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The advent of the Coronavirus Disease 2019 (Covid-19) pandemic in late 2019 precipitated a profound transformation in the daily lives of individuals across the world, with notable implications for global mental health. The fear of the virus became a significant source of anxiety and stress, compounded by the rapid dissemination of information, both accurate and inaccurate, through digital media. The growing reliance on digital platforms for health information during the pandemic underscored the significance of eHealth literacy, which pertains to the capacity to locate, comprehend, and utilize health data from digital sources. As reliance on digital platforms for health information increased, it became imperative to examine the potential impact of digital health literacy on fear and anxiety levels related to the novel coronavirus disease (2019-nCoV), also known as Coronavirus Disease 2019 (Covid-19).
Objectives
The objective of this study is to examine the relationship between fear of the Coronavirus disease 2019 (Covid-19) pandemic and mental health, while investigating the influence of eHealth literacy on these fears.
Methods
The study was conducted on a sample of 158 individuals from the general population, representing a diverse range of demographic characteristics. The data were collected using a structured questionnaire comprising three sections: demographic information, the Fear of Coronavirus Scale (FCV-19S), and the eHealth Literacy Scale (eHeals). A statistical analysis was conducted to investigate the relationships between demographic factors, levels of fear, and eHealth literacy. Additionally, a comparative analysis was performed to assess the differences between individuals who had and had not contracted the virus.
Results
The analysis revealed no statistically significant differences in the levels of fear regarding the novel coronavirus disease (Covid-19) or eHealth literacy between different demographic groups, including gender, age, education, and health status. Nevertheless, a statistically significant discrepancy was observed in the level of fear between individuals who had contracted the virus and those who had not. Specifically, those who had not been infected exhibited higher levels of fear compared to those who had previously contracted the virus. No significant differences were identified in eHealth literacy based on infection status.
Conclusions
In conclusion, the findings of this study indicate that while demographic factors do not appear to influence the level of fear or digital health literacy, personal experience with a confirmed case of infection does. Those who have not contracted the virus tend to experience greater fear, suggesting that familiarity with the disease may reduce anxiety. These findings underscore the necessity for interventions.
Two high security Forensic Psychiatric Centers (FPC) were implemented in the last decade in Flanders (FPC Ghent and FPC Antwerp). FPCs provide court[1]ordered treatment for forensic psychiatric patients (called “internees”) that have committed a criminal offense related to their psychiatric disorder and who are at a high risk for recidivating.
Objectives
Treatment is often mandatory and lengthy, and per[1]sonal rights are highly restricted, which has an impact on treatment motivation and overall patient wellbeing (Lutz et al., 2022). While the Risk Need Responsivity (RNR) model - which focuses on risk reduction – was and still is the prominent model for offender rehabili[1]tation, other aspects are currently given more atten[1]tion. This includes the Good Lives Model (GLM) and the recovery movement, that aim at improving the achievement of skills necessary to maintain a good live and give meaning and value in one’s existence (Lutz et al., 2022).
Methods
Data collection and statistical analyses The descriptive analyses of categorical and continuous variables was done using SPSS version 28. Valid per[1]centages were given. Assumption testing was per[1]formed and found that the data were not eligible for parametric examination. The significance level was set at .05.
Results
Weight and BMI At the initial measurement, the mean weight was 89.3 kg (SD ¼ 21.64, range ¼ 46–222 kg). The mean weight at second measurement was 92.6 kg, with a standard deviation of 21.90 and a range of 46.6–185.6. The second weight measurement occurred 812.2 days or 2.2 years (SD ¼ 552.39, range ¼ 7–3084 days) after the initial measurement. The weight difference between the two measurements ranged from a weight loss of 53.8 kg to a weight gain of 51.6 kg and showed a mean weight increase of 2.2 kg (SD ¼ 10.41)1
Conclusions
The overall conclusion of the study is that obesity, MetS, smoking, as well as substance misuse are highly prevalent among our high security population. These are all risk factors associated with somatic morbidity and mortality. Our study showed that obesity and MetS were found across psychiatric diagnoses and the presence of metabolic syndrome was not limited to the use of SGA.
Remote interaction offers new opportunities for medical-psychological rehabilitation, providing access when in-person consultations are limited. The proactive model of psychosomatic medicine, focusing on prevention and can to enable continuous monitoring and active patient engagement, crucial for those affected by post-COVID syndrome and war.
Objectives
Analyze the effectiveness of a medical-psychological rehabilitation program for anxiety and depressive post-COVID disorders, as well as post-traumatic symptoms resulting from war, in the context of remote interaction.
Methods
The study sample consisted of 240 individuals with anxiety and depressive post-COVID disorders. The tools used in the study included the PHQ-9, GAD-7, and PCL-5.
Results
By day 63, according to the PHQ-9, depression in the study group decreased to 6.942±5.073, while in the control group it remained at 15.567±6.540 (p < 0.001; t = 11.437). According to the GAD-7, anxiety reduced to 3.991±3.589 in the study group, whereas in the control group it remained higher at 12.966±3.980 (p < 0.001; t = 18.355). According to the PCL-5, PTSD symptoms decreased to 13.295±8.727 in the study group, while in the control group they remained high at 29.177±13.541 (p < 0.001; t = 10.836).
Conclusions
The study results indicate that the medical-psychological rehabilitation program, delivered through remote interaction, effectively reduces symptoms of depression, anxiety, and post-traumatic stress in individuals with post-COVID disorders amid wartime conditions.
Borderline personality disorder (BPD) is characterized by instability in the area of one’s own self and affective reactions, instability in relationships, and impulsive behavior. BPD patients experience dissociative or quasi-psychotic symptoms much more often than the general population. These symptoms directly affect the daily functioning of patients, often preventing them from taking up professional work or having a stable family life. The etiology of dissociative experiences in BPD patients is still unknown. One of the biological models suggests that biological changes in the brain occur on the basis of a traumatic experience, which can produce symptoms. The arcuate fasciculus (AF) is a structure of white matter that interconnects Broca’s area and Wernicke’s area in the brain. AF is often considered in the context of research on psychotic symptoms. For this reason, we hypothesize that AF may be related to dissociative symptoms in BPD patients.
Objectives
The aim of our study was to investigate a relationship between the integrity of AF and symptomatology of dissociation in patients with borderline personality disorder.
Methods
45 BPD subjects and 43 healthy controls (HC) participated in the study. A DTI analysis was performed on all study participants. The psychopathology of BPD was assessed using the Dissociative Experiences Scale - Taxon (DES-T). The AF analysis was then conducted using fractional anisotropy (FA) parameter.
Results
BPD significantly more often than the control group experienced dissociative experiences. We could not identify differences in the integrity of the AF between the two groups. Nevertheless, we examined the correlation between the quality of the AF structure and the severity of dissociative symptoms (r=-0.0299, p=0.039).
Conclusions
The attenuation of the structure of AF may be involved in symptomatology of dissociation in patients with BPD. Further structural brain studies are needed in the BPD population.
Extreme preterm birth (<28 weeks) is a significant risk factor for adverse neurodevelopmental outcomes in infants but also for heightened psychological stress in parents, both of these impacting on parent-child bonding style. Abnormal parent-child bonding may impact, in turn, on child’s emotional development. Longer stays at NICUs, with their stressful environment and caregiving demands, alongside psychosocial factors and perinatal complications can exacerbate parental emotional stress.
Objectives
(i) To compare, around birthtime, levels of anxiety and depressive symptoms in parents of extremely preterm newborns (EPTN) compared to parents of born-at-term healthy control (HC) newborns; (ii) to assess, in parents of EPTN, longitudinal changes in levels of anxiety and depressive symptoms from birth up to 40 postmenstrual weeks (40PMW), and their association with demographic, clinical and environmental risk factors; (iii) to assess, in parents of EPTN, the impact of NICU-related stress and psychosocial / family context on levels of symptoms; and (iv) to examine, in parents of EPTN, the association between levels of anxiety and depressive symptoms and parent-child bonding quality around hospital discharge.
Methods
Observational, longitudinal, prospective, 24-month follow-up study. We recruited a cohort of n=150 EPTN and n=50 HC (the PeriStress-PremTEA cohort) in two tertiary hospitals in Spain. Of those, parents of n=70 EPTN and n=42 HC successfully completed, around birthtime (and at 40 PMW in EPTN) the STAI state & trait, BDI, PBQ, MSPSS and PPS at NICU questionnaires. We also gathered demographic, clinical and obstetric data from all patient & HC families. We compared, in EPTN vs HC, parental symptom levels around birth. Using logistic regression, we assessed, in EPTN, the association between demographic/perinatal variables, parental symptom levels around birth time and parent-child bonding quality at discharge.
Results
Both fathers and mothers of EPTN showed higher anxiety and depressive symptom levels than those of HC (all p<.01). In EPTN, parental symptom levels around birth time were highly correlated with PSS NICU scores (p<.01). Levels of anxiety and depressive symptoms in mothers of EPTN predicted parent-child bonding quality at discharge, above and beyond other potential risk factors, as did level of depressive symptoms in fathers of EPTN (p<.01).
Conclusions
Our findings support the need to establish screening and longitudinal monitoring programs of psychopathology in parents of EPTN, both for mothers and fathers of these children, and even more so in higher-risk subgroups, such as those with higher perception of NICU-related stress.
Childhood sexual abuse (CSA) is a major public health concern and is closely associated with dissociative symptoms. According to the betrayal trauma theory, dissociation can be interpreted as a response towards betrayal trauma (i.e., trauma perpetrated by a close person, such as a family member). No previous study has validated this theory with a focus on CSA in the Chinese context.
Objectives
We hypothesized that people with betrayal CSA, but not non-betrayal CSA, would report significantly more dissociative symptoms than people without CSA. We also hypothesized that betrayal CSA, but not non-betrayal CSA, would be significantly associated with the severity of dissociative symptoms. We tested the hypotheses in two independent Chinese-speaking samples.
Methods
Sample 1 (N = 91) consisted of participants seeking treatment in an evaluation study; while Sample 2 (N = 376) included community health service users in a survey study. In both Chinese-speaking samples, participants completed the two CSA items on the Brief Betrayal Trauma Survey and the 16-item Dissociative Features Section of the Self-report Dissociative Disorders Interview Schedule (SR-DDIS). ANOVA and regression analyses were used to test our hypotheses.
Results
Across both samples, participants with betrayal CSA reported significantly more dissociative symptoms than those without any CSA (Sample 1: M = 5.60, SD = 3.14 vs M = 3.67, SD = 3.06; F = 3.301, p = .041, Sample 2: M = 2.06, SD = 2.49 vs M = 0.93, SD = 1.32; F = 8.428, p < .001). As hypothesized, no significant differences in dissociative symptoms were observed between participants with and without non-betrayal CSA (Sample 1: M = 4.00, SD = 3.71 vs M = 3.67, SD = 3.06; Sample 2: M = 1.14, SD = 1.83 vs M = .93, SD = 1.32). Across both samples, betrayal CSA, but not non-betrayal CSA, was significantly associated with dissociative symptoms (Sample 1: β = .250, p = .024, Sample 2: β = .189, p < .001), after controlling for age and gender.
Conclusions
This study provides cross-cultural evidence for the betrayal trauma theory. We suggest that proactive family-centered child protection is needed to prevent CSA, and screening for dissociative symptoms is also necessary in CSA survivors.
The rigid maintenance of an acquired response in participants with obsessive-compulsive (OC) traits has been widely reported in the literature (e.g., Hassoulas et al., 2014; 2017; 2024). As such, demonstrating flexibility in responding to concurrently presenting stimuli with differing rates of reinforcement has also been shown to be difficult for those diagnosed with OCD (e.g., Clayton et al, 1999). Matching Law proposes a quantifiable description of behaviour when consequences to responding under two concurrently presented schedules of reinforcement differ. The application of a matching procedure, whereby participants exhibiting OC traits are presented with concurrent schedules of reinforcement, would highlight this difficulty in distinguishing between stimuli that provide different rates of reinforcement. That is, the competing sources of reinforcement would relate to the concurrent stimuli that individuals with OCD have been shown to have trouble attending to separately.
Objectives
Sensitivity to concurrent schedules has not been previously investigated in the context of OCD. As such, two experiments were designed to measure matching behaviour between groups of participants with and without OC traits.
Methods
A total of 60 participants (33 females, 27 male) were recruited to take part in the two studies. The Maudsley Obsessive-Compulsive Inventory (MOCI) was used to screen for the presence of OC traits. Concurrent variable intervals (VI) were presented over ten trials, with an aversive auditory stimulus serving as a punisher superimposed during every second trial. During the first experiment, VI 20-second schedules were concurrently presented with VI 40-second and VI 60-second schedules. The ratio between concurrent schedules was widened during the second experiment; with VI 20-second schedules presented alongside VI 100-second and VI 180-second schedules.
Results
A significant interaction of trial with OC traits was revealed when the punisher was presented in experiment 1, F(4,68)=2.68, p < 0.05, but not in experiment 2 (p>0.05). The findings suggest that the presence of an auditory punisher facilitates schedule-sensitive responding in participants with OC traits, but that schedule-sensitivity is lost when intervals between concurrent schedules are widened. Figures 1 and 2 display response ratios for both high and low scoring groups during experiments 1 and 2 respectively.
Image 1:
Image 2:
Conclusions
The widening of the schedule ratios in the second experiment disrupted sensitivity to the schedule contingencies for the OC group. Greater flexibility in responding within this group can therefore be facilitated by considering specific parameters and rates of reinforcement.
Over the last decade, there has been a growing recognition of the importance of identifying and treating cognitive impairment associated with bipolar disorder, as it persists during remission periods. Evidence suggests that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An increasing body of research aims to improve understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments
Objectives
The aim of this study is to explore the prevalence of cognitive impairment among bipolar disorder patients and identify related factors.
Methods
It was a cross-sectional, descriptive, and analytical study conducted on bipolar disorder patients from the Psychiatry “A” Department, Hedi Chaker University Hospital. Clinical and sociodemographic data were collected from March to September 2023 through a questionnaire along with The Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) for evaluation of subjective cognitive impairment
Results
A total of 37 patients with BD completed the questionnaire. The mean age was 45.4 ± 13.9 years, with a sex ratio (M/F) of 1.46.
Our results showed that 73 % of patients were with BD type I and 27% were with BD type II.
The mean score of COBRA was 12.54 ± 7.62 and 32.4% of participants presented subjective cognitive disorder.
Subjective cognitive disorder was significantly associated with the number of relapses, hospitalizations and suicide attempts, with respectively p< 0.001, p= 0.02 and p= 0.05
Female patients and patients with poor income presented significantly more subjective cognitive disorders (p = 0.01 and p = 0.02, respectively).
The COBRA score was positively correlated with the number of relapses (p<0.001, r = 0.67).
Conclusions
Our findings indicate that a significant proportion of individuals with bipolar disorder report cognitive difficulties, which may impact their daily functioning and quality of life. Key factors such as poor income, female sex, and the number of relapses and suicide attempts were associated with higher levels of perceived cognitive dysfunction. These results highlight the need for greater attention to cognitive symptoms in the clinical management of bipolar disorder.
The Lancet Commission noted severe mental health service disparities in low- and middle-income countries facing crises. Regarding this, the World Health Organization (WHO) developed the early adolescent skills for emotions (EASE), an experimental group-based intervention delivered by non-specialists, to offer evidence-based psychological support for adolescents with mental distress.
Objectives
This systematic review and meta-analysis assesses EASE’s effectiveness in alleviating post-traumatic stress disorder (PTSD) compared with enhanced treatment as usual (ETAU).
Methods
We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing EASE with ETAU. Our outcomes included the overall improvement in post-traumatic and depressive symptoms, measured by the Children’s Revised Impact of Event Scale (CRIES-13) and the Patient Health Questionnaire-Adolescent version (PHQ-A) scores respectively. We pooled mean differences (MD) with 95% confidence intervals (CI) in RStudio using a random-effects model. Heterogeneity was assessed with I² statistics.
Results
Six RCTs were included with 1,417 patients, of whom 642 (45.3%) received EASE treatment. In 67% of the studies, Syria was the main location of RCT’s. A total of 688(49%) were female. CRIES-13 (MD = -0.18, 95% CI [-1.88, 1.52], p = 0.84, I² = 0%; Figure 1) and PHQ-A (MD = -0.69, 95% CI [-1.47, 0.09], p = 0.08, I² = 15%; Figure 2) scores in the EASE intervention group compared to the ETAU group showed no significant difference. In both outcomes the heterogeneity was low.
Image 1:
Image 2:
Conclusions
The benefit of EASE in improving mental distress in adolescents is uncertain. Additional trials will provide new evidence for EASE potential therapeutic benefits.
Lumateperone, an atypical antipsychotic drug, has a dual mechanism of action by combination of activity at central serotonin (5-HT2A) and dopamine (D2) receptors.
Objectives
This subgroup analysis of an Indian Phase 3 study was conducted to evaluate the efficacy and safety of Lumateperone 42mg compared to Quetiapine 300mg in treatment of Bipolar II depression when stratified based on baseline body mass index (BMI).
Methods
The phase-III, randomized, multi-centric, assessor-blind, parallel-group, active-controlled, comparative, non-inferiority study included patients with Bipolar II depression with moderate severity having a Montgomery-Asberg depression rating scale (MADRS) score ≥20 and Clinical global impression–bipolar version–severity (CGI-BP-S) score ≥4. The study was conducted after receiving regulatory and ethics committee approvals. The patients were randomized (1:1) to either receive Lumateperone 42mg [Test] or Quetiapine 300mg [Comparator] for 6 weeks. The patients were stratified based on baseline BMI: Subgroup 1 [S1]: <25Kg/m2 and Subgroup 2 [S2]: ≥25Kg/m2. For efficacy outcomes MADRS score, CGI-BP-S (total score, depression subscore and overall bipolar illness subscore), and Quality of life enjoyment and satisfaction-short form questionnaire (Q-LES-Q-SF) score were evaluated and for safety outcomes treatment emergent adverse events (TEAEs) were assessed. [Clinical trial registration: CTRI/2023/10/058583]
Results
This subgroup analysis included 462 patients, out of which 276 in S1[Test=139; Comparator=137] and 186 in S2[Test=92; Comparator=94]. The baseline demographic characteristics were comparable in between treatment arms across subgroups. The primary endpoint of reduction in MADRS score from baseline to Day 42 in Test arm was non-inferior to Comparator arm in both subgroups [Figure 1] as the upper 95% CI was below the pre-defined margin of 3.0. The reduction of CGI-BP-S (total score, depression subscore and overall bipolar illness subscore) from Day 14 to Day 42 were comparable in both Test and Comparator arms in both subgroups. The improvement in Q-LES-Q-SF score from baseline to Day 42 were comparable in both Test and Comparator arms in both subgroups. The incidence of TEAEs were similar in both treatment arms [S1: Test=38.1% and Comparator=36.5%; S2: Test=29.3% and Comparator=34.0%] and no serious adverse events were reported.
Image 1:
Conclusions
This subgroup analysis demonstrated that Lumateperone 42mg is non-inferior to Quetiapine 300mg in treatment of Bipolar II depression as assessed via MADRS score from baseline to Day 42, irrespective of baseline BMI and both treatments were found to be well tolerated. Hence, Lumateperone can be considered as valuable treatment option in management of Bipolar II depression.
Disclosure of Interest
A. Dharmadhikari: None Declared, P. Chaurasia: None Declared, Y. Patel: None Declared, D. Choudhary: None Declared, P. Dasud: None Declared, M. Bhirud: None Declared, P. Meena: None Declared, F. Shah: None Declared, G. Ganesan: None Declared, B. P. Rathour: None Declared, K. Mistry: None Declared, M. Dutta: None Declared, A. Ramaraju: None Declared, S. Mangalwedhe: None Declared, S. G. Goyal: None Declared, G. Kulkarni: None Declared, A. Mukhopadhyay: None Declared, P. Chaudhary: None Declared, G. T. Harsha: None Declared, M. Parikh: None Declared, S. Dey: None Declared, S. Sarkhel: None Declared, N. Jyothi: None Declared, A. Kumar: None Declared, N. Sooch: None Declared, A. Shetty Employee of: Sun Pharma, S. Saha Employee of: Sun Pharma, P. Devkare Employee of: Sun Pharma, A. Shetty Employee of: Sun Pharma, D. Patil Employee of: Sun Pharma, P. Ghadge Employee of: Sun Pharma, A. Mane Employee of: Sun Pharma, S. Mehta Employee of: Sun Pharma
Shared psychotic disorder (folie à deux) is a rare mental health condition where delusions are transmitted from one person to another within a close relationship. Understanding these complex dynamics is crucial for effective diagnosis and treatment.
Objectives
To present two cases of shared psychosis involving close relatives diagnosed with schizophrenia, aiming to open discussion on the complex dynamics of familial relationships and their impact on mental illness.
Methods
2 case reports.
Results
We present two cases of shared psychosis involving close family members. The first case involves two sisters, aged 43 and 48, both diagnosed with paranoid schizophrenia. The 43-year-old sister was admitted following a suicide attempt and exhibited active psychosis with paranoid delusions. During her hospitalization, the older sister displayed identical delusions and refused her sibling’s treatment, leading to her own admission. Both sisters, previously untreated and highly educated, were managed with antipsychotic medications. While the delusions were encapsulated during treatment, concerns remain about their shared living environment and its potential influence on their ongoing recovery.
The second case involves a 33-year-old woman with a decade-long history of schizophrenia who was brought to the emergency room malnourished and uncommunicative, having not eaten for over a week. She was fed via a nasogastric tube during her lengthy hospitalization and placed on a regimen of Clozapine. The patient exhibited severe negative symptoms and behaviors suggestive of auditory hallucinations. Her mother, also of low educational and socioeconomic status, was present throughout her stay but displayed delusional beliefs that interfered with her daughter’s treatment. Following restrictions on the mother’s access to the patient, the daughter showed slight improvement and began eating independently.
Conclusions
These cases highlight the significant impact that familial relationships and shared psychosis can have on the progression and management of schizophrenia. The challenge in treating shared delusions lies not only in addressing the symptoms but also in mitigating the interpersonal dynamics that may perpetuate them. Further investigation into family-based psychosis and its treatment is warranted.
Social anxiety disorder (SAD) and body dysmorphic disorder (BDD) share a unique and intricate relationship, often presenting with overlapping yet distinct anxieties about social evaluation. In patients who have undergone repeated surgical interventions, the added dimension of neuropathic pain further complicates the clinical picture, as seen in this 48-year-old male. His preoccupation with his perceived nasal and upper lip deformities, coupled with neuropathic pain from multiple reconstructive surgeries, underscored a profound interplay of psychological and somatic symptoms, warranting a multidimensional therapeutic approach.
Objectives
To elucidate the diagnostic overlap between SAD and BDD in a patient with neuropathic pain post-surgery, to explore the off-label use of pregabalin in addressing both anxiety and neuropathic pain symptoms, and to highlight the subtle clinical distinctions between social phobia related to perceived physical flaws (BDD) versus the broader fear of negative evaluation in social contexts (SAD).
Methods
The patient’s history includes five reconstructive surgeries to correct perceived nasal and upper lip deformities, which resulted in significant spastic neuropathic pain. This pain was exacerbated by the patient’s intense anxiety regarding his physical appearance, manifesting as avoidance behaviors, fear of negative social evaluation, and repetitive self-evaluative behaviors typical of BDD. Initial treatment involved clonazepam and mirtazapine combined with psychotherapy. Despite partial relief of anxiety symptoms, neuropathic pain persisted, exacerbating his body image concerns. Pregabalin was introduced under the assumption that neuropathic pain was worsening his BDD-related distress and social anxiety symptoms.
Results
Following the introduction of pregabalin, the patient demonstrated marked clinical improvements. The dual efficacy of pregabalin, particularly in its off-label role for social anxiety, contributed to a reduction in the fear of social situations, previously fueled by BDD-related preoccupations. The remission of neuropathic pain, in conjunction with improved social functioning, underscores the utility of pregabalin in addressing the complex somatopsychic interactions in patients with comorbid psychiatric and neuropathic conditions.
Conclusions
This case highlights the intricate diagnostic and therapeutic complexities in managing co-occurring social anxiety and body dysmorphic disorder, where psychosomatic pain further distorts the clinical picture. The addition of pregabalin, despite its off-label status for SAD, proved to be a pivotal intervention, addressing both the patient’s physical and psychological distress, incorporating psychopharmacology, pain management, and psychosocial interventions to effectively restore function and quality of life.
Specific Learning Disorder (SLD) is a significant comorbidity in children with Attention Deficit Hyperactivity Disorder (ADHD). Both ADHD and SLD are neurodevelopmental conditions that share common characteristics, such as deficits in executive functions. Identifying SLD in patients with ADHD is crucial because targeted educational interventions are the primary treatment for SLD.
Objectives
This study aimed to evaluate the utility of the Stroop Test (ST) in differentiating SLD from ADHD.
Methods
79 patients (42 with ADHD and 37 with both ADHD and SLD) participated in the study. Sociodemographic information and ST performance metrics (completion time, omission errors, and commission errors) were collected by a child and adolescent psychiatrist. Additionally, parents completed the Turgay DSM-IV ADHD Rating Scale to assess the severity of ADHD symptoms.
Results
There were no significant differences between the ADHD and ADHD+SLD groups regarding age, gender, or ADHD symptom severity. The ADHD+SLD group exhibited longer completion times across all sections of the ST. Omission errors in the fourth and fifth sections were significantly higher in the ADHD+SLD group. After adjusting for age, gender, and ADHD symptom severity, the completion time in the fifth section and omission errors in the fourth and fifth sections remained significant. Receiver Operating Characteristic (ROC) analysis identified cut-off scores for the fifth section’s completion time (42 seconds; Sensitivity: 0.62, Specificity: 0.66) and omission errors (1 error; Sensitivity: 0.64, Specificity: 0.61). Moreover, omission errors in the fifth section predicted being in the ADHD+SLD group (p= .006, Odds Ratio [OR]= 1.527, 95% CI= 1.127–2.068).
Conclusions
The findings suggest that the ST may be a valuable tool for diagnosing SLD in patients with ADHD. In particular, the completion time and omission errors in the fifth section of the ST may serve as practical diagnostic indicators. Further research with larger sample sizes is necessary to confirm these results.
Empathy, a key component of an effective physician-patient relationship, is understood as a multifaceted socio-cognitive ability influenced by various cognitive, emotional, social factors. While it has been extensively studied in medical students and healthcare professionals overall, there is limited research on empathy skills among psychiatrists, whose profession especially demands a strong capacity for empathy in their practice.
Objectives
This study aimed to explore the different facets of empathy among Tunisian psychiatry trainees and assess their connections with demographic, occupational, emotional, and social variables.
Methods
Across-sectional study was conducted. An online survey was proposed to 120 Tunisian psychiatry trainees. In addition to sociodemographic and work-related variables, it comprised the Davis’s Interpersonal Reactivity Index, a 28-item tool used for a multidimensional assessment of empathy with four distinct subscales: Perspective taking(PT), Empathic concern(EC), Personal distress(PD) and Fantasy scale(FS). The survey also included the Difficulties in Emotion Regulation Scale(DERS), the Perceived Stress Scale(PSS), the Social Support Questionnaire(SSQ) and the General Self-Efficacy Scale(SE). Factors associated with empathy were evaluated using t test/ANOVA for categorical variables and correlation for continuous predictors.
Results
The total participation rate was 71% and the mean empathy subscores were as follows: 19.04 ± 3.95 for PT, 20.41 ± 3.71 for EC, 12.67 ± 4.41 for PD and 16.40 ± 4.91 for FS. Empathy dimensions’ scores were significantly associated with the rank in the siblings, mother’s level of education, satisfactory relationship with the mother, extra-professional activities and personal psychiatric history. They also were associated with work-related factors such as the year of residency, the desired choice of specialty, the training in a general hospital with a consultation-liaison psychiatry and the perceived verbal aggression from colleagues.
Empathy dimensions’ scores, mainly those of PT and PD, were correlated with emotion regulation difficulties. In fact, PT scores were negatively correlated with five of the six emotion regulation difficulties and PD scores were positively correlated with all the six emotion regulation difficulties of the DERS. EC scores were positively correlated with PSS total score and the number of social supports. PT scores were positively correlated with SE total score and PD scores were negatively correlated with SE total score.
Conclusions
Our findings underscore empathy’s complexity, revealing that in psychiatry trainees, it is shaped by contextual, emotional, and social factors. Without assessing these dimensions and mediators, empathy remains a theoretical concept rather than a teachable and improvable skill.
Sciatica pain represents a typical symptom of spinal radicular syndromes. Disability due to this pain can affect mental health of patients.
Objectives
Our study aims to assess the relationship between mental health and disability among patients with chronic sciatica.
Methods
We conducted a descriptive, analytical and cross-sectional survey among patients suffering from documented common sciatic pain evolving for more than 3 months. We collected socio-professional data. We used the Hospital Anxiety and Depression Scale (HADS) and the Oswestry Disability Index (ODI).
Results
Our study population was exclusively female, including 69 patients. The mean age of participants was 56.2 ±12.6 years. The most frequent etiology of sciatica pain was a herniated disc, followed by lumbar spinal stenosis and spondylolisthesis. The root path was L5 in 49 cases and S1 in 20 cases. The mean Oswestry score was 25 ± 4.1. The disability was moderate, severe and crippled respectively in 10.1%, 82.6% and 7.2% of patients. Regarding the patients’ anxiety levels, it was found that 76.8%, 20.3%, and 2.9% appeared to have mild, moderate, and severe anxiety, respectively. As for the depression levels of patients, 13 were mildly depressed (18.8%), 20 were moderately depressed (29%), and 36 were severely depressed (52.2%). We found that anxiety and depression were correlated with disability (p = <0.05, r = 0.2).
Conclusions
Our findings highlight a correlation between altered mental health and disability among patients with chronic sciatica. It is crucial to screen psychiatric disorders among these patients in order to improve their well-being.
The transition from childhood to adulthood is a complex process and an important developmental task with many opportunities and risks. Despite the fact that almost three-quarters of psychiatric disorders begin before the age of twenty-four, adolescents and young adults are poorly represented in psychiatric research, and the data used to guide diagnosis and treatment in this group rely mainly on studies in adult populations. The mental health system in Germany is also not organized to meet the needs of this age group, and as a result, the treatment outcomes for young adults in inpatient or day-care units of adult psychiatric centers are mostly unsatisfactory. For this reason, it is crucial to implement mental health care concepts that are tailored to the needs of young adults.
Objectives
Here we present a milieu-therapeutic inpatient care concept, ‘House of the Future,’ which integrates different therapeutic approaches to provide holistic and targeted support for young adults in need of psychiatric care.
Methods
An innovative inpatient psychiatric care concept for young adults from a psychiatric training hospital in Lower Saxony, Germany, will be presented in detail.
Results
The concept of the ward incorporates a variety of therapeutic approaches, including milieu therapy, systemic family therapy, and psychodynamic therapy. Additionally, it incorporates safe-wards elements and numerous non-verbal, innovative techniques such as art therapy, occupational therapy, music therapy, and sports therapy adapted for this age group. We provide a structured and needs-based environment for young adults, enabling them to engage with their experiences without being defined by their disorder or solely integrated into psychiatric systems. Our holistic approach aims not only to treat symptoms but also to promote sustainable personal development and a healthy lifestyle that empowers young adults. Young adults represent the future, and the development of their future is contingent upon the efficacy of the social support system, which is itself a significant challenge. Consequently, social work and pedagogical support are among the most essential elements of the concept. In addition to the comprehensive presentation of the concept, opportunities for networking with integration support institutions, day clinics, and specific outpatient units will be provided.
Conclusions
Adolescence and young adulthood are distinct developmental stages with unique needs. To reach optimal outcomes and to build our future on a safe base, it is fundamental to implement tailored care models in psychiatric settings that are in harmony with the specific requirements of this age group. Project ‘House of the Future’ aims to be a best practice example to address these needs.
Background: Bipolar disorder (BD) is marked by dramatic mood and energy shifts, often mirrored in speech. Traditional diagnosis and monitoring largely rely on subjective clinical assessments. However, advancements in natural language processing (NLP) present an opportunity for more objective speech pattern analysis.
Objectives
Aims: This study aims to (i) identify correlations between speech features and BD symptom severity, (ii) create predictive models for diagnostic and treatment outcomes, and (iii) pinpoint significant speech features and optimal tasks for analysis.
Methods
The CALIBER study is a longitudinal, observational project collecting audio from BD patients during euthymia, acute manic or depressive episodes, and recovery phases. Patients engaged in clinical interviews, cognitive assessments, standard readings, and storytelling (Figure 1). Automatic diarization and transcription enabled the extraction of speech features, including acoustic properties, linguistic content, formality, and emotionality. Analyses include (i) correlation of speech features with clinical scales, (ii) predictive modeling using lasso logistic regression, and (iii) feature importance identification.
Results
Preliminary data from 76 patients (24 manic, 21 depressed, 31 euthymic) were analyzed. The cohort had a mean age of 46.0 ± 14.4 years, 63.2% female. Mean YMRS scores dropped from 22.9 ± 7.1 to 5.3 ± 5.3 post-mania, and HDRS-17 scores in depressed patients fell from 17.1 ± 4.4 to 3.3 ± 2.8 post-recovery. Euthymic patients showed lower baseline scores.
Conclusions
Automated speech analysis in BD can provide objective biomarkers for diagnosis and monitoring, highlighting subtle pre-relapse changes and informing treatment strategies. Establishing standardized protocols is vital for developing a global speech database to support collaborative research and enhance BD management.
Disclosure of Interest
G. Anmella Grant / Research support from: GA has received CME-related honoraria, or consulting fees from Adamed, Angelini, Casen Recordati, Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, Rovi, and Viatris, with no financial or other relationship relevant to the subject of this article., Consultant of: GA has received CME-related honoraria, or consulting fees from Adamed, Angelini, Casen Recordati, Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, Rovi, and Viatris, with no financial or other relationship relevant to the subject of this article., M. De Prisco: None Declared, J. Joyce: None Declared, C. Valenzuela-Pascual: None Declared, G. Chatzisofroniou: None Declared, D. Hidalgo-Mazzei: None Declared, E. Vieta: None Declared
In the setting of product systems over group-embeddable monoids, we consider nuclearity of the associated Toeplitz C*-algebra in relation to nuclearity of the coefficient algebra. Our work goes beyond the known cases of single correspondences and compactly aligned product systems over right least common multiple (LCM) monoids. Specifically, given a product system over a submonoid of a group, we show, under technical assumptions, that the fixed-point algebra of the gauge action is nuclear if and only if the coefficient algebra is nuclear; when the group is amenable, we conclude that this happens if and only if the Toeplitz algebra itself is nuclear. Our main results imply that nuclearity of the Toeplitz algebra is equivalent to nuclearity of the coefficient algebra for every full product system of Hilbert bimodules over abelian monoids, over $ax+b$-monoids of integral domains and over Baumslag–Solitar monoids $BS^+(m,n)$ that admit an amenable embedding, which we provide for m and n relatively prime.
Adverse Childhood Experiences, referring to potentially traumatic events such as sexual abuse, rejection, and family dysfunction, are strongly associated with the development of psychiatric disorders, including anxiety, depression, and substance misuse. Peer victimization related to sexual orientation and gender identity or expression has been linked to higher rates of depressive symptoms, disrupted educational paths, trauma, and increased use of substances such as alcohol and drugs. Gender-diverse youth are particularly vulnerable to substance misuse, especially in environments with limited support and prevalent discrimination.
Objectives
To emphasize the complex interactions between substance use, early trauma, and gender identity struggles, while highlighting the importance of a multidisciplinary therapeutic approach.
Methods
This case report was developed through detailed psychiatric interviews and assessments conducted during the patient’s follow-up in an outpatient addiction treatment unit. The case description is supported by a focused literature review on PubMed using the keywords “Adverse Childhood Experiences”, “Substance Use Disorder” and “Gender Identity”.
Results
The patient is a young adult with a history of polysubstance use, starting in adolescence. His substance use was closely associated to early trauma, including childhood sexual abuse and rejection by family and peers after disclosing his sexual orientation. These events led to dropping out of school, running away from home, and experiencing homelessness. As a result, he developed long-standing anxiety, depressive symptoms, and emotional instability. Internal struggles with gender identity, alongside ongoing familial conflict and unstable romantic relationships, further worsened his psychopathology. After a multidisciplinary intervention involving psychiatry, psychology, and social services, he showed significant improvements in emotional regulation, anxiety management and has remained abstinent since starting treatment.
Conclusions
Personal experiences, especially during childhood and adolescence, profoundly influence mental health and behaviors in adulthood. This case underscores the interaction between adverse childhood experiences, substance misuse, and discrimination related to sexual orientation, illustrating how these factors collectively impact psychiatric health. The patient’s journey through addiction, identity struggles, and mental health challenges reflects the deep influence of both personal trauma and systemic issues. This case highlights the need for multifaceted therapeutic approaches that address the psychological, social, and familial factors underlying the patient’s condition.