The clinical high-risk for psychosis (CHR) is mainly established by the presence of attenuated positive symptoms (APS), but there is evidence of the role of attenuated negative symptoms (ANS) in the development of psychotic spectrum disorders. It is important to establish a link between APS and ANS in patients at CHR in order to improve early detection of psychosis.

Establish the relationship between APS and ANS in depressive patients at CHR.

130 depressive young in-patients at CHR with APS (average age 19.5) and 71 ones with ANS (average age 19.5) were examined. The HDRS scale was used to assess depressive symptoms, the SOPS scale was used to assess APS and ANS, and the SANS scale was used to assess ANS. The results are presented in median values.

No differences were found between two groups in the severity of depressive symptoms on the HDRS scale and CHR symptoms on the SOPS scale (22 vs 23.5 and 45 vs 43 respectively). Statistically valid differences have been established between the groups in the APS severity on the sub-scale of positive symptoms SOPS: 11 and 7 (p 0.001). No differences in the ANS severity on the sub-scale of negative symptoms were detected (17 and 18.5, p=0.207). There were also no differences in the ANS severity on the SANS scale (40 and 47, p=0.163).

It has been established that patients at CHR with APS also have ANS, which may have clinical significance for early detection of psychosis.

No significant relationships.

Despite the long history of burnout studies, the problem of burnout among psychiatric specialists in Russia is insufficiently studied. The risk of burnout is the highest among psychiatrists in the first 10 years of their career.

To assess the prevalence and severity of burnout in early career psychiatrists (ECPs) in Russia.

An anonymous online survey of ECPs in Russia was conducted in July-August 2019 with a screening for burnout using the Maslach Burnout Inventory (MBI). The final sample consisted of 165 people (61.2% women; mean age 31.05±3.88). 95.2% of respondents lived in urban areas.

A high level of burnout according to at least one of the MBI scales was revealed in 71.5% of ECPs: in 79 (78.2%) women and 39 (60.9%) men (χ2(1)=5.74; p=0.017). Mean values of the MBI Emotional Exhaustion scale corresponded to 23.33±8.97 and 17.97±8.49 (U=1999.5; p=0.003), the MBI Depersonalization scale – 10.46±4.81 and 9.16±4.22 (U=2598.5; p=0.083), and the MBI Personal Accomplishment scale – 33.02±5.98 and 35.32±5.75 (U=2409.5; p=0.026) for women and men, respectively. The following risk factors for professional burnout were identified: female sex (OR=3.54 [95% CI: 1.96; 6.39], p<0.001), overlapping of several working positions (OR=2.44 [95% CI: 1.36; 4.37], p=0.003), difficulties in work due to changes in documentation requirements introduced since the start of career (OR=2.32 [95% CI: 1.31; 4.11], p=0.004).

A high frequency of burnout among ECPs in Russia was revealed which suggests the urgent need for studies assessing the ways to prevent burnout in psychiatrists in Russia.

No significant relationships.

Diabetes has been associated to affective disorders and mental health problems which complicate the management of the disease. Emotional intelligence (EI), or the ability to perceive, facilitate, understand and regulate emotions has shown to be a protective factor of emotional disorders in general population.

To evaluate the role of EI and EI training in the biological and psychological variables related to people with Type 1 and 2 diabetes.

A systematic review was conducted in PubMed and Scopus database without time limitations, for studies examining the link between diabetes and EI. A total of 11 eligible studies were selected according to the inclusion criteria.

We divided the results into four sections: 1) EI and HbA1c, 2) EI training effects, 3) Differences in EI between persons with diabetes and without diabetes, and 4) EI and psychological adjustment and well-being. The results showed negative correlations between EI and HbA1C, positive effects of EI training on quality of life, anxiety and glycaemic control, no differences in EI between people with diabetes and healthy individuals and, finally, negative correlations between EI and different psychological variables such as diabetes-related anxiety and distress, and positive correlations with quality of life, well-being and marital satisfaction.

EI appear to be a promising protective factor for biological and psychological variables in individuals with diabetes. This systematic review offers a starting point for a theoretical and practical understanding of the role played by EI in the management of diabetes. Limitation and future lines of investigations will be discussed.

No significant relationships.

Nefashot - (meaning “Souls” in Hebrew) is a social activist initiative that aims to promote mental health (MH) awareness in the public domain through cultural, artistic, and dialogue-based events.

The two main objectives of this project are: to raise awareness and promote dialogue about MH issues in the public sphere and to create an inclusive environment for people living with MH conditions where their voices can be heard.

For this purpose, we have created a week of events around the international mental health day on October 10th. Our strategy for producing the MH week is by 4 stages: 1) Call for action which is published widely on social media 2) Collection of forms filled, connections and personal accompaniment 3) Event directed accompaniment, and group meeting around common topics 4) Publication as a group to strengthening the sense of belonging and enhancing community visibility.

Our 80 events over the last three years have been organized by creators, artists, people with and without mental illness, family members, and professionals. Participants are extended in the event production by geographical location, type of art or culture event, type of relation to MH (for example, family member) and by social groups (Arabic/English speakers, LGBT), as well as collaborations within the group.

Promoting MH through public activism is ideal because it enable each participant to shape the process as well as the product. Furthermore, we find the relationship between art and MH enriching in both directions.

No significant relationships.

The 8-item Stress Mindset Measure-General (SMM-G) is an instrument designed to assess stress-is-enhancing and stress-is-debilitating mindsets. The stress-is-enhancing stress mindset positively correlates with well-being indices and work productivity and negatively correlates with depression and anxiety scores. Mindset could be changed after a psychological, psychoeducational, or psychotherapeutic intervention.

We aim to adapt the SMM-G for adolescents and to explore its factor structure and psychometric properties in a sample of Russian students.

A total of 564 Russian students (337 men, 229 women) from 9 universities aged 17 to 23 years (М=19,9) participated in the study. We computed reliability indicators, conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Psychometric indicators are shown in Table 1. As a result of EFA (maximum likelihood, varimax rotation), two factors (eigenvalues 3,430 and 1,645) were extracted, accounting for 42,9% and 20,6% explained variance. Then, we tested the proposed model via CFA (Table 2).Table 1.

Psychometric indicators

The first factor includes all odd-numbered questions, while the second factor contains all even-numbered questions. This is consistent with the questionnaire’s structure, leading to a natural interpretation of factors as the stress-is-enhancing and stress-is-debilitating mindsets.Table 2.

CFA results

Russian adaptation of SMM-G has shown good psychometric characteristics and constitutes a useful assessment instrument.

No significant relationships.

Evidence suggests that besides having stigmatizing misconceptions towards people with mental illness, medical students and doctors often resist seeking help for their own mental issues. This is a vulnerable group for stress and other mental health problems, due not only to professional burden but also high perfectionism and low self-compassion.

To analyse the relationship between mental health stigma (MHS) and other variables related to personality and emotional states in a sample of medical students.

634 medicine and dentistry students (mean age = 21.6±6.9;81.4% female) answered to a survey including sociodemographic data, self-perception of psychological health/SPPH and the Portuguese validated versions of: Link’s Perceived Discrimination and Devaluation (PDD) scale to assess MHS and its two dimensions - social stigma/SocS and self-stigma/SelS; Depression Anxiety Stress Scale (DASS-21); Neff’s Self-Compassion Scale (SCS); and Big Three Perfectionism Scale (BTPS). Correlations, t-student tests and linear regressions were performed with SPSS 27.0.

Stigma correlated negatively to SPPH and positively to DASS, the negative poles of SCS (self-judgement, isolation and over-identification) and BTPS second-order factors (all from p<.05 to p<.01). No gender differences in MHS were observed. Participants with higher mean levels of total and SelS had significantly higher scores in all DASS dimensions and lower SPPH; participants with higher SocS also scored higher in DASS, but didn’t reveal lower SPPH. Isolation was a significant predictor of SocS (R2=2.8%;p<.05); isolation and narcissistic perfectionism were significant predictors of SelS (R2=11%;p<.01).

Our results highlight the importance of including MHS as a main need in the curricula of future doctors.

No significant relationships.

Mental health problems (MHP) are common among elite athletes (EA) and have received increased attention recently, revealing the need to assess them properly. Although EA are increasingly speaking out on their own MHP in public, research-informed approaches for practitioners are still lacking.

We aim to perform an overview of the MPH among EA, emphasizing the potential risk factors and interventions.

We conduct a non-systematic review of the recent evidence on the topic using PubMed/Medline database.

Although EA have comparable prevalence rates of MHP to the general population, they are exposed to various sports-related stressors. Studies reveal that 50% of EA face MHP during their career, with onset peak around 19 years. Therefore, there is a need for early detection and intervention. Burnout, alcohol abuse, anxiety, depression, insomnia and eating disorders are some MHP reported. Their management should address psychosocial and environmental aspects. Psychoeducation and psychotherapy are considered the first line treatment. Moreover, EA may encounter barriers to seeking mental healthcare. Therefore, it is important to promote positive attitudes about MHP, create an environment that supports mental well-being, resilience, psychological flexibility, self-compassion and coping skills. Screening tools may facilitate the process, so there is a need for validated athlete-specific questionnaires for MHP screening and measuring.

Mental health is an integral dimension of EA wellbeing and performance and should be assessed. Specific programs to support EA mental health are recommended and research targeting common MHP for athletes are needed to better understand how to minimize their distress.

No significant relationships.

Insomnia and Nightmare disorder are the two most common comorbid sleep disturbances in psychotic conditions. However, insomnia and psychotic symptoms are umbrella terms that hide the heterogeneity of these concepts. Several studies have found that worsening sleep quality is associated with the strengthening of psychotic symptoms. Until now, there was less interest in the relationship between the specific insomnia symptoms (trouble with falling asleep, fragmented sleep, early awakenings, daytime consequences) and the specific dimensions of schizotypy (disorganization, unusual perceptual experiences, anhedonia, and impulsive nonconformity).

The study aimed to depict the network structure of insomnia, dreaming features (dream recall/bad dream/nightmare frequency), and schizotypy dimensions.

Exploratory network analysis was conducted on cross-sectional data of the general population (N=1419, 77 % female). We modeled the interrelations between insomnia symptoms (Athens Insomnia Scale), dreaming features (the frequency of dream recall/bad dreams/nightmares), and the dimensions of schizotypy (OLIFE-S).

show a highly connected network with strong stability. The nodes of schizotypy, insomnia, and dream feature perfectly correspond to their own clusters, but the nodes were also densely connected between the three clusters. Disorganization, frequent awakenings, and nightmares are the most central nodes of the clusters. The node of frequent nightmares seems to be the bridge symptom in this network which connects unusual experiences dimension and frequent awakenings.

These results suggest that specific dimensions of schizotypy and specific sleep complaints are differently connected. However further research is needed to investigate the finer details of these heterogenic phenomena.

No significant relationships.

Clozapine has proven to have a unique efficacy on treatment-resistant schizophrenia (TRS). Nevertheless, studies show that 47%-63% of clozapine-treated patients may fail to respond after around 12-years of treatment (CRS). Several augmentation strategies have been proven to be effective in CRS.

Hereby, we present two clinical cases of CRS successfully managed with brexpiprazole augmentation.

A 48-year-old man without comorbid substance use, treated with clozapine-brexpiprazole augmentation, and a 20-year-old man with comorbid substance use, treated with clozapine-brexpiprazole combination and subsequently with twice-injection aripiprazole (TIA). They were administered with the following assessments at t0, t1-3 (first month), t4-8 (monthly until 6-month follow-up): CGI, BPRS, PANSS, CDSS, Craving VAS, BARS, BIS-11, HRS-A, MADRS, YMRS, AIMS.

At 1-month follow-up, both patients showed a considerable improvement (respectively 75% and 55.9% reduction of PANSS total score). At 6-month follow-up, reached only with the first patient, we noticed a further improvement (an overall 37.5% reduction of PANSS total score from the baseline).

The present work is the first report describing combination treatment strategies with clozapine and brexpiprazole which appear to give promising results.

No significant relationships.

Women present a second peak of incidence of psychosis during menopausal transition, partially explained by the loss of estrogen protection conferred during the reproductive years. Despite this, few studies compare sociodemographic, biological, clinical varibles and neurocognitive performance between women with early onset of psychosis (EOP) and those with late onset of psychosis (LOP).

Our aim was to characterize both groups in a large sample of women, of which 294 were FEP patients (EOP = 205; LOP = 85) and 202 were healthy controls (HC) grouped following cutoff point (<>40 years of age) in previous studies.

Clinical and laboratory assessments were completed. Neurocognitive performance was also evaluated, and a cognitive global deficit score (GDS) was derived. ANCOVA was used for comparisons.

EOP women were more frequently single and unemployed than comparable HC. Cholesterol levels in LOP women were higher than those of EOP women. LOP presented less severe symptoms, and higher scores in processing speed and premorbid IQ than EOP patients. Cannabis and alcohol use were also more frequent in EOP than LOP women.

Women with EOP and LOP show several sociodemographic, neuropsychological and clinical differences which may be valuable for planning personalized treatment emphasizing in socialization and differential generational dynamics. Some of these differences may be due to the aging process, while others might be influenced by factors such as lack of estrogen neuroprotection. In turn, drug consumption, low IQ and recent experienced trauma could as well reduce efficacy of hormonal neuroprotection.

No significant relationships.

According to current knowledge inflammation seems to be strongly associated with pathogenesis of schizophrenia. Multiple studies and meta-analyses showed increased levels of inflammatory markers in plasma of schizophrenia patients. Individual studies have shown a relationship between the levels of inflammatory markers and the presence of deficit syndrome, but their results are inconsistent.

Analysis of associations between inflammatory markers and the presence of deficit syndrome in schizophrenia.

Studied group consisted of 50 patients with diagnosed schizophrenia (F20) for at least 10 years, including 14 patients with deficit schizophrenia (DS) and 36 patients with non-deficit schizophrenia (NDS). DS and NDS did not differ significantly in age, BMI, duration of schizophrenia, types and doses of antipsychotics (chlorpromazine equivalent), but differed in sex (x2=4.28,p=0.039). Concentrations of inflammatory markers i.e. IL-6,IL-8,IL-10,TNFα,IFNγ,CRP were measured in serum using sensitive ELISA assays.

Initial analysis showed significantly lower concentration of IL-8 in DS compared to NDS (t=-3.18,p=0.002). This association remain significant (F=7.63,p=0.0085) after co-varying for age, sex, BMI, duration of schizophrenia, type of antipsychotic medications and antipsychotics doses. Multiple logistic regression showed that female gender (OR=0.18 [0.04-0.87],p=0.034) and higher IL-8 concentrations (OR=0.03 [0.002-0.39],p=0.007) are independent predictors of lower odds of having DS.

Low IL-8 concentrations seem to be promising predictor of the presence of DS in schizophrenia patients, but results need further investigations. The research was funded by Polish Minister of Science and Higher Education’s program named “Regional Initiative of Excellence” in 2019–2022, grant number 002/RID/2018/2019 to the amount of 12000000PLN and by National Science Centre, Poland (2019/03/X/NZ5/00719)

No significant relationships.

Schizophrenia is a psychotic disorder strongly associated with suicidal behaviour up to 20-50 times higher than those in the general population. However, treatments from primary healthcare workers and mental health specialists may improve daily function and increase recovery.

Our study aims to investigate if the frequency of interactions with healthcare specialists affects suicidal ideation for patients with schizophrenia.

84 patients diagnosed with schizophrenia spectrum disorder were recruited from the Centre of Addiction and Mental Health (CAMH) in Toronto, Canada. Patient medical charts were reviewed to determine the number of therapeutic interactions in two periods: up to three months from baseline, and retrospectively 3 months before baseline.

19 patients with worsening suicidal ideation had an average of 5.1 more visits following baseline (SD = 6.94), compared to 64 patients with non-emergent SI had 12.0 more visits following baseline (SD = 18.8).

Patients with worsening suicidal ideation had fewer visits from healthcare professionals as compared to those without worsening suicidal ideation. However, further research is necessary to determine the correlation between healthcare visits and suicidal ideation in this population.

No significant relationships.

We present the case of a 48-year-old female patient diagnosed with schizoaffective disorder whose father passed away recently. The patient was facing an appalling mourning which was expressed in the form of behavior disorder and positive psychotic symptoms. Mourning is a natural reaction to the loss of a loved one which involves an internal world transformation, affecting both images of the self and the perceived environment.

To analyse the guidelines for mourning approach in chronic psychotic patients.

A case report is presented alongside a review of the relevant literature regarding mourning in patients with chronic psychotic conditions.

Accepting the loss, working through disruptive emotions, adjusting to a world without the deceased and finding an enduring connection with the loved one are the four tasks of mourning described by Worden. In our case, the patient was immersed in the first two tasks. Difficulties in accepting the loss, tolerating harmful emotions and establishing new affective links were observed, as well as massive projection of unbearable emotions such as sadness, anger, fear and guilt. The available literature identifies these idiosyncrasies as common in the grief processing in patients with chronic psychotic disorders.

In patients with psychosis, difficulties in symbolization, emotional processing and social bonding could have repercussions in the development of grief. However, these features do not imply a pathologic mourning. Tolerating mourning as a normal reaction in psychotic patients is needed, even if the patient expresses non-typical symptoms such as acute psychosis symptoms, hallucinations or behavior disorder.

No significant relationships.

Naming and comprehension are standing amog the basic language functions, which allow individuals to realize the communication domain of language. Naming and comprehension imparements are well-studied (Sebastian et al., 2018) in most affected patient groups (for example aphasia patients), but at the same time schizophrenia process may cause it’s specific language disorders (Andreasen et al., 1985). Adolescent age is a very sensitive period in the context of beginning of schizophrenia.

The purpose of present study was to identify which language imparement (naming or comprehension) is the most affected in adolescent non-psychotic schizophrenia in this age. Also, authors were aimed at the check of selected tool sensitivness to schizophrenia patients

Subjects of present study were patients with schizophrenia of Moscow psychiatry clinic (n=20, mean age=14,4), subdivided by DS (F20.xx, F21.xx) and syndromes (national Russian psychiatric subdivision inside the DS). All DS and syndromes were additionally qualified by the clinical professional. Following methods were used: medical history analysis (expert diagnosisqualification, syndromic analysis), Test “Quantative Language Assessment in Aphasia” (QLAA) (Tsvetkova et al., 1981), statistical analysis. QLAA consists from the 4 subtests: naming of objects (NO), actions (NA); comprehension of objects (CO), actions (CA). Answers were quantified by the 3-mark scale (0-0,5-1).

Mean QLAA NO = 14,5; NA = 14,5; CO = 16; CA = 19. Ingroup comparison using U-criteria showed that differences between NO and CA are the most significant (p<0.05). Differences in all other pairs are not so significant.

language comprehension is studied group of adolescent patients with schizophrenia is the most affected language domain

No significant relationships.

Schizophrenia is a mental disorder with a high risk of suicide, which is one of the leading causes of early death in schizophrenia patients.

It was aimed to examine the relationship between the SIRT1 gene and suicidal behavior in patients with schizophrenia, to identify specific polymorphisms and to provide individual protective approaches by predicting suicidal behavior.

100 patients with schizophrenia were included in our study. The SIRT1 gene was analyzed using the whole exome sequencing method, and 22 SNPs were identified. In addition, participants’ socio-demographic, psychiatric history, and suicidal behavior evaluation form data were recorded. A comparison was made between the two groups according to suicidal behavior.

When sociodemographic and psychiatric history of the participants were compared in terms of suicidal behavior, no significant difference was found. SIRT1 gene SNP; rs2236318; (TT genotype), rs10997870 (GG genotype) was associated about 4 times increased risk in suicidal behavior; rs41299232 (CC genotype) 3.7 times; rs7896005 (AA genotype) with 3.4 times also. Although rs201230502 (TC genotype) and rs36107781 (TC genotype) were more common in the group with suicidal behavior, they lost their significance in regression analysis due to the low number of cases.

Our study showed that schizophrenia has many risks that increase suicidal behavior , but clinical and sociodemographic data are insufficient to predict suicidal behavior. Considering the inheritability of the disease and the effect of genetics on behavior, SIRT1 gene SNP; (rs2236318, rs10997870, rs41299232, rs7896005, rs201230502 and rs36107781) genotypes were found to be associated with suicidal behavior in schizophrenia patients.

No significant relationships.

In nightmare disorder, dysfunctional emotion regulation goes along with poor subjective sleep quality, which is characterised by pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during REM phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers.

We hypothesised that cardiac variability is attenuated in participants experiencing frequent nightmares as opposed to healthy control subjects during less deep sleep stages and an emotion-evoking picture-rating task.

Based on the second-nights’ polysomnographic recordings of 24 nightmare disordered (NM) and 30 control (CTL) subjects, we examined HRV during pre-REM, REM, post-REM and slow wave sleep periods, separately. Additionally, ECG recordings of wakeful periods such as resting state before sleep onset and an emotional picture-rating task were also analysed.

According to our results, a significant difference was found in the HR of the NM and CTL groups in the nocturnal segments but not during resting wakefulness before sleep onset, suggesting autonomic dysregulation, specifically during sleep in nightmare disorder. However, despite the accelerated HR of NM subjects at night, they did not exhibit lower HRV. Regarding the emotional task, we also found a contrast between the NM and CTL subjects’ HR and HRV, which might indicate altered processes of emotion regulation in nightmare disorder, but the two groups’ subjective picture ratings did not differ.

In summary, our study suggests that there might be some trait-like autonomic changes during sleep, but also state-like autonomic responses to emotion-evoking pictures in nightmare disorder.

No significant relationships.

Insomnia is one of the most common major health issues during the COVID-19 pandemic. There has been limited evidence that showed the correlation between insomnia and COVID-19 using Google trend.

To investigate the impact of the COVID-19 pandemic on interest in insomnia, including national mental health by a Google trend analysis that implicitly represents the state of distress and concern for this pandemic.

We examined the Google trend search query data from these sleep-related keywords: insomnia, restless leg, and obstructive sleep apnea (OSA) from 1 Jan 2020 to 30 May 2020 and explored the correlation between the internet search volumes for insomnia and the cumulative number of new COVID-19 cases. In addition, we investigated the internet search pattern over time, before and during the COVID-19 pandemic.

During the early phase of the COVID-19 pandemic between January and May 2020, the Relative Search Volumes (RSV) curves showed that the cumulative number of new COVID-19 cases was significantly correlated with the rising search for these keywords linking to sleep-related conditions as follows: ‘insomnia’ (r = 0.41, p < 0.001), and ‘restless leg’ (r = 0.19, p = 0.009). However, it was not correlated with the keyword ‘OSA’ (r = -0.14, p = 0.07).

These findings emphasize the impact of the COVID-19 pandemic on insomnia and the crucial need for public mental health interventions to be offered and accessible. The Google trend could be used as a new tool for public mental health surveillance in a new normal lifestyle.

No significant relationships.

Impaired sleep quality is among the most common complaints in psychopathological conditions including psychotic states. The clinical relevance of sleep disruption is, however, notoriously overlooked and considered as a secondary symptom that automatically ameliorates if the mental problem is adequately treated. Nevertheless, research findings indicate that sleep quality has a causal role in the occurrence and maintenance of psychotic states, and instead of being merely the “nocturnal impact” of an underlying mental disorder, shows bidirectional associations with mental health complaints.

Although the majority of studies examined the links between sleep and psychosis by cross-sectional assessments, sleep quality and psychotic-like experiences both fluctuate from night to night and day to day, respectively, even in non-clinical populations. The prospective assessment of these variables hence allows for the analyses of the temporal (and intraindividual) associations between sleep and psychosis. In our studies, we examined the temporal, bidirectional associations between sleep quality and psychotic-like states.

Across three experience sampling studies with participants from the general population ( N = 73 / 166 / 60), we assessed sleep quality and daytime psychotic-like phenomena every day for at least two weeks. Using mixed-effects models, we examined if sleep quality predicted psychotic-like experiences the following day, and also if psychotic-like experiences predicted sleep quality the following night.

Our findings consistently highlight the dominant direction of prediction from sleep to daytime psychotic-like experiences, whereas the inverse direction is not supported by enough evidence.

Individuals at risk for psychosis could benefit from sleep-specific interventions that could be integrated into treatment protocols.

No significant relationships.

Pharmacological and cognitive neuroenhancement refer to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers, to enhance cognition, mood, work or school performance, or to promote pro-social behaviour. Literature on the topic is meagre, and available data only partially enlightens their use.

The aim of this paper is to review and comment on the available literature on pharmacological neuroenhancement and, secondary, on emotional enhancement.

A systematic review was conducted according to the PRISMA guidelines. Pubmed, Scopus, Embase, PsychInfo and Google Scholar databases were accessed to select English language articles, published from 1980 to April 2020. 11746 papers were initially selected and 123 papers were finally included.

Available literature indicates a widespread and increasing use of different kinds of substances, drugs and food supplements mainly with neuroenhancing purposes, especially amongst specific populations of young healthy subjects. The evidence regarding their efficacy is controversial. Further, a limited or no awareness regarding the possible consequences of their abuse/misuse emerges amongst users.

Despite the limited evidence that some substances may improve cognitive functions in healthy subjects and neglecting their detrimental side effects and potential risk of misuse, abuse and addiction, there is an increasing worldwide use of the so-called neuroenhancers, especially in some categories of individuals, such as university students. Further studies are needed to collect reliable data on the effects of neuroenhancers in healthy subjects. Neuroenhancement puts into question the concept of authenticity, so that the problem requires to be analyzed within a complex ethical conceptual frame.

No significant relationships.

Sleep and circadian disturbances have been widely studied in patients with bipolar disorder (BD) (Duarte Faria et al., 2015; Gonzalez, 2014). However, there is no clear evidence about the role of peripheral biomarkers of circadian cycle in this population.

This systematic review aims to identify potential endocrine biomarkers of circadian rhythm in blood and study their relationship with sleep problems in BD.

An electronic search of Pubmed and PsycoInfo databases were performed. It includes articles about the topic from 1991 to 2021. The search strategy was: (“Peripheral biomarkers” OR “biological markers” OR biomarker OR cortisol OR melatonin OR orexin OR hypocretin) AND (blood OR serum OR plasma) AND (“sleep-wake” OR “circadian rhythm” OR sleep OR insomnia) AND “bipolar”.

92 records were obtained after excluding duplicates. Only five studies met the inclusion criteria (n = 499; BD = 125; unipolar depression = 148; schizophrenia = 80; controls = 146). The endocrine parameters analyzed were: cortisol (3 studies), melatonin (1 study) and orexin-A (1 study). Overall, no significant associations between these biomarkers and sleep disturbances, assessed with subjective (psychometric evaluation) and/or objective (polysomnography) measures, were detected.

This systematic review highlights the lack of studies that explores the role of endocrine biomarkers related to circadian function in the pathophysiology of sleep disturbances in BD.

No significant relationships.