demonstrated greater activation in the right angular gyrus compared to HC (p = 0.008), while the MCI group exhibited more pronounced differences L-R precuneus, right cerebellum exterior, right angular gyrus, and right middle frontal gyrus regions indicating further cognitive decline (p< 0.001, p< 0.001, p= 0.001, p= 0.017 respectively).

This study identifies critical brain regions, with a particular emphasis on the right angular gyrus, associated with the early stages of AD in individuals with low anxiety scores. The activation in these areas likely correlates with an early inhibition deficit at the systems level in individuals with preclinical memory impairment. However, the role of anxiety in preclinical AD is complex and variable among individuals. Anxiety may serve as an early response to subtle cognitive changes in some, while in others, it might emerge as a consequence of these changes. Moreover, the relationship between anxiety and neural alterations in AD could be bidirectional, where anxiety both influences and is influenced by the disease’s progression. These findings highlight the importance of considering anxiety when identifying early biomarkers for AD and suggest that targeted interventions addressing anxiety may help slow cognitive decline.

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Body dysmorphic disorder (BDD) consists of preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others, and which cause a great social deterioration. Its prevalence in aesthetic medicine is around 10 percent, and it is higher in women.

The overall objective of this systematic review is to gather integrated evidence to ascertain the prevalence of body dysmorphic disorder in an aesthetic medicine practice and its association with satisfaction with the results of the derived interventions.

An initial search of ScienceDirect, PubMed, PsycInfo, Cochrane, and CINAHL was conducted. In addition, scientific journal publications, book articles and clinical guidelines were used. The search terms were: “body image”, “eating disorder”, and “aesthetic medicine”. The search included results from January 2000 to January 2023, in Spanish and English.

The total number of participants in all studies was 3004. 42.86% of the studies were conducted between 2000 and 2009, while the rest were conducted from 2010 onwards. It has been observed that most patients with BDD seek non-psychiatric treatment for their perceived appearance defects. The result after an aesthetic intervention is that in most patients with BDD there is no improvement in the concern for the perceived body image defect, and they present greater dissatisfaction. A high number of patients with BDD are being overlooked in aesthetic medicine practice who should receive a combined medical and psychological intervention.

It is necessary to create protocols for an early diagnosis of body dysmorphic disorder in the aesthetic medicine practice which include a comprehensive approach.

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Wilson disease is an autosomal recessive disorder that leads to defective copper metabolism. It manifests as neurologic, hepatic and psychiatric symptoms (Benhamla et al. Encephale 2007; 33(6):924–32). Through a case series of three family members, we emphasize the varied presentation of Wilson disease, and the need for investigation of metabolic causes of such symptoms especially in families with a history of consanguinity.

We aim to underscore the importance of considering metabolic causes of psychiatric symptoms, particularly when these symptoms cluster within families.

The cases are presented followed by an exploration of social context, gaps in existing literature, and suggestions for clinical practise.

Case 1: A 32-year-old male previously having received diagnoses of Treatment-Resistant Schizophrenia and Obsessive Compulsive Disorder over a period of 13 years presented with cognitive decline, delusions of persecution and reference, 2nd and 3rd person auditory hallucinations, preoccupation with cleaning and a significant decline in the ability to perform activities of daily living. Despite extensive psychiatric treatment, his symptoms worsened, raising suspicion for an underlying medical condition.

Case 2: A 16-year-old male, once a bright student, presented with progressive cognitive decline, poor working memory, social withdrawal, needing assistance with ADLs and sialorrhea for 2 years. These symptoms were initially misattributed to psychological stress and academic pressure, but the lack of response to treatment and worsening neurological signs of poor coordination raised suspicion for an organic cause. His eye exam was positive for Kayser Fleischer ring and his serum ceruloplasmin was below threshold level. This prompted a similar workup for his elder brother which was positive for Wilson disease.

Case 3: The mother of the aforementioned two patients, after witnessing her younger son’s decline, developed major depressive disorder with psychosis. Her symptoms started follwoing the stress of her children’s health problems and their lack of response to treatment.

Upon genetic counselling, the siblings of the first two patients revealed that they were both respectively engaged to be married to their first cousins and that their mother was adamant about these matches due to family traditions.

These cases underscore the need for a heightened suspicion of Wilson disease and other metabolic disorders in patients who belong to regions with high rates of consanguinity and have clustering of psychiatric disorders in their family. Further studies are needed to determine the true prevalence of Wilson disease in Pakistan which may be relatively high due to the common practise of cousin marriages (Zimbrean et al. Gen Hosp Psychiatry. 2014;36(1):53–62).

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Understanding resilience becomes important given that adversity is an unavoidable fact of human life. Over 70% of respondents in a sample of 68,894 people reported at least one traumatic event in their lifetime. The neurotoxic effects of these experiences range from compromised neurocompetence, psychopathology including PTSD and depression, to adverse physical effects.

To determine if we could reliably agree on ratings of resilience on a five point scale to aid future studies of the role of resilience in recovery and relapse.

To assess resilience we developed a five point scale with 1 being the least and 5 behind the most resilient pattern. We found a water metaphor useful to conceptualize these five levels of resilience. Resilience in an ever-changing world can be likened to navigating in a body of water. Adversity tosses us into the water. Here are our levels:

We used kappa statistics to assess our level of agreement among ourselves (three raters) after studying and discussing prototypical stories for each rating level.

Practicing with training videos, we found we could achieve 84% agreement on the five ratings with 3 raters.

Percent overall agreement = 84.00% Free-marginal kappa = 0.80

95% CI for free-marginal kappa [0.66, 0.94]; Fixed-marginal kappa = 0.78; 95% CI for fixed-marginal kappa [0.62, 0.93]

When we added AI, we got Percent overall agreement = 71.33% Free-marginal kappa = 0.64; 95% CI for free-marginal kappa [0.50, 0.79]

Fixed-marginal kappa = 0.61; 95% CI for fixed-marginal kappa [0.51, 0.71]

The individuals who fit into the pattern of low resilience tended to have a high amount of childhood adverse experiences as shown through the ACE survey. The accumulation of these events in combination with external variables shape resilience. Factors including intelligence/education level, drug/alcohol use, positive role models, exposures to nature/art/spirituality, and community/family norms steer a person down a set of patterned thinking and actions which ultimately depict their overall life story.

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Constipation is a common side effect of antipsychotic drugs [1] that has not received much attention.

In patients treated with clozapine, constipation may be the most common side effect, affecting one in three patients [2, 3].

Cases of delayed detection of symptoms of constipation or inadequate treatment of constipation have resulted in paralytic ileus, faecal impaction, intestinal obstruction and even death [4,5].

However, other risk factors for constipation are also common in people with schizophrenia, such as low socio-economic status, a sedentary lifestyle, and illnesses and medications associated with constipation.

Translated with DeepL.com (free version)

To assess constipation in patients with schizophrenia hospitalised at the Arrazi psychiatric hospital in Salé and to study the factors associated with these symptoms: socio-demographics, lifestyle, psychotropic drugs, other drugs and co-morbidities such as diabetes and obesity.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria as well as questions on the lifestyle of hospitalised patients with schizophrenia to assess constipation in these patients and study the factors associated with these symptoms.

Exclusion criteria: intellectual disability.

A total of 167 patients admitted to the psychiatric hospital for management of schizophrenia were collected. Approximately 69% were male. Adherence to antipsychotics was poor in most patients. 53% were on haloperidol, 25% on olanzapine and 12% on clozapine. Diabetes was present in 21% of patients. Constipation was present in 57% of patients. Most participants had a lifestyle without physical exercise and a balanced diet.

Constipation is common in patients with schizophrenia on antipsychotics, with the risk of complications sometimes severe. It is recommended that clinicians assess antipsychotic-induced constipation and manage it effectively.

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Patients with schizophrenia spectrum disorders continue to face societal stigma. This stigma contributes to their loneliness and marginalization, acting as a significant barrier to recovery and clinical stabilization. While medication and clinical follow-up are essential for treatment, social factors are also crucial for individuals to achieve a functional and fulfilling life. It is necessary to explore these factors in this this study.

To explore the social factors affecting the recovery and clinical stabilization of patients with schizophrenia spectrum disorders.

• - To identify the support needs of these patients to enhance their functional and fulfilling lives.

• - To assess the impact of societal stigma on the well-being and integration of individuals with schizophrenia.

• - To examine the role of mental health professionals and family involvement in reducing stigma and improving social functioning.

• - To highlight the importance of vocational interventions and supportive environments in facilitating the integration of patients into society.

For the purpose of conducting the non-systematic narrative review on the topic, we performed a search for articles in the PubMed database.

Improvements in the effectiveness of antipsychotics and earlier intervention are enabling more patients to reach a cognitive level that supports a functional life, including maintaining interpersonal and occupational relationships. Thematic analysis has identified four key support needs: skill development, vocational intervention, support and encouragement, and a supportive work environment.

The involvement of mental health professionals with the patient’s family is also crucial for addressing and reducing the stigma associated with the illness, thereby enhancing understanding of the individual within the context of their condition.

Social anhedonia, which impairs social functioning, is a significant concern. Additionally, the risk of suicide is notably higher during the initial phase of schizophrenia compared to the general population.

After achieving clinical stabilization with antipsychotics and other psychotropic medications, intervention in the social sphere becomes crucial for the patient’s well-being and functionality. Having a professional occupation, when feasible, is a positive indicator of patients’ integration and their role in society.

To support this integration, psychiatry services and civil society must enhance their efforts. This includes developing occupational services, establishing partnerships with local businesses, and improving public awareness about schizophrenia.

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A person with “high-risk mental status (HRMS)” indicates that the person, usually young people between the ages of 14 and 25, is more likely to develop psychosis. These people have attenuated psychotic symptoms without reaching the intensity or frequency of a frank psychotic episode. It is suggested that psychological trauma could favor neurochemical and psychopathological changes in a vulnerable individual. It would be interesting to study the role of psychotherapeutic interventions in the course of high-risk mental states and their possible evolution to a psychotic disorder.

We present the case of an 18-year-old adolescent whose diagnosis was high risk of psychosis.

This work has several objectives. On the one hand review current information on high-risk mental status (EMAR). On the other hand, develop a discussion about whether the EMAR category should be a diagnostic entity or just a condition.

A bibliographic search has been carried out in the main sources of medical information such as Pubmed, Uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed in order to expose its own experience in this field, defining specific interventions as well as results.

The case presented is of an 18-year-old female patient. She states that the main reason for consultation is something that happened last Sunday, at which time he had “an identity crisis” in which he did not know if he was a girl or a boy. The reasoning behind this fact is that “as Pablo Alborán likes him, perhaps he is a boy”. Given the bizarreness of the explanation and the patient’s particular contact, I explore a previous psychopathological situation. She says that since last year she feels more insecure, with diffuse fear that it is difficult to specify or nominate something specific: “in class and that is very difficult for me, public presentations”, she says that “everything scares me”, she says that she has a non-specific fear that has been maintained even increasing over the months and that has led him to have greater anguish. Even though the patient dates the beginning of the picture on Sunday, it is noteworthy that the previous Thursday she had requested a consultation with psychology in the private circuit that although she does not know how to specify the reason “because of fears” it seems that the anguish resulting from this fear had been increasing, having greater difficulties for the presentations in class. The contact is psychotic and the situation that the patient describes is typical of a “treme” situation, cataloged in the current literature as a High-Risk Mental State.

High-risk mental states are not a diagnostic category according to current classifications, although it is necessary to reach a consensus on what the diagnosis implies and what would be the way to proceed when a patient presents these symptoms.

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Very late-onset schizophrenia-like psychosis (VLOSLP) is one of the largest group of mental illnesses in late life after dementia and depression. The question of role of cognitive impairment and the risk of dementia development in this group is still open.

To determine the relationship between cognitive impairment and clinical features.

65 patients (62 woman, 3 man), medium age 72,5 [63,5; 78,5], medium age of onset 69 [62; 76] with schizophrenia (F20), n=23; chronic delusion disorder (F22.81), n=7, organic schizophrenia-like disorder (F06.2), n=7, schizoaffective disorder (F25), n=11, manifesting after 60 years, underwent clinical examination. The assessment was carried out using clinical-psychopathological, psychometric and statistical methods.

Based on clinical and psychopathological features, 3 clinical groups were formed. The group of patients with acute polymorphic symptoms with mental disorganization included 25 patients. The cognitive impairment was the most acute in this group and correlated with psychotic and affective symptoms. It reduced by the 28th day of investigation, but didn’t reach the normative ones, which may indicate the presence of persistent cognitive dysfunction associated with the present neurobiological changes and creates particular concern regarding the development of a neurodegenerative process in this group of patients.

The 2nd group included 30 patients with a predominance of paranoid symptoms with an “age” coloring, which, however, wasn’t the leading plot. Cognitive impairment was less pronounced compared to the first group and was stable in nature, was not associated with the degree of reduction of psychotic and affective symptoms. This allows us to consider it as a predictor of the development of psychosis.

The 3rd group included 10 patients and was characterized by the prevalence of affective and delusional symptoms with acute sensory delirium, pseudodementia at the height of the condition. The degree of cognitive decline at the beginning of the study was comparable with patients in the 2nd group. High correlations were established between the degree of reduction of productive and affective symptoms and the improvement of cognitive functions. A complete reduction of existing disorders was noted by the end of treatment, which may indicate a more congenial prognosis.

This study confirms the results of previous studies on presence cognitive impairment in patients with VLOSLP, and in addition demonstrates specific differences in cognitive profiles depending on the clinical variant of VLOSLP.

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Recent studies have demonstrated the positive effects of mindfulness-based interventions on stress reduction in healthy individuals. Individuals with schizophrenia spectrum disorders (SSD) often experience elevated stress levels due to multiple factors. According to literature, plasma and saliva levels of oxytocin (OXT) and cortisol can serve as biological stress markers. However, the interaction between mindfulness, stress, and the oxytocinergic system in SSD remains unexplored.

This exploratory study investigates the impact of mindfulness-based group therapy (MBGT) on biological stress parameters, including OXT and cortisol levels in plasma and saliva, and changes in psychological stress parameters.

A blinded, randomized, and controlled study was conducted. Participants were assigned to either MBGT with four weekly sessions in addition to treatment as usual (MBGT+TAU) or only treatment as usual (TAU). Venous blood and saliva samples were collected before and after the MBGT sessions to determine OXT and cortisol levels. Self-reported questionnaires measured stress via visual analogue scales before and after the MBGT sessions.

A total of 48 outpatients with SSD received either MBGT+TAU (n=25) or TAU (n=23). Analyses revealed a significant reduction in subjective stress levels during each MBGT session. After the MBGT sessions, a significant reduction in cortisol levels was observed, which correlated with the reduction in subjective stress experience. During the first session, oxytocin levels significantly increased in the saliva. However, in the last session, there was a significant decrease in oxytocin levels in both blood and saliva. Additionally, the MBGT+TAU group showed significantly lower OXT plasma levels at the end of the intervention compared to the TAU group.

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The outcomes of this study provide insights into the potential effects of mindfulness on biological and psychological stress parameters in SSD. Consistent with recent research, we found significant effects on subjective stress and changes in oxytocin and cortisol levels throughout the MBGT intervention. A fully powered trial is needed to determine the efficacy of these findings.

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Suicidal ideation, encompassing thoughts, planning, and the desire for death, is a critical facet of the suicidal process, potentially leading to suicide attempts and completion. Understanding its prevalence and severity among college students is vital for preventive interventions.

Our study aimed to estimate the prevalence and severity of suicidal ideation among college students.

We conducted a cross-sectional and analytical study among students from various faculties in Sfax between October 2022 and January 2023. Student recruitment occurred electronically through a Google Forms questionnaire, emphasizing anonymity and the study’s scientific purpose. We utilized the Suicidal Ideation Attributes Scale (French Version) (SIDAS-FR) to identify and assess the severity of suicidal ideation.

Our sample comprised 149 students, predominantly female (83,20%), with an average age of 26 years. Among them, 78,5% were single, and 81,9% lived with their families. Nearly half of the students were from the Sfax Faculty of Medicine, and 64,4% were in their 3rd cycle of education. The mean total score on the SIDAS scale was 1,21 +/- 3,84. Suicidal ideation was reported by 11,4% of participants, with 5,36% indicating moderate to high severity. Factors associated with suicidal ideation included psychiatric disorders (p=0,00), alcohol consumption (p=0,033), psychotropic medication use (p=0,001), and unsatisfactory intrafamily communication (p=0,036).

Suicidal ideation, a concerning issue, particularly among young people, demands focused attention in public health efforts. Understanding the associated factors is pivotal for prevention strategies, emphasizing the importance of mental health support and effective communication within families.

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With increase in life expectancy, there is growing interest in quality of life. Sleep is receiving increasing attention among the elderly.

This study aimed to investigate the changes in sleep quality with increasing age and the effect of age on the components of the Pittsburgh Sleep Quality Index (PSQI).

We used data from the Community Health Survey conducted by the Korea Center for Disease Control and Prevention in 2018. A total of 228340 participants in this nationwide survey. Sleep quality was assessed using the PSQI. Adults aged ≥ 19 years were divided into six age groups and one-way analysis of variance (one-way ANOVA) was used to compare the mean values of PSQI of each group. By comparing the scores for each PSQI component in those aged ≥ 65 years and < 65 years, we aimed to reveal the differences in special components according to age group.

In total, 223334 respondents were included in the study. Based on a one-way ANOVA, the PSQI score generally increased with age. Although the average PSQI score of patients in their 40s was lower than that of patients in their 30s, there was no significant difference between the two groups (p = 0.11). When the PSQI component was compared between the population aged over and under 65 years, the population aged ≥ 65 years scored higher in most components. In contrast, daytime dysfunction scored higher in the population aged < 65 years.

Sleep quality tends to decrease with increasing age. Several factors, including physiological changes, underlying physical conditions, and psychosocial factors, may contribute to a decrease in sleep quality with age.

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Cognitive dysfunction is well documented in patients with schizophrenia and bipolar disorder, including impairments in attention, memory, executive function and social cognition. These impairments are associated with poor social functioning and reduced activities of daily living.

Various therapeutic interventions have targeted cognitive impairment in both schizophrenic and bipolar patients. Several trials and meta-analyses are currently available. In addition to psychopharmacology, cognitive remediation programmes are available and have been shown to be applicable in clinical practice.

In conclusion, as we move towards more integrative and personalised treatment strategies for schizophrenic and bipolar patients, new assessments and therapies are available to target cognitive dysfunction. Not least because there are currently no cognitive enhancers on the market, it is hoped that new pharmacological adjunctive strategies can improve cognition in schizophrenia and bipolar disorder.

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