Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure leading to dysfunctionality.

This case report aims to discuss a case of a 21-year-old female with major depressive disorder and trichotillomania, management challenges, and the importance of a comprehensive, multifaceted therapeutic approach to address both disorders effectively.

A 21-year-old female college student and youth church leader presented with chronic hair-pulling and depressive symptoms. She had low self-esteem and a strong need for validation. Despite her responsibilities, she struggled with emotional distress exacerbated by family dynamics and her church role. Her symptoms were linked to self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp, and Major Depressive Disorder.

Initial pharmacologic management was Fluoxetine 20mg/day up titrated to 40mg/day with no improvement hence shifted to Escitalopram 20mg/day and N-acetylcysteine 1200mg/day with noted significant improvement in symptoms. Non-pharmacologic strategies included supportive-expressive psychodynamic psychotherapy, cognitive-behavioral techniques, and family therapy. Psychoeducation, suicide safety planning, and an interprofessional approach with dermatology co-management were also integral.

Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes.

This case highlights the significance of addressing both TTM and its comorbid conditions for effective treatment outcomes. The interplay between TTM and MDD underscores the need for comprehensive treatment plans incorporating pharmacological and psychotherapeutic approaches. Future practice should consider the benefits of an interprofessional approach for managing complex cases like this.

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Clozapine, traditionally prescribed for treatment-resistant schizophrenia, has shown potential for off-label use, particularly in affective and personality disorders characterized by severe impulsivity, nonsuicidal self-injury (NSSI), and suicidality (Delgado et al 2020, Journal of psychiatric research, 125, 21-27). Emerging evidence suggests that clozapine’s unique pharmacodynamic profile (serotonergic activity and high affinity for D4R, α1R, H1R) may contribute to reducing aggression and impulsivity and offer therapeutic benefits for borderline personality disorder (BPD). This is particularly relevant given the high suicide risk in BPD patients, with an estimated annual rate up to 10%, 50 times higher than the general population. Despite this, current treatment guidelines for BPD typically limit pharmacological interventions in favor of psychotherapeutic approaches (Pascual JC et al Int Clin Psychopharmacol. 2010, 25(6), 349-55). However, clozapine’s ability to modulate impulsivity and emotional dysregulation could provide a valuable adjunct in the treatment of this complex disorder.

To evaluate the efficacy of clozapine in reducing impulsivity, emotional dysregulation, and suicidality in patients with BPD.

The study cohort consisted of 47 patients (29 women) with a mean age of 28 years (IQR: 22-44), all diagnosed with BPD resistant to previous pharmacological treatments. Clozapine was introduced after a comprehensive risk-benefit assessment. At baseline, 96% of patients were taking mood stabilizers or anticonvulsants, 87% were taking SSRI/SNRI antidepressants, 81% were taking antipsychotics, and 66% were taking other medications such as benzodiazepines or gabapentinoids. Clinical assessments using the RIPoST-40, MOAS, and Columbia scales were administered at baseline, one week (T1), one month (T2), and three months (T3). Data were analyzed using repeated measures ANOVA and Friedman’s test with significance set at p<0.01 after Bonferroni correction.

Significant reductions in all scores were observed at T3: RIPoST-40 scores decreased by 40.15% (p<0.0001), MOAS by 58%(p<0.0001), Columbia Scale scores by 70.20% (p<0.0001). At month 3, clinical response, defined as a ≥50% reduction in scores, was achieved by 11% of patients on the RIPoST-40, 70% on the MOAS, and 94% on the Columbia Scale.

Clozapine demonstrated significant reductions in impulsivity, emotional dysregulation, and suicidality in patients with BPD, with rapid improvements observed within the first week and sustained through 3 months. These findings suggest that clozapine, in combination with psychotherapy, may be an effective treatment strategy for the most severe symptoms of BPD. Further prospective studies with larger cohorts are needed to validate these preliminary results and to assess the long-term safety and efficacy of clozapine in this population.

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Accidents, whether minor or severe, can have significant psychological impacts, especially in elderly populations. Stress related to accidents often exacerbates pre-existing conditions or leads to new mental health challenges such as anxiety, depression, or post-traumatic stress disorder (PTSD). The psychological impact of accidents on elderly individuals is often compounded by physical frailty, social isolation, and diminished coping mechanisms. Following an accident, elderly individuals may face prolonged recovery periods, limited mobility, and a reduced sense of independence, all of which can heighten stress levels. Additionally, the fear of future accidents may lead to avoidance behaviors, further isolating them from social interactions and routine activities, thus exacerbating anxiety and depression. Pre-existing mental health conditions, such as mild cognitive impairment or chronic illness, can worsen under accident-related stress.

This study aims to explore recent trends in understanding and addressing accident-related stress in elderly individuals, focusing on the psychological, social, and physiological factors contributing to their vulnerability. The primary objective of this study is to examine the psychological, social, and physiological factors that increase the vulnerability of elderly individuals to accident-related stress.

A mixed-methods approach was used, combining a systematic review of literature from 2015 to 2024 and interviews with mental health professionals. The sample consisted of 30 peer-reviewed studies and 25 elderly individuals aged 65 and above who had experienced accidents within the last year. Studies were selected based on relevance to accident-related stress in the elderly, with an emphasis on post-accident psychological outcomes and interventions.

Results indicated that the elderly are more susceptible to prolonged stress responses following accidents due to physical fragility, social isolation, and reduced coping mechanisms. The review also highlighted an underutilization of mental health services in this demographic, despite the availability of stress-reduction programs. Furthermore, findings showed that older adults who participated in targeted mental health interventions, such as cognitive-behavioral therapy and peer support groups, experienced better outcomes in managing stress compared to those who did not.

In conclusion, accident-related stress in the elderly presents unique challenges that require specialized attention. Healthcare providers should prioritize early identification and tailored interventions to mitigate the long-term psychological effects of accidents in this vulnerable population.

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Suicide remains a major cause of death in prison (Status report on prison health in the WHO European Region 2022). In comparison with adults from general population, incarcerated people are at increased risk of presenting suicide-related behaviours (Fazel S, et al. Lancet Psychiatry 2017; 4 946–52). Although certain studies have identified effective programs to reduce suicide in prison context (Carter A, et al. EClinicalMedicine 2022; 44 101-266), there is little evidence examining the relationship between moderators of effectiveness at individual and contextual levels.

This study aims to review empirical research on moderators of effectiveness of interventions in prison to reduce suicide, summarizing effect sizes across studies.

For this systematic review and meta-analysis, we searched EBSCOhost, ScienceDirect, PubMed and ProQuest for articles published from 1990 to 2024. Elegible studies included those evaluating the effect of psychological interventions, delivered to adults during incarceration, on suicidal prevention. The impact of moderators covering bibliometric features (i.e. year of publication, country), methodological features of the study (i.e. sample size, mean age of participants, sex ratio, study design, assessment type and tools), suicide-related features (main outcome, previous suicide history), and other relevant variables (prison type and location, type and length of sentence) as well as psychological traits (alcohol or drugs misuse or other treatments) were also included. This review was conducted in accordance with PRISMA guidelines. Meta-analyses using random-effect models were used to pool effect sizes for moderators’ outcomes. The protocol was pre-registered with PROSPERO, CRD42024538967.

Of 7728 articles retrieved, 18 studies (1695 participants, 330 [19.5%] females, 756 males [44.6%], and 609 [35.9%] unknown) met the inclusion criteria. Mean ages were 32·0 years, and ethnicity data was not sufficiently reported to be aggregated. Type of prison was mostly public sector and located in rural areas. Studies were frequently conducted in UK (n=8; 44%) and used varying study designs; most frequently pre-post with no control group (n=9; 50%). On average, prevention programs in prison context were effective in decreasing suicide deaths, suicidal ideation and self-harm (n=14; 78%).

Findings suggest that explanations for efficiency of psychological interventions to prevent suicide behaviour and self-harm in prison context, are moderated by physical environment, individual and psychosocial factors. Future research identifying what factors moderate treatment outcomes in suicide and self-harm prevention within prison environments could help elucidate associated factors of efficiency, helping develop potential therapeutic actions.

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Adults with intellectual and developmental disabilities (IDD) have higher rates of psychiatric disorders, such as depression, anxiety, and bipolar disorder, compared to the general population. Unique challenges, like cognitive impairments and communication barriers, require tailored treatments. This poster reviews strategies for managing these conditions in adults with IDD, focusing on adaptations in psychopharmacology and psychotherapy.

To outline treatment approaches for depression, anxiety, and bipolar disorder in adults with IDD, highlight limitations and necessary adaptations, and advocate for collaborative treatment models involving healthcare providers and caregivers.

A literature review identified studies and guidelines on psychopharmacologic and psychotherapeutic interventions tailored to adults with IDD, examining the effectiveness of pharmacological agents, cognitive behavioral therapy (CBT), and other adaptations.

Current treatments for depression, anxiety, and bipolar disorder in adults with intellectual and developmental disabilities (IDD) often deviate from standard protocols, requiring modifications in both pharmacological and therapeutic approaches. Depression management in IDD typically relies on selective serotonin reuptake inhibitors (SSRIs), adapted with gradual dose escalation and close monitoring due to limited data on their specific effects in this population. Psychotherapy, particularly group cognitive behavioral therapy (CBT), has shown notable efficacy, with studies reporting significant symptom reduction in treated groups. For anxiety disorders, low-dose SSRIs remain the primary pharmacological option, with cautious titration to minimize adverse effects, while benzodiazepines are generally avoided to prevent paradoxical responses and disinhibition. CBT-based interventions, including graduated exposure therapy customized for specific phobias or triggers, show promise, though further randomized trials are warranted. Managing bipolar disorder in IDD is particularly challenging due to the heightened risk of severe functional impairment and symptom overlap, with mood stabilizers like lithium and antipsychotics administered sparingly given potential metabolic and neurological side effects. Given limited research, clinical strategies often rely on individualized treatment plans informed by provider expertise and patient-specific needs.

Treatment for psychiatric disorders in adults with IDD requires significant adaptation, with careful dosing and monitoring of medications to minimize adverse effects. Evidence supports CBT as an effective option, yet there is a critical need for more research, especially randomized trials, to develop more robust guidelines specific to this population. Close collaboration between healthcare providers and caregivers is essential for successful outcomes.

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Handwriting is mainly a motor process involving an efficient level of motor organization lead-ing to fine coordination of movements, thus, children with developmental coordination disorder (DCD) are particularly affected with handwriting disorders.

We aimed to investigate handwriting disorders in DCD children in order to better understand the semiology of dysgraphia.

Data from 65 children aged 5 to 15 years (mean age 8.9 years, SD = 2.5) with DCD were collected on DSM-V criteria. They had no other medical or psychiatric condition and born full-term. They were assessed with handwriting testing and standardized assessments of neuropsychological, neurovisual, MRI and neuropsychomotor functions (NP-MOT neurodevelopmental battery), including muscular tone examination. Particular attention was paid to minor neurological dysfunctions (MND) which can be detected with the NP-MOT battery, such as a mild phasic stretch reflex (PSR).

Findings showed a high rate of visual perceptual motor, visuo-spatial, and visuo-constructional impairments (> 82%), visual pursuit disorders (93%) and 89% of handwriting disorders (HD, n=58). Among these HD, there are 83% of poor handwriting (PH) and 17% of dysgraphia (DysG). Moreover, we found in HD, 36% of PSR (with 29% in PH vs 70% in DysG) correlated to imbalance of axial tone (hyper-extension) associated with increase of neuropsychomotor disorders such as dissonance between spontaneous gestural, usual and psychosocial lateralities (P = 0.03), impairments of coordination between upper and lower limbs (P = 0.001), impairments of manual dexterity (P < 0.001), impairments of dynamic balance (P = 0.002), and dysdiadochokinesis (P < 0.001). Comparing PH and DysG groups, dysgraphia is associated to PSR (P = 0.04). 38% of abnormal MRI scans were heterogeneous and non-specific to the level of handwriting disorder and to PSR.

Dysgraphia appears to be a singular disorder as a comorbidity of DCD, which is significantly associated with a high incidence of motor impairments, suggesting a disturbance of the motor pathway (mild distal spasticity of the pyramidal corticospinal tract dysfunction). The presence of MND such as PSR highlights a mild impairment of the motor voluntary movement from the premotor cortex. PH appears primarily due to an immaturity of handwriting gesture consecutive to disorders of coordination programming in DCD.

Dysgraphia should be assessed not only with a simple handwriting test (legibility and speed) but completed with a developmental standardized physical neuropsychomotor examination assessing the presence of MND because to know the nature of the disorder is useful in clinical decision-making processes for handwriting remediation.

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Children in special education schools are particularly susceptible to developing mental health issues. Specifically, it is estimated that 40% of individuals with intellectual disabilities have a comorbid mental disorder diagnosis (1). However, access to mental health services for patients with intellectual disabilities remains far below expectations. Numerous barriers impede this access, including a lack of coordination between professionals and service providers responsible for their care (2).

Therefore, interventions within special education schools, promoting early detection and intervention for psychopathology and facilitating coordination between educational and healthcare services, are critically important.

We present an innovative mental health care resource designed for special education schools in the Community of Madrid, Spain. This initiative combines multi-disciplinary expertise with flexible, hybrid care delivery to ensure accessibility for students across 14 public schools. The team consists of a psychiatrist, a clinical psychologist, and a mental health nurse who provide both in-person and remote assistance, addressing the psychopathology exhibited by their students.

Preliminary results suggest that this intervention has the potential to improve early detection rates of mental health issues and foster better coordination between education and healthcare systems. This model could serve as a blueprint for similar programs worldwide, addressing significant gaps in mental health care for children with intellectual disabilities.

(1) Cooper, S. A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. The British Journal of Psychiatry, 190, 27–35. https://doi.org/10.1192/bjp.bp.106.022483

(2) Whittle, E. L., Fisher, K. R., Reppermund, S., Lenroot, R., & Trollor, J. (2017). Barriers and enablers to accessing mental health services for people with intellectual disability: A scoping review. Journal of Mental Health Research in Intellectual Disabilities, 11(1), 69–102. https://doi.org/10.1080/19315864.2017.1408724

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Alcohol consumption of mothers can lead to problems in emotional and behavioural development of children. However, less is known about the effects of paternal alcohol drinking.

We aimed to investigate whether maternal or paternal alcohol consumption during pregnancy longitudinally affected children’s mental health.

We analyzed a total of 2,013 parent-child triads (52% of children were males) from the European Longitudinal Study of Pregnancy and Childhood. Data on alcohol consumption was obtained from questionnaires from both parents during pregnancy and after the child’s birth. Mental health and behaviour of children was assessed with Strength and Difficulties Questionnaire (SDQ) at ages 7, 11, 15, and 18 years old, as reported by mothers and children themselves. The associations were tested using linear regression, adjusting for parent’s age at child’s birth, child’s sex, and other socio-demographic and psychosocial covariates. We also tested an interaction between the exposure and children’s sex.

Maternal alcohol consumption was associated with higher total SDQ scores at ages 7, 11, and 18 years old when the outcomes were reported by mothers, but only at 11 when reported by children. We did not observe any dose-response relationship, and the effect size did not change during the follow-up. Results of the linear regressions are displayed in Table 1. We did not detect any effect modification by child’s sex. The effects were observed across various domains of SDQ (except for the peer problems subscale): in the emotional symptoms subscale at age 11 when reported by both mother and child, in the conduct problems subscale at ages 7 and 11 when reported only by mother, in the hyperactivity/inattention subscale at age 18 when reported only by mother. Paternal alcohol consumption was not associated with the total SDQ score.Table 1

Association of maternal alcohol consumption with the total score of Strength and Difficulties Questionnaire

* p-value < .05. The reference category is no alcohol consumption. Results are from a fully adjusted model.

Maternal alcohol consumption has a long-term effect on children’s mental health in particular when reported by mothers. Interventions preventing maternal alcohol consumption during pregnancy may protect children’s mental health.

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Psychological First Aid is (thankfully) not something most people use daily – yet it’s crucial for responders to be trained, confident and fully prepared for unexpected emergencies. So how can we ensure this readiness? The answer is AI avatars in virtual reality! At VirtualSpeech, in partnership with Region Västra Götaland, we’ve developed AI roleplay simulations that enable crisis and emergency teams to not only practice their psychological support skills but also receive personalized feedback on their performance and tips for improvement.

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Germany is one of the countries that has taken in a large number of refugees. Around 2.25 million now have recognised protection status in Germany. In addition, Germany has taken in over 1,215,048 refugees from Ukraine. All of these people are very vulnerable refugees who are exposed to many risk and stress factors before, during and after their migration. As a result, they have a high prevalence of mental disorders such as post-traumatic stress disorder (PTSD), depression, anxiety, substance use and persistent grief disorder. At the same time, refugees face numerous barriers to accessing medical care, such as language and cultural barriers, administrative barriers, structural, institutional and interpersonal discrimination and racism. There is also unequal treatment in Germany between refugees from Ukraine and other regions of the world. In addition, healthcare provision has recently been tightened due to changes in the Asylum Seekers’ Benefits Act. This presentation will focus on the sitaution in Germany and discuss üossible solutions.

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Schizophrenia is a severe mental disorder linked to a life expectancy 15-20 years shorter than the general population1, due to higher rates of cardiovascular disease, cancer, metabolic disorders, and increased risk of suicide and accidental deaths2.

This study aims to analyze survival and causes of death in a cohort of schizophrenia patients over a 10-year period, providing insights into mortality patterns in this population.

This 10-year retrospective study followed 635 schizophrenia patients, aged 18 or older, enrolled from 2010 to 2013 at the Clinical Hospital of Psychiatry and Neurology, Brasov, Romania. Patients with schizo-affective or other psychotic disorders were excluded. Data included demographics, clinical history, and survival outcomes, with causes of death confirmed by a Forensic Medical Specialist.

The study included 635 patients diagnosed with schizophrenia. The mean age at baseline was 48,01 ± 11.36, 42.04% were males, and the mean age of onset of schizophrenia was 26.68 ± 8.01.The average duration of illness was 21.27 ± 11.41 years. Among the cohort, 20.31% patients were treated with LAIs antipsychotics, and 17.16% were on clozapine. Of the 635 patients followed, 123 (19.4%) died during the 10-year follow-up. The average age at death was 59.04±11.96. According to the 2023 Eurohealth report and the World Health Organization, the overall life expectancy in Romania is 76.3 years 3. The data on schizophrenia patients suggests a significant disparity between their average age at death and the overall life expectancy in Romania. Schizophrenia patients in Romania live, on average, about 17 years less than the general population. Of the deceased, 13% died in psychiatric wards, and 17.88% were in chronic care at the time. Among the deceased patients, 18 were on typical antipsychotic LAIs. None of the patients in the deceased cohort were on atypical LAIs. Cardiovascular disease was the leading cause of death (27.64%), followed by infections (17.07%) and cancer (12.19%). Metabolic causes accounted for 4.06%, respiratory for 1.62%, hepatic for 3.25%, and both neurological and gastrointestinal causes for 0.81%. The cause of death was undetermined in 15.45% of cases. Violent deaths accounted for 17.07% of cases, with 8 suicides and 13 accidents. Out of the 13 accidental deaths, 7 were due to choking-related asphyxiation during eating. Four of these patients were on haloperidol, 2 on quetiapine, and 1 on flupenthixol.

The 17-year lower life expectancy for schizophrenia patients highlights the urgent need for targeted public health interventions and improved preventive care. Additionally, the high mortality from cardiovascular disease, cancer, and infections, along with choking-related risks from antipsychotic medications, underscores the importance of careful medication management to enhance patient safety and survival.

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The postpartum period is critical for the onset of mood disorders. Three primary postpartum affective disorders are recognized: baby blues, postpartum depression, and postpartum psychosis, each differing in prevalence, presentation, and treatment. Obstetric factors like primiparity, complications during pregnancy and birth, Cesarean sections, and preterm births are associated with increased neuropsychiatric risks during the puerperium.

This study analyzes the demographic, clinical, and obstetric factors linked to postpartum psychiatric disorders and case management in women hospitalized at the Hospital of Psychiatry in Chisinau, Moldova, over a five-year period.

A longitudinal, retrospective study was conducted, reviewing medical records of 35 women hospitalized between 2019 and 2024. A literature review was also performed to identify relevant obstetric and clinical risk factors.

Patients ranged from 20 to 41 years old, with an average age of 29.8 years ±1,5 years. Out of reviewed cases, 42.9% were from urban areas, 25.7% had a family history of psychiatric illness, and 54.3% developed postpartum psychosis after their first birth, suggesting primiparity as a key risk factor. Psychosis onset ranged from three days to two months postpartum in 45.7% of cases, with 37.1% showing symptoms within the first two weeks. Comorbidities included cardiovascular diseases (20.0%), digestive disorders (14.3%), renal issues (8.6%), and autoimmune conditions (2.9%). Severe mental and behavioral disorders (F53.1) were diagnosed in 74.3% of cases, while 25.7% had milder forms (F53.0). First-time hospitalizations accounted for 88.6%, but 48.6% had prior hospitalizations, with later diagnoses evolving into paranoid schizophrenia, schizotypal disorder, and recurrent depression. Psychological consultation was provided in 48.6% of cases, using tools like PHQ-9, TAG, MMPI, BDI. Treatment varied significantly, with antipsychotics, antidepressants, and benzodiazepines prescribed, yet no standardized protocol was followed.

Primiparity is a significant risk factor for postpartum psychiatric disorders, with early onset often occurring within the first two weeks. This underscores the critical need for prompt recognition and intervention. Comorbid disorders add complexity to patient management. The variability in pharmacological and nonpharmacological treatment highlights a gap in evaluation and case management, potentially delaying timely diagnosis and treatment and it emphasizes the need for consistent and standardized guidelines. The evolving nature of diagnoses, reinforces the importance of ongoing monitoring, psychoeducation, and psychological support throughout the postpartum period.

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Behavioral addiction is well-established for gambling but still debatable for other pleasurable behaviors such as eating. Attachment style is defined as a psychological concept describing the dynamics of human interpersonal interactions. Studies investigating the influence of attachment style on food addiction are rare.

The aim of the study was to evaluate the association between food addiction and the quality of attachment

A cross-sectional study was conducted online with a non-clinical population. All participants completed an anonymous e-questionnaire containing sociodemographic data, background, substance use and self-reported weight and height. Attachment style was assessed with the Relationship Scale Questionnaire (RSQ). Food addiction was screened with modified Yale food addiction scale questionnaire (mYFAS 2.0).

A total of 114 individuals had fully responded to the questionnaire. The mean age was 32.28 ± 9.32 years with a sex ratio of 0.48. The mean BMI was 23.7 kg/m2 ± 5.5. Most of participants (64%) had an insecure attachment style and 36% had a secure one. The results of the mYFAS 2.0 showed that 11.4% of participants had a food addiction and 8.8% had a severe form. BMI was significantly associated with food addiction which was more common in participants who had a BMI greater than 22.2 kg/m2. A statically significant association between insecure attachment style and food addiction was found.

Our study showed the importance of studying attachment style in food addiction. More research is needed to prove the association between food addiction and different attachment styles.

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Autism Spectrum Disorder is usually diagnosed in early childhood, but an increasing number of adults are identified as autistic later in life (Huang et al., 2020). Many experience frustration due to missed early intervention opportunities. The lack of recognition of their condition during childhood or adolescence may have contributed to secondary mental health issues, such as anxiety, depression or low self-esteem, complicating the adjustment process after diagnosis (Bargiela et al., 2019). However, providing appropriate support can enhance their quality of life and promote better mental health outcomes.

To assess the patient’s clinical case to identify autism spectrum disorder in older adulthood.

A 23-year-old male patient complained of an inability to concentrate, stress and fear when around people, and difficulties in social situations. Objectively observed: stereotyped movements, noticeable anxiety, avoidance of eye contact, non-compliance with social rules, specific language use and slow thinking. The patient had no history of diagnosed psychiatric illness. Since childhood, he has disliked the feeling of clothes touching his body, physical contact with others, making eye contact. The patient also exhibited impaired social development, being unable to initiate and maintain relationships with peers. Stereotypical, repetitive movements, sensory processing deviations have been observed since childhood. The patient has various phobias from a young age. Psychological examination revealed insufficient attention with observed fluctuations, impaired attention-shifting ability. The pace is very slow, the thinking is characterized by an average level of generalization, concreteness, and stereotypy. Personality traits included rigidity, depression, compulsiveness, internal tension. Based on the clinical picture and psychological tests, the patient was diagnosed with F84.0 Autistic Disorder, according to the International Classification of Diseases, 10 th Revision. In this case, the following methods were used in the assessment: Kraepelin’s and Schulte’s methods, pictograms, the 4-1 method, the Childhood Autism Rating Scale.

The literature highlights that ASD involves difficulties in social interaction, repetitive behaviors, sensory sensitivities, and distinct thinking patterns. Up to 90% of individuals with ASD experience sensory irregularities, which is consistent with this case, as the patient shows social challenges, repetitive movements, slow thinking, and sensory issues. Diagnosing autism in adulthood can improve quality of life by fostering understanding and access to support. In this case, the patient’s past social and workplace difficulties may be attributed to autism, guiding the development of effective support strategies.

In conclusion, while a late autism diagnosis can be life-changing, it also comes with unique challenges that must be addressed through appropriate support.

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Xp11.22 duplication syndrome, a rare genetic condition first identified in 2009, has fewer than 100 documented cases in the literature. To date, little is known about the genotype-phenotype relationship in this rare genetic syndrome and there is a paucity of data specifically regarding catatonia in this condition.

The primary aim of this case report is to provide a comprehensive description of the clinical presentation, diagnostic approach, and management strategies employed in a case of catatonia occurring in the context of Xp11.22 duplication syndrome and ASD.

Methods of this case report include assessment of the patient via thorough psychiatric and medical evaluation, as well as additional information obtained through chart review and collateral sources.

Our patient, a 15-year-old Caucasian male, was diagnosed with Xp11.22 duplication syndrome at age 3 due to speech and motor delays. At 14, he experienced sudden behavioral and motor changes, including withdrawal, repetitive speech, slowed gait, and repetitive motor behaviors like “rewind” actions. Over 3 months, symptoms included emotional lability, self-injurious behaviors, and significant disruption to daily functioning. Outpatient management with olanzapine and quetiapine worsened agitation. Referred to a specialist, he was started on lorazepam up to 12 mg daily for suspected catatonia. ECT was considered, but further workup ruled out seizure disorder and autoimmune encephalitis. Pediatric neurology found no alternative etiology and recommended ECT. On admission, BFCRS score was 14, showing catatonic symptoms like automatic obedience, mutism, and immobility. Lorazepam was reduced to 2 mg three times daily, and amantadine 100 mg twice daily was continued. An acute ECT course of 12 bilateral treatments over four weeks reduced catatonic symptoms, improving mutism, motor speed, and daily activities. During a 56-day hospitalization, he received 7 maintenance treatments. Upon discharge, BFCRS decreased to 7, and he continued lorazepam and amantadine.

This case report underscores the complexity of managing catatonia in patients with Xp11.22 duplication syndrome and ASD, highlighting the potential need for multimodal treatment approaches. The significant improvement observed with the addition of ECT to the treatment regimen emphasizes the importance of considering this option in cases of refractory catatonia, even in patients with complex genetic and neurodevelopmental backgrounds. This case raises important questions about the underlying neurobiological mechanisms of catatonia in the context of Xp11.22 duplication syndrome and ASD.

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Hypericum spp., particularly Hypericum perforatum (such as St. John’s Wort), produce hypericin and hyperforin, secondary metabolites that play critical roles in the plant’s defense mechanisms. These compounds, characterized by their polycyclic and lipophilic properties, have evolved to deter herbivores and protect against pathogens. Understanding the evolutionary pressures that shaped these compounds enhances our knowledge of their biochemical roles.

This review aims to synthesize current knowledge on the evolutionary development of hypericin and hyperforin within the Hypericum genus, focusing on how these metabolites evolved to fulfill defensive ecological functions.

A comprehensive literature review was conducted, examining phylogenomic studies, structural analyses, and biochemical research related to the biosynthesis of hypericin and hyperforin. We reviewed relevant phylogenetic data to understand the diversification of these compounds across Hypericum spp.

The literature supports that hypericin and hyperforin evolved in response to selective pressures during the Cretaceous-Paleogene boundary, with their complex polycyclic aromatic structures optimized for defense. These structures, which include conjugated π-systems, are central to the compounds’ ability to deter herbivores and resist pathogens, reflecting an evolutionary adaptation that is conserved across the genus.

The evolution of hypericin and hyperforin within Hypericum spp. is a prime example of how secondary metabolites serve dual purposes in nature and human use. The phylogenetic and biochemical insights reviewed highlight the importance of these compounds as both ecological defenses and pharmacologically active agents.

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Personality disorders are often comorbid with anxiety and depression disorders, complicating the diagnostic process. Cancer patients with personality disorders who face the anxiety and discomfort associated with the diagnosis, symptoms, and medical treatment may encounter challenges. They might distort reality as a means of emotional self-preservation or display aggression.

This review seeks to delve into the challenges in cancer patients exhibiting dysfunctional personality traits or personality disorders.

A non-systematized literature review was carried out on PubMed and Google Scholar. The following terms were searched: (“personality disorders” OR “personality traits”) AND (“cancer” OR “cancer patients”).

Personality traits persistently influence behavior patterns, choices, environmental interactions, and stress responses. Personality can impact cancer development and progression through multiple avenues: by perpetuating unhealthy lifestyle behaviors rooted in personality traits; through negative affect such as depressive or anxious symptoms, as well as ineffective coping mechanisms; and by serving as an etiological factor for somatic diseases or mental disorders that predispose individuals to cancer. While some epidemiological studies have reported a positive association between personality and cancer development or progression, the majority find no significant correlation, leading researchers to conclude that there is no substantial link between personality and an increased risk of cancer.

Meeting the diverse challenges associated with cancer requires adaptability, flexibility, and resourcefulness. Research suggests that specific personality traits, like neuroticism and negative affectivity, are linked to lower quality of life among cancer patients, while extraversion and optimism are correlated with more favorable outcomes.

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The onset of the COVID-19 pandemic necessitated the declaration of a global emergency. The pervasive fear of contagion has transformed daily life practices, and lockdown measures globally implemented to mitigate virus transmission have led to a spectrum of adverse psychological effects, including anxiety, sadness, frustration, disorientation, and potential for post-traumatic stress disorder, significantly affecting mental health.

This study aims to evaluate the psychological effects of the COVID-19 pandemic on the well-being of trainee teachers.

A descriptive analysis was conducted on a cohort of 370 Moroccan trainee teachers, with a mean age of 28.30 ± 5.99 years. Data were collected using a self-administered questionnaire designed to assess the presence and extent of psychological distress, along with sociodemographic and professional characteristics, during the lockdown.

The findings revealed that 65.1% of the confined trainees experienced obsessive tendencies, and 40% reported that their daily activities were restricted, affecting their normal life pursuits. Furthermore, 68.3% expressed moderate to high stress levels due to various factors, such as financial and professional concerns, potential loss of family members, or personal hospitalization. Half of the trainees expressed concern for their future prospects and feelings of ennui during these unprecedented times.

The findings reveal the enduring psychological impacts of the COVID-19 pandemic on trainee teachers, with significant stress and psychological disorders noted. This emphasizes the critical need for targeted mental health support and proactive resilience-building within educational systems, not only aiding recovery but also preparing educators for future pandemics.

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