The assessment of technology in hospital settings is a crucial step towards ensuring the delivery of efficient, effective, and safe healthcare.

This study conducts a Hospital-Based Health Technology Assessment to evaluate the efficacy of a screening rapid test for mild Traumatic Brain Injury (mild TBI) utilizing blood biomarkers, specifically Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal Hydrolase L1 (UCH-L1). The assessment focuses on the clinical utility and performance characteristics of the proposed rapid test within a hospital setting.

The screening model was meticulously examined for its ability to accurately detect mild TBI, considering the sensitivity and specificity of GFAP and UCH-L1 as blood biomarkers. The study involved a thorough evaluation of the test’s diagnostic accuracy, comparing its outcomes with established standards for mild TBI diagnosis.

Results from the Hospital-Based Health Technology Assessment highlight the potential of the GFAP and UCH-L1 blood biomarker-based rapid test as an efficient screening tool for mild TBI within a hospital environment. The evidence results show that the test is highly sensitive (91 percent to 100 percent) for the prediction of acute traumatic intracranial lesions, which helps rule out injury when the result is negative. When used within 12 hours of injury in adult patients with mild TBI, this test holds promise in reducing the utilization of CT.

The findings contribute valuable insights into the feasibility and reliability of implementing this technology for timely and accurate identification of mild TBI, enhancing clinical decision making and patient care in hospital settings.

Smoking prevalence in patients with mental illness ranges between two to 4 times higher than general population. This higher prevalence has a multifactorial origin, and some of the possible causes are still unknown.

They have a higher prevalence of tobacco-associated diseases and higher mortality.

Additionally, these patients have greater difficulty in treating and quitting smoking.

A relationship has been found between severity of mental illness and smoking. Risk of suicide seems to be higher in patients with higher tobacco consumption. Schizophrenia is the mental illness that has been most closely related to smoking, with a prevalence close to 90%.

The aim of this work is reviewing the current bibliography referring to smoking treatments for patients with mental illness

A literature search using electronic manuscripts available in PubMed database published during the last ten years and further description and discussion of a single-patient clinical case

The treatment of tobacco dependence in patients with mental illnesses is sometimes waited until there is psychiatric stability, which can take a long time in those cases with more severe mental disorders, which can have negative physical and psychiatric consequences.

The combined treatment of cognitive behavioral therapy and pharmacological treatment is the most effective approach. Nicotine replacement therapy can be useful, while combined use of antidepressants or anxiolytics is also recommended.

Bupropion has shown efficacy. In patients with schizophrenia it does not seem to worsen positive symptomatology, but improving the negative one. It should not be used in patients with bipolar disorder or bulimia.

Varenicline has shown efficacy in the general population, but limitations were established in patients with mental illness, although it is the drug that has shown greater efficacy. However, is not currently available in our country.

Cytisine is a drug with limited number of studies in the psychiatric population but it may be a reasonable treatment alternative.

The prevalence of tobacco use in patients with mental illness is higher than the general population, especially in paranoid schizophrenia. The consequences on physical health and the evolution of psychiatric illness are very relevant. Based on above, a multidisciplinary and coordinated management involving psychiatrists and other specialists in the treatment of these patients should be desirable.

None Declared

Parental Alienation Syndrome (PAS) was proposed by Richard A. Gardner in 1985. It is assumed to occur in some distressing marriage break-ups, when a parent “brainwashes” his children so they reject the other parent in an unjustified way. But, is it the result of a conscious act as Gardner suggests? Or could it also appear as part of a shared psychosis?

To assess the possibility of the appearance of PAS as a consequence of paranoid contagion or shared psychosis.

We present the case of a 45-year-old patient and her 9-year-old daughter, who is allegedly assaulted by her father during visits, according to both. Mother and daughter continually request attention in the emergency department for this reason, with no obvious injuries. A bibliographic review is carried out on the PAS and shared psychosis. We compare the existing data with our case.

A paranoid cognitive style is observed in the 45-year-old patient, and it is observed that her daughter stops rejecting the father when she spends time separated from her. The contagion of delirium is the nuclear mechanism of shared psychosis. It is known that children with PAS may have distorted memories and incorporate beliefs of others through suggestion. There is also an inverse relationship between the number of visits by the alienated parent and the undervaluation of the child. We have not found any studies linking shared psychosis with PAS.

The existing bibliography on PAS is scarce. The possibility of an existing paranoid contagion mechanism has not been addressed yet.

No significant relationships.

It has been suggested that dysregulation of sex hormones is associated with schizophrenia. However, obesity and metabolic syndrome are very common between schizophrenic patients, and it can also dysregulate sex hormones so they could act as confounders.

To determine if estradiol and progesterone are abnormally elevated regardless of obesity or metabolic syndrome in men with SCZ.

We measured serum levels of progesterone and estradiol in 56 schizophrenic male patients at treatment with a depot antipsychotic. Subsequently, we studied the association or independence of our results with obesity or metabolic syndrome by a Chi Square Test.

66.07% of our patients elevated progesterone levels, 19.64% of our patients elevated estradiol levels, and 16.07% of our patients elevated both, progesterone and estradiol, simultaneously. We found no relationship between increased estradiol and / or progesterone with obesity and / or metabolic syndrome.

Estradiol and progesterone are abnormally elevated regardless of obesity and / or metabolic syndrome in male schizophrenic patients on depot treatment.

No significant relationships.

To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.

An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.

Spanish older adults with metabolic syndrome (MetS).

A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.

Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).

According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.

Psychiatry has had long standing recruitment difficulties. Many efforts have been made to explore strategies that encourage interest in the specialty, with early university experience being an important factor in ultimate career choice. The Royal College of Psychiatrists ‘Choose Psychiatry’ guidance for medical schools outlines four key areas of focus: teaching excellence, placement quality, leadership and enrichment activities, with other research reporting similar conclusions. The aim of this study was to assess attitudes towards psychiatry amongst first year medical students, examine what input they would welcome from psychiatrists at this stage of their career and consider if their wishes are in keeping with the ‘Choose Psychiatry’ guidance.

All first-year medical students at St George's University of London were approached in October 2019 and offered the opportunity for early psychiatry exposure. 60 students were recruited. Data were collected in November 2019 via an online questionnaire comprising of baseline demographics, the 30-item Attitudes Towards Psychiatry questionnaire (ATP-30) and a free-text question asking what students would like from psychiatry at this stage of their education. Quantitative data were analysed using Excel, whilst qualitative data were analysed thematically.

The mean ATP-30 score was 113.83 (SD 12.57, range 70-135). Gender, ethnicity and religious background were not associated with a change in ATP score. Undergraduates’ attitudes were more positive than those of postgraduates (independent t-test revealed a p-value of 0.087). Seven themes were identified outlining what students wanted from psychiatry, the most prominent being: (a) learning about the lifestyle of a psychiatrist and finding a role model, (b) exploring the patient perspective, (c) exploring the interaction between psychiatry and specialities and (d) having an opportunity to develop communication skills.

The findings demonstrate higher ATP-30 results than previous literature has reported, potentially due to mental health awareness campaigns in recent years. As undergraduates were found to have a higher mean score, targeting them for additional psychiatry contact may be beneficial. Themes identified by students in this study support ‘Choose Psychiatry’ guidance, whilst also highlighting the potential for combining some psychiatry with other specialties in the curriculum. Integration with communication skills teaching might help engage those not initially psychiatry-inclined. Further study will be required to establish whether implementing the suggested strategies can lead to improvement in student ATP-30 scores and ultimately increased recruitment rates.

Although deficits in affective processing are a core component of anorexia nervosa (AN), we lack a detailed characterization of the neurobiological underpinnings of emotion regulation impairment in AN. Moreover, it remains unclear whether these neural correlates scale with clinical outcomes.

We investigated the neural correlates of negative emotion regulation in a sample of young women receiving day-hospital treatment for AN (n = 21) and healthy controls (n = 21). We aimed to determine whether aberrant brain activation patterns during emotion regulation predicted weight gain following treatment in AN patients and were linked to AN severity. To achieve this, participants completed a cognitive reappraisal paradigm during functional magnetic resonance imaging. Skin conductance response, as well as subjective distress ratings, were recorded to corroborate task engagement.

Compared to controls, patients with AN showed reduced activation in the dorsolateral prefrontal cortex (dlPFC) during cognitive reappraisal [pFWE<0.05, threshold-free cluster enhancement (TFCE) corrected]. Importantly, psycho–physiological interaction analysis revealed reduced functional connectivity between the dlPFC and the amygdala in AN patients during emotion regulation (pFWE<0.05, TFCE corrected), and dlPFC-amygdala uncoupling was associated with emotion regulation deficits (r = −0.511, p = 0.018) and eating disorder severity (r = −0.565, p = .008) in the AN group. Finally, dlPFC activity positively correlated with increases in body mass index (r = 0.471, p = 0.042) and in body fat mass percentage (r = 0.605, p = 0.008) following 12 weeks of treatment.

Taken together, our findings indicate that individuals with AN present altered fronto-amygdalar response during cognitive reappraisal and that this response may serve as a predictor of response to treatment and be linked to clinical severity.