A 15-day compulsory rotatory rural psychiatry posting was introduced into the MD psychiatry curriculum at NIMHANS to orient trainees to the functioning of community mental health services.

To capture the views and subjective experiences of the 32 residents posted in rural psychiatry services under District Mental Health Program (DMHP) using qualitative interviews.

In-depth qualitative interviews were conducted to understand the residents’ experience in various aspects of the community psychiatry posting. The interviews were audiotaped and later, transcribed. Thematic analysis of transcripts was done.

The analyzed data was converted into 41 codes and 12 themes. The themes related to positive experiences were good clinical exposure and skills to practice in low-resource settings, focus on preventive mental health care, enhanced communication, administration, leadership skills, and increased empathy. After training, the residents also reported gaining insights into the attitude of policy-makers and increased interest and confidence to practice in a rural setting. The themes highlighting the perceived challenges ranged from personal reasons, such as food or transportation, to professional ones like stigma, limited resources, a burdensome amount of paperwork, limited availability of psychotropics, and communication barriers. Residents who expressed interest in practicing rural psychiatry in the future cited a good wage, higher levels of self-satisfaction, confidence, and an emotional connection to their native place as motivating factors. Those who did not want to join DMHP had concerns such as not having adequate skills for working in a low resource setting, compromised basic needs, superiors not being sensitive to mental health issues, additional non-psychiatric work, job instability and lack of academic and research opportunities.

The posting to nearby DMHP centers was feasible and contributed positively to the training experience of the residents. Positive experiences, challenges, and other lessons learned by these residents could help them plan their career in rural psychiatry. It was found that both the residents and the DMHP team contributed to each other’s growth. This posting was likely to boost residents’ confidence to work in rural settings and could also aid in easing the crisis of lack of community-based mental health experts. The authors advocate for the national implementation of such rural psychiatry posting.

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Since the beginning of the modern psychiatry the acute units have established a “locked door” policy. Some studies show that this condition may increase patient’s discomfort and affect the perception of health quality of care (Boyer L, 2009, Eur Psychiatry Dec;24(8):540-9). Lately, several European countries such as Germany, Switzerland and Spain are starting to implement the “open-door” policy but its impact on patient’s satisfaction is still unknown (Hochstrasser, L, Frontiers in Psychiatry, 9(57). https://doi.org/10.3389/fpsyt.2018.00057) .

To help characterize the advantages of the “open-door” policy implemented in an acute inpatient psychiatric unit in order to assess the patient’s view of it.

This is a descriptive observational study carried out at an inpatient psychiatric unit. Data were collected after the implementation of the open door policy on June 2019, assessing the patient satisfaction of 31 subjects who completed the SATISPSY-22 scale at the time of discharge. Results are described using the average and its standard deviation.

Results show scores in all items above 50 points, being the care team and the quality of care the most valued ones with 82 and 79 points respectively. The overall score is above 65 points (Fig. 1).

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In line with previous studies, our data suggests that the main impact of the “open-door” policy implementation is on patients’ perception of the care, being Quality of care and satisfaction with the Staff the items with highest scores. This could be explained by patients trusting more in the Care team, which would help enhance the therapeutic relationship improving therapeutic adherence, treatment adequacy and the outcome. Nevertheless, the Feeling related to hospitalisation was found to be the item with the lowest score. This could mean strategies should focus on improving patient’s insight regarding their clinical state and their need to be admitted. Our study supports the hypothesis that open-door policy in acute psychiatric units is seen positively by patients and that further research should be carried.

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Evidence shows that racism can have a negative effect on mental health in the lived experiences of Black people and People of Colour. In critical theory discourse including postcolonial and decolonial approaches, racism is suggested to be an everyday phenomenon. Additionally, racism specifically targets the perceived cultural and phenotypic foreignness of Black migrants and migrants Of Colour, as well as the ascribed migrant status attributed to the perceived foreignness of racialized persons who do not actually have any direct migration experiences.

The stigma associated with severe mental disorders such as psychosis has historically been applied to Black people and People of Colour who have been engaged in anti-racist activism as a form of punishment and social control. Higher incidence rates of psychosis in racialized communities have frequently been conceptualized as cultural differences in family composition and levels of expressed emotion in families. The objective of this study is to sensitively investigate psychosis as a potential mental health consequence of racism.

The incidence rates of psychosis - positive symptoms, negative symptoms, non-affective psychosis disorders and first episode psychosis - among migrants by country of migration were compiled in an umbrella review, which offers a summary of meta-analyses. Quantitative research has the limitation of enabling the observation of patterns but not allowing an understanding of the reasons behind them to be theorized through the data. Therefore, qualitative methods complement the quantitative data. Twenty people of diverse genders who self-identified as Black people or People of Colour in Berlin were interviewed about their experiences of racism and sexism and about how those experiences affected their mental health.

The umbrella review found an association between migration and psychosis, with migration from the Caribbean and African countries showing the strongest correlation. A constant comparative analysis of the qualitative data suggests that racism contributes to the emergence of a subclinical psychosis symptomatology profile that consists of a sense of differentness, negative self-awareness, paranoid ideation regarding general persecution, and self-questioning with self-esteem instability.

The findings are interpreted as a situational diagnosis, as coined by the psychiatrist and political philosopher Frantz Fanon in the seminal book ‘Black Skin, White Masks’ (1975). The findings are also contextualized within a critique of institutional racism, both historically and currently, and within an intersectional discussion of the need for structural competency and the provision of safety for racialized groups in clinical settings.

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Almost nine months after the start of the war between Russia and Ukraine, millions of people have been affected physically, economically and mainly mentally. Those who have stayed in their homeland, and the ones that have chosen to emigrate to a safer place.

The objective of this article is to assess the importance of social stressors in the onset of a brief psychotic episode, even in the absence of substance abuse or previous illnesses.

The case of a 45-year-old woman is described, known by the Pediatric Emergency Service, for being the tutor of a patient who suffered from anxiety attacks, having emigrated without her parents from Ukraine together with her 5 brothers. The psychotic episode begins when our patient gets notified that she must abandon the custody of the girl, because she will have to go to Turkey with her legal guardians. The family explains the behavioral changes that the patient made and how the clinical picture worsened.

She was admitted at the Hospital’s Psychiatry Service and antipsychotics treatment started. After 5 days, the episode had completely been solved.

In conclusion, we highlight the importance of social problems in the development of a psychiatric pathology and the necessary elements to prevent it: family support network, fast and efficient care services and availability of hospital and pharmaceutical resources.

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As a result of Russia’s large-scale military aggression against Ukraine, many civilians were forced to leave their homes. Emotional disorders associated with fear for one’s life and relatives, loss of housing, work, and stable social ties are found in the majority of forcibly displaced persons.

The purpose of our study was to study the characteristics and expressiveness of affective disorders in displaced persons as a result of Russian aggression against Ukraine. Studied affective disorders in 24 forcibly displaced females. Age of the surveyed 30-50 years. Contacted with psychiatrist because the insistence of relatives. Patients were not identified and applied earlier about mental disorders to psychiatrists. To quantify anxiety, we used a scale HAM-A.

Clinico-psychopathological.

Affective disorders in the examined patients can be confidently attributed to adjustment disorders. According to the ICD-10, an adaptation disorder (F43.2) was diagnosed. Most of them were dominated by depressive and anxiety-depressive modalities of affective disorders. According to the HAM-A scale, the level of anxiety was 14±2.7. Most patients showed few irritability and anger, which is probably due to the inability to respond to the cause of their troubles and problems. However, some patients (6 people) expressed gloomy irritability, anger (clinical sighnificant) a feeling of hostility towards others. It is necessary to note the undulation of these manifestations, often aggravated under the influence of external factors.At the same time, the immediate environment often suffered, on which all the troubles fell. The behavior of such patients became maladaptive, significantly disrupting communication.

Therapeutic impact on internally displaced persons should be aimed not only at overcoming anxiety and depressive syndrome, but also irritability and anger. This should be taken into account when planning psychotherapeutic programs, it is possible to prescribe normotimics.

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Internet gaming disorder (IGD) refers to a pattern of persistent gambling behaviour or recurring gambling, on the Internet, with impaired control, increased priority, and continuation or escalation of gambling despite the occurrence of negative consequences. Currently, online gambling - more frequent among men - represents a very important, constantly growing economic activity. Since the COVID-19 pandemic and the need to conduct classes online, there has been an increase in the rate of IGD in children and youth (7-25 years old). Comorbidities, namely attention deficit hyperactivity disorder (ADHD), have been associated with a higher prevalence of IGD. They share core traits, such as impulsiveness, seeking immediate reward, deficient motivation, and hostility, which may translate into neuroimaging similarities.

Non-systematic review of the literature about neuroimaging of IGD comorbid with ADHD.

A search was conducted on PubMed and other databases, using the MeSH terms “Internet Addiction Disorder”, “Attention Deficit Disorder with Hyperactivity” and {“MRI” OR “fMRI” OR “functional connectivity” OR “neuroimaging OR neural alteration OR neuronal alteration OR neural change"}.

IGD and ADHD have shared and disorder specific patterns of structural and functional abnormalities, particularly in reward function. For instance, IGD has been associated with lower putamen grey matter volume (GMV), while ADHD patients have lower GMV in the orbitofrontal cortex. Disorder-specific fMRI activation has been observed in the precuneus in IGD; in ADHD, there is special activation in the fusiform gyrus. Finally, shared structural and functional alterations between IGD and ADHD seem to converge in the prefrontal-striatum circuit, especially the anterior cingulate cortex.

ADHD has been suggested as the most significant predictor of IGD in cross-sectional and prospective studies, however there is no study that clarifies their relationship. It is unclear whether IGD causes ADHD symptoms or whether a problem with gambling is a prodromal sign of the development of full ADHD. Studies revealing common neurobiological foundations between these disorders are pivotal to understand their basic mechanisms, while alerting to the necessity to screen for both pathologies when one is present. They may also point to an overlapping target (the reward circuit) for behavioural and pharmacological treatment.

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Schizotypy refers to a continuum of symptoms from subclinical manifestations in the general population to severe symptoms in schizophrenia spectrum disorders. Neuroimaging studies revealed significant relationships between schizotypy and cortical anatomy in the general population. However, it remains unclear whether these structural associations has a gender specificity.

The present study used structural MRI data to investigate the relationship between subclinical schizotypy symptoms and cortical and subcortical morphometric measures in male and female samples of healthy individuals.

164 right-handed healthy unmedicated individuals (18.0-34.9 years, 57% females) underwent structural MRI at 3T Philips scanner. T1-weighted images were processed via FreeSurfer 6.0 to quantify cortical thickness for 34 regions-of-interest (ROIs) according to Desikan atlas and volumes for 7 subcortical structures at each hemisphere. Schizotypy levels were assessed using self-report Schizotypal Personality Questionnaire, total schizotypy score and 4 factors scores (Cognitive-perceptual, negative, disorganized and paranoid factors as per Stefanis et al. Schizophr Bull. 2004; 30 335-350) were calculated. Partial correlation analysis (ppcor version 1.1, R version 4.2.1) was used to assess the associations between ROIs cortical thickness and total schizotypy or 4 factors scores including age and sex as covariates. The same analysis was performed for subcortical volumes including intracranial volume as additional covariate.

In male group we revealed a positive correlation between greater thickness of the left caudal middle frontal gyrus and higher total schizotypy (r=0.42, punc=0.0003, 95% CI [0.21–0.60]) and negative factor of schizotypy (r=0.49, punc<0.0001, 95% CI [0.28–0.65]) (Image). No correlations survived correction for multiple comparisons in female sample. There were no differences in age, caudal middle frontal gyrus thickness, total schizotypy or negative factor of schizotypy scores between male and female subgroups.

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The results suggest that the association of dorsolateral prefrontal cortex (DLPFC) and levels of schizotypy is gender specific. We showed that total and negative schizotypy positively correlated with thicker DLPFC in male but not in female sample. The present data are inverse to findings of prefrontal cortical thinning observed in schizophrenia. Such correlations suggest that thicker cortex could be a potential compensatory mechanism or could reflect alterations in trajectory of cortical thickness reductions across the lifespan.

The work was supported by RFBR grant 20-013-00748

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There is growing evidence to suggest that delusions in schizophrenia-spectrum disorders are associated with altered brain connectivity. Disruptions in long association fibers, such as the superior longitudinal fasciculus, are among the most consistent findings in psychosis. However, functional connectivity (FC) correlates of such structural alterations and their implications in delusional symptoms remains unclear.

The study used a hypothesis-driven approach and aimed at exploring structural connectivity (SC) disruptions of the left superior longitudinal fasciculus (part with parietal terminations, SLFP) and their FC correlates in a group of psychotic patients with persistent delusions across diagnostic categories within the schizophrenia-spectrum.

Sixteen right-handed patients (23.1-53.8 years, mean age 39.6±8.5, 44% females) with delusional disorder (DD, n=10) and schizophrenia (SCZ, n=6), presenting with persistent delusions, and 16 matched healthy controls (23.0-56.4 years, mean age 38.9±11.1, 44%females) underwent diffusion-weighted 3T MRI (DW-MRI), while patients additionally underwent resting-state 3T fMRI (rsfMRI). DW-MRI data were processed via FreeSurfer6.0 and TRACULA to derive axial (AD), radial (RD) diffusivities and fractional anisotropy (FA) for left SLFP. rsfMRI data were processed with SPM12 and Conn v19c to calculate ROI-to-ROI FC between lateral prefrontal and inferior parietal components of the frontoparietal network (FPCN) according to Yeo atlas (Yeo et al. J Neurophysiol. 2011; 106(3) 1125-65), which is sought to represent cortical projections of the SLFP (Image). Partial rank-based correlation analysis (with age and sex as covariates, ppcor v1.1, R v4.2.1) was used to explore the associations between SC and FC measures involving the SLFP, PANSS and BABS scores.

Compared to healthy controls, patients showed decreased AD in left SLFP [F(1, 28)=14.9, p=0.0006; Cohen’s d = −1.3, 95% CI: −2.1 to −0.5]. No RD or FA alterations were found. We revealed a correlation between AD in left SLFP and fronto-parietal FC within the FPN (r = 0.58, p = 0.031) in patients. Correlation between FC and PANSS total score (r = −0.54, p = 0.045) did not survived correction for multiple comparisons. No other correlations between SC or FC, chlorpromazine equivalents and clinical scores were revealed.

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The findings suggest that the structural connectivity disruptions of the SLFP may mediate FC strength within the FPN in patients with persistent delusions. However the limited sample size and the lack of correlations between connectivity measures and clinical scores do not allow to conclude definitely whether the revealed structural-functional connectivity pattern underlies delusional symptoms, which should be elucidated via further research.

This study was supported by RFBR grant 21-515-12007

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Autism spectrum disorder (ASD) refers to a group of conditions characterized by quantitative differences in the morphology of the cortex and subcortex. Analyzing brain morphology qualitatively provides complementary information about possible underlying neurobiology. Studies of neuroradiological findings in ASD have produced mixed results in a large and independent sample.

A small cerebellum associated with pons hypoplasia, or a posterior fossa cyst, may indicate causal developmental mechanisms. Therefore, neuroradiological findings could help elucidate the neurodevelopmental processes associated with ASD.

MRI “minor abnormalities” also included dilatation of the Virchow-Robin gaps, an enlarged cisterna magna, pineal gland cysts, and arachnid or choroidal cysts not included in specified categories.

There were anomalies in the corpus callosum (hypoplasia), cerebellum, brain stem, abnormal white matter signal intensity, macrocephaly, ventriculomegaly, abnormal myelination patterns, ventricular system size, Arnold Chiari I malformation, cortical dysplasia and atrophy, hippocampal malformations, and pituitary glands. These anomalies were referred to as “major abnormal findings”.

The most common minor abnormality is the mega cisterna magna. Some authors propose a minor abnormality such as this as a marker for brain dysgenesis. According to Zimmer and colleagues, enlargements of the cisterna magna are generally accompanied by cerebellar hypoplasia and ventriculomegaly, as well as lower performance on speech tasks (verbal and semantic fluency) common among individuals with autism spectrum disorders. The relationship between the presence of mega cisterna magna and language difficulties could be studied further in a subsequent study. Abnormal dilation of the cisterna magna is thought to be related to alterations in the cerebellar volumes.

Clinical MRI assessments may be helpful in the context of diagnoses and are potentially valuable for further studies of the pathogenesis of autism. The potential utility of routine brain MRI is in discovering early morphologic biomarkers for ASD.

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Alcohol use disorder (AUD) is a diagnosis that includes both addiction and abuse concepts that entered our lives with the DSM-5. The prevalence of AUD is 8.1% in men and 1.7% in women in Türkiye, and it is getting more and more common. Biopsychosocial factors play a role in the etiology of AUD.

The brain reward system, which includes many cortical and subcortical structures, plays an active role in the initiation and maintenance of alcohol dependence. In this study, we aimed to reveal the structural changes in alcohol dependence.

15 cases with AUD and 17 healthy controls were compared in terms of total white matter, total gray matter, nucleus accumbens, amygdala and hippocampus volumes. AUDIT, MAST and alcohol addiction severity scale were administered to all participants. Magnetic resonance imaging of all participants was performed. Then, the relevant regions were painted cross-sectionally and volume measurements were made. The case group was evaluated for the diagnosis of AUD with SCID-V. Volume averages were evaluated with Student’s t test. ANCOVA was used to remove confounding factors and re-evaluate the difference between volumes.

Although there were differences between volumes in the first analyzes with Student’s t test, they were not statistically significant.

Age and gender variables, which were determined by the literature to have an effect on volume measurements, were re-evaluated with the ANCOVA test. When the effects of age and gender variables were removed in the evaluation, the right hippocampus volume was found to be significantly reduced in the AUD group compared to the control group (F=5.26, p=0.03). Again, no significant difference was observed in the two groups in terms of areas other than the volume of the right hippocampus. Pearson correlation analysis was used to evaluate the relationship between scale scores, duration of alcohol use and amount taken, and volumetric measurements, but no statistically significant relationship was found.

Different findings have been reported in the literature regarding the examined region volumes. Our study found volumetric changes consistent with most previous studies. For more generalizable results, studies with a large number of participants are needed.

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Long term cannabis use has been expanding drastically over the last two decades and has become a major health issue worldwide. Recent studies demonstrate that brain complications in adults with cannabis use are associated with cognitive and emotional impairments, but little is known about the relationship between structural alterations and behavioral manifestations. Therefore, studying the relationship between alterations of emotional system, in parallel with structural degenerative phenomena is very critical.

Hence, the aim of this study is to demonstrate such alterations by making use of appropriate paradigms during BOLD-fMRI scans. Positive, negative and neutral emotions were examined, in relations with DTI and functional connectivity.

11 cannabis addicted patients volunteered for the study. Volunteers were fully healthy. However, any additional comorbidity was a strict criterion of exclusion, and a healthy general state was an indispensable criterion of inclusion. Additionally, it was excluded any patient that have any additional substance use such as tobacco, alcohol, cocaine, etc. And strict use of cannabis was a must.

All patients underwent blood and urine assessments to ensure the selection criteria.

All patients underwent BOLD-fMRI and anatomical MRI using both motor and emotional paradigm.

The motor task consisted of rest alternating with finger tapping. The emotional task included 3 conditions. Positive, neutral and negative were each alternating with silent mental counting. The fMRI data was processed using SPM12 package. A sample of 12 age-matched controls was also included.

The present results are based on analysis of behavioral and BOLD-fMRI data of 11patients and similar age-matched controls. Analysis of behavioral data showed an alteration of emotional abilities in cannabis addicted patients compared to controls. Analysis of fMRI data revealed significant changes of activation within a large cortical network including prefrontal cortex and parietal cortex, and that emotional responses and BOLD signal were inversely correlated.

These findings demonstrate that the brain of cannabis addicted patients undergoes and emotional alterations that parallel silent structural degenerative phenomena. Although the causal mechanisms are still to be investigated, the fact that functional impairments can be detected in emotional, cognitive and motor domains calls for the development of preventive measures using neurobehavioral tools for this population of patient, and even in at risk users.

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People with mental disorders may present impairments in cognitive and metacognitive functions. Self-reflection is the ability to reflect on oneself (specifically on one’s behavior, emotions, and thoughts) and insight is the awareness of one’s internal experience. Mindwandering (MW) is defined as the tendency to divert attention from current reality without a clearly defined intention. It can be spontaneous or deliberate. Several studies have investigated these alterations in patients with schizophrenia (SZ), while less is known for people with substance use disorder (SUD).

The aim of the present study was to explore self-reflection, insight and MW in a group of patients with SZ and SUD.

The Self-reflection and Insight Scale (SRIS) and the spontaneous (MW-S) and deliberate (MW-D) mindwandering scales were administered to 25 patients with SZ, 21 patients with SUD, and 21 healthy controls (HC). Linear regressions were performed to evaluate the associations between the variables under study.

Preliminary data showed that SZ and SUD patients presented lower SRIS and MW values than HC. Examining MW in detail, participants with SZ reported higher scores at than MW-D, while in people with SUD, MW-D scores were higher than MW-S scores. Linear regressions revealed that MW-D was negatively associated with self-reflection in SUD; moreover, insight scores were negatively associated with MW-S in SZ.

Our preliminary results confirm the importance of acting on the elements of metacognition in patients with mental disorders to improve the general outcome of the disease. A comprehensive therapeutic approach should include psychotherapeutic and social interventions aimed at increasing attention and introspection.

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ECT is a recognised, safe and effective treatment for severe/psychotic depression. Neuro and functional brain imaging has indicated what specific changes take place with ECT and at what stage. This study aims to explore the specific impact on depression and mood symptoms as ECT progresses, using longer version of Hamilton Depression Rating Scale at star, mid poitn and end point of ECT.

Patient themselves are often keen advocates of ECT (if they found it effective and tolerable).

specifically to consider the impact of ECT on mood and depressive symptoms as ECT progresses.

This is to reconsider and reflect on if ECT is effective and also to consider at what satge of treatment ECT appears to have the greatest impact or brings about the greatest change

All patients having ECT will be assessed and clerked as per routine but will also be assessed using Hamilton Depression Rating Scale (17 item version), an observer rated scale to assess severity of depressive symptoms. This will be used with all ECT patients, regardless of diagnosis or indication for ECT. Basic demographic details, diagnosis, co morbidities and previous ECT recorded.

Findings

Patients are are ideally assessed before ECT has started to give a baseline/true reflection of their depressive illness and then at the mid point (around session 6) and then at the end of treatment (ideally session 12).

Hamilton depression Rating scale (HDRS) longer version is used - 17 questions with scores out of 40. Higher scores indicate more severe depression. HDRS is an observer rated scale, with numerous questiosn about biological symptoms of depression and is a well established assesment tool. The same rater was used to try to rule out observer bias.

Patients had a significant drop in HDRS scores as ECT progressed, with the biggest drop being between the start of ECT and the midpoint. Thsi trend continued from mid to end point but with a less steep gradient.

mean HDRS scores at start were 24/40 (indicting severe depression).

Mean HDRS at midpoint 12/40 (indicating mild depression)

Mean HDRS at end opf ECT 5/40 (indicating nromal range/no depression)

ECT works for mood symptoms associated with depression. All patients having ECT had a reduction in their HDRS scale as ECT progressed, most marked in the 1st half but this trend continued in 2nd half (but at slower rate). This was the case even for patients who were not having ECT for mood symptoms (eg for aggression or psychosis).

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Human endogenous retroviruses (HERVs) are genetic elements resulting from ancestral infection of germline cells. HERVs have been associated with multiple complex disorders, including neurodevelopment disorders, namely autism spectrum disorder (ASD).

In this review, we aim to explore the relationship between endogenous retroviruses and autism spectrum disorder.

A non-systematic review of literature published in the Pubmed database in the last ten years was performed. A combination of the search terms “autism spectrum disorder”, “ASD”, “endogenous retrovirus”, “human endogenous retrovirus”, “ERV” and “HERV” was used. Articles were selected based on title and abstract review.

Preclinical and human studies suggest that the abnormal expression of endogenous retroviruses can represent a biological trait of neurodevelopment disorders in affected individuals and their parents. The precise epigenetic processes that underpin this relationship remain elusive. Nonetheless, HERVs play various roles, modulate host immune response and may affect human embryogenesis. All of these factors can participate in the interplay among genetic vulnerability, environmental risk factors, and maternal immune activation that contribute for the development of ASD.

There is a recent, mounting body of evidence linking HERVs and ASD. Whether HERVs behave as a cofactor for the development of ASD or an epiphenomenon of neurodevelopmental disorders remains unclear. Further research is needed to assess if there is causality and evaluate the potential for HERVs to serve as biomarkers for ASD.

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This study investigated the influence of synesthetic experiences on working memory and hypothesized that Grapheme-Colour Synaesthesia causes enhanced working memory for the materials in the congruent condition.

The current study uses the existing experiments conducted within the field of Synaesthesia as a basis in order to find out whether synaesthesia influences working memory for the letters, words, and days of the week that elicit synesthetic experiences

Experimental research design was used to identify the extent of the causal relationship between Synaesthetic and non-Synesthetic experiences and enhanced working memory in both Synesthetes and non-Synesthetes. A short screening questionnaire, Stroop task, and N-back task was used to measure the relationship between the two variables for quantitative measurement. (Radvansky, 2011), This study uses materials such as Stroop task and n-back task from Robinson’s (2015) work, Radvansky’s (2011), and Terhune et al. (2013) work. However, certain changes in the methodology of the current study makes it easier and efficient to conduct this study with a different population.

Grapheme-Color synesthetes (Mean= 1276.682 milliseconds) appear to take less amount of time in responding correctly to the incongruent stimulus in the Stroop Task than non-Synesthetes (Mean= 1487.89 milliseconds). Secondly, Grapheme-Color Synesthetes (Mean=1170.929 milliseconds) have a significant difference in accuracy of responding in the congruent condition of the Stroop Task with the non-Synesthetes (Mean= 1491.159 milliseconds). Further evidence from the N-back Task also demonstrated a significant relationship between the variables in both incongruent and congruent conditions; Grapheme-Color Synesthetes (Mean= 2621.390 milliseconds) showed a significant difference in correctly responding to the nonmatching stimulus in N-back Task with Non-Synesthetes (Mean= 2854.351 milliseconds). Similarly, Grapheme-Color Synesthetes (Mean=1330.130 milliseconds) showed a large difference in responding correctly to the matching stimulus in the N-back Task with Non-Synesthetes (Mean= 2301.071 milliseconds). Grapheme-Color Synesthetes were faster in responding correctly than non-Synesthetes in all conditions.

Regardless of what have been concluded as a result of the current study, it is difficult to reach at any conclusions taking into account the oppositions about working memory of Grapheme-Color Synesthetes in different studies. Therefore, the data suggest that future studies should further test the capacity of working memory in Grapheme-Color Synesthetes.

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Frontotemporal dementia (FTD) is the second most common type of dementia seen between 45-65 years of age and affects the frontal and/or temporal lobes. FTD is clinically characterized by progressively the change in behavior, personality, and language dysfunctions.

Clinical features of FTD include restlessness, disinhibition, apathy, blunted affect, avolition, social withdrawal, impulsiveness, and loss of executive function. Most patients with FTD act as socially inappropriate behaviors, not talking much, compulsive-like acts, poor insight, and psychiatric features including hallucinations and paranoid delusions. According to symptoms, the diagnosis of FTD may be confused with depression, mania, or schizophrenia.

In this case report, we wanted to draw attention that FTD should be considered in the differential diagnosis of late-onset psychosis.

A 53-year-old female, married, uneducated, and not having children patient has applied to our clinic with complaints, that started a year ago, about social withdrawal, activity, decreased sense of purpose, neglecting personal hygiene, not eating well, and acting inappropriately and impulsively.

The patient reported that she was walking out of the house for hours, having profanity speeches, and forgetfulness.

She was admitted to the psychiatry hospital a year ago and discharged with a diagnosis of bipolar disorder.

Brain MRI showed atrophy of frontal and anterior temporal structures bilaterally. PET scan demonstrated left frontal, parietal, and temporal hypo perfusion of the brain.

In our clinical observation, she had apathy, inappropriate jokes, lack of eye contact, flat affect, lack of gesturing when communicating, unable to respond to questions, and visual hallucinations.

Due to the similarity of the clinical resemblance of BPAD and FTD, the diagnosis of FTD can be confusing. In this case, amnesia and sudden onset of the symptoms with rapid destruction may help the diagnosis of FTD.

Psychosis symptoms in our clinical observation also suggested the diagnosis of psychosis. However, its atypical course and early-onset psychosis symptoms brought us closer to organic pathology. Investigations of structural and functional brain imaging may help support the diagnosis.

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Psychiatric symptoms in FTD may cause misdiagnosis. Organic pathologies should be kept in mind, especially in late and sudden onset symptoms.

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Epilepsy is a neurologic condition characterized by spontaneous jerky body movements. It is a chronic morbid condition mostly diagnosed during childhood. Patients are maintained on long-term medications to prevent recurrent seizures that can damage the brain. Medications used for the management of epilepsy have several side effects and require proper monitoring. Patients with epilepsy are at increased risk of psychiatric comorbidities.

Our aim is to find factors responsible for causing suicidality in patients with epilepsy.

A review was conducted using Pubmed database with the search terms [epilepsy] OR [neurological conditions] OR [suicide] OR [suidical attempt] OR [suicidal ideation] OR [depression] OR [psychiatric diseases] OR [mood disorders] OR [anxiety] OR [sleeplessness] which yielded around 800 articles. The number was later reduced to be centered around the main area of interest and produced around 40 articles.

Results show that many contributing factors play an unavoidable role in promoting suicidal ideation that can lead to suicidal attempts in epilepsy. The stigma associated with epilepsy leads to social isolation, lack of opportunities, financial constraints, and impact on close relationships which can be the reasons for depression. According to the review, the foremost contributing factor is the underlying social, emotional, and economic condition of epilepsy patients. Depression and anxiety are the most prevalent psychiatric comorbidities in epileptic patients. Epileptic patients who develop psychiatric ailments show decreased adherence to medications that further worsen the problem.

Though, this area in neurology has started getting attention for further research and guidelines. But efforts are still inadequate for this to be put into clinical practice. More desperate actions needed to be taken for proper diagnosis and management of suicidal ideations by proper use of assessment tools so that timely actions are planned. This is a highly demanding area due to the impact of depressive symptoms on the prognosis of the chronic neurologic condition.

Keywords: Suicidality; Epilepsy; neurology.

None Declared

Autism spectrum disorder (ASD) is currently defined as persistent deficits in social communication and social interaction additional to repetitive behavioural patterns, and restrictive interests or activities. Several studies suggested that ASD is accompanied by defective perception and altered response to the environmental factors, including environmental and social stress. In this context, frequent reports addressed the manifestation of different stress-related behavioural and physiological patterns, such as restless leg syndrome, migraine, and functional gastrointestinal disorders (FGIDs). Thus, a major problem in ASD patients’ management could be related to the exacerbated effects of stress.

In this study, we aimed to find a correlation between the stress perception and response and the manifestation of some neurological and FGIDs in ASD.

The main scientific databases were screened for studies describing the effects of stress in autism patients and animal models. Exclusion criteria: (1) studies not written in English language; (2) not available as full text; (3) not describing stress response; and/or (2) functional gastrointestinal manifestations in autism.

The repetitive behaviours have a heterogenous pattern in both severity and manifestations, varying from repetitive motor movements and inflexible adherence to routines to hypo- or hyper-reactivity to exterior stimuli. Moreover, some studies describe repetitive behaviours as altered stress coping mechanisms meant to relieve anxious states – one of the main stress axis activation effects. We recently described some significantly reported FGID-like manifestations in ASD that could be the result of various abnormalities in the brain – gut interaction, such as impaired parasympathetic activity and increased endocrine stress response. In this context, there could be a correlation between the altered perception and response to stress and the FGID-like manifestations, as we previously described the stress axis implication in one of the most common FGID, irritable bowel syndrome – which is also frequently reported in ASD cases.

In ASD, the perception and response to environmental and social stress could be impaired. Thus, impaired stress coping mechanisms, defective stress axis, and altered behavior could lead to stress-specific manifestations, such as restless leg syndrome, migraine, and irritable bowel syndrome.

Funding: *B. I.-M. and *R. M.-A. are supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program

I. M. Balmus Grant / Research support from: B. I.-M. is supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., M. A. Robea Grant / Research support from: R. M.- A. is supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., R. Lefter: None Declared, A. Ciobica: None Declared, L. Gorgan: None Declared, C. Stanciu: None Declared, A. Trifan: None Declared

Our previous reports on rodent models suggested that chronic stress exposure could lead to cognitive impairments, gastrointestinal transit changes, and oxidative stress. Zebrafish (Danio rerio) models are nowadays gaining more attention due to their advantages, as well as their complete neurobehavioral, biochemical, and genetic description and great similarity to human.

The aim of this study was to describe and to identify possible interdisciplinary applications of the neurobehavioral and biochemical changes induced by chronic stress exposure in zebrafish.

The main scientific databases were screened for English-written studies describing chronic stress exposure effects in animal models. Inclusion criteria: (1) studies performed on zebrafish models; (2) reporting stress exposure effects on the animal behaviour, cognition, oxidative, and/or inflammatory status. Exclusion criteria: (1) studies not focussing on chronic stress exposure paradigm or (2) not using zebrafish models.

We found that chronic stress exposure was applied to larvae, juveniles, and adult zebrafish. The neurobehavioral effects were mainly suggesting memory deficits and socio-affective impairments (such as anxiety and depressive-like behaviours). Several studies found oxidative stress and inflammatory-related response in brain and gut. While our previous research experience in rodents thought us that chronic stress exposure could model functional gastrointestinal disorders of which mechanisms mainly address an impaired brain – gut interaction (irritable bowel syndrome), the data regarding the gastrointestinal status of zebrafish in similar experimental conditions are rather scarce. Some recent studies suggested that stress-exposed zebrafish showed impaired digestion and intestinal glucocorticoid receptors functions. Furthermore, it was reported that the zebrafish response to stress could be improved by probiotic administration and gut microbiota modulation.

Chronic stress exposure paradigm is often associated with cognitive and affective-like impairments. Several oxidative stress and inflammation-related changes were also reported. Further studies are needed to describe the brain – gut interaction-associated functional gastrointestinal impairments in zebrafish.

Acknowledgements: *B. I.-M. is supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program.

I. M. Balmus Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., R. O. Cojocariu: None Declared, R. Lefter: None Declared, L. Gorgan: None Declared, A. Ciobica: None Declared

The most common liver diseases associated with the fat accumulation in the hepatic tissue are metabolic associated fatty liver disease (MAFLD), non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis (NASH). Many studies previously reported several key mechanisms tying hepatic injury to extrahepatic manifestations. In this way, the co-occurrence of cognitive decline, mood, and affective changes could suggest the existence of a strong neurological component predisposing to neuropsychiatric comorbidities.

In this study, we aimed to describe the neurological and neuropsychiatric comorbidities of MALFD, NAFLD, and NASH.

The main scientific databases were screened for English-written studies using the following key words: ”cognitive decline”, ”neuronal loss”, ”affective disorders”, ”anxiety”, ”depression”, ”MAFLD”, ”NAFLD”, ”NASH”. Exclusion criteria: (1) studies not focussing on fatty liver diseases; (2) not describing comorbid conditions; (3) not providing correlative analysis of disease co-occurrence or mechanistic associations.

Hepatic encephalopathy (HE) is the main NAFLD/NASH extrahepatic manifestation commonly characterized by impaired cognition, rapid mood swings, depressive and anxious behaviours, and defective sleep. It is currently reported that more than 70% of the cirrhotic patients develop HE. Cognitive impairments and brain tissue reduction were found in NAFLD patients, while MAFLD patients’ cognitive dysfunctions (mild cognitive impairment and hippocampal-dependent memory impairment) were not associated with the presence of metabolic syndrome. Similarly Alzheimer’s disease (AD) was not described as comorbid in MAFLD. By contrast, since NAFLD and NASH are often characterized by insulin resistance and dyslipidaemia – significant triggers of dementia. By far the most prevalent neuropsychiatric comorbidity in NAFLD and NASH is the major depressive syndrome, diagnosed in almost 30% of the cases. Also, a correlation between the anxiety manifestation and the progression from NAFLD to NASH was described. In this context, as a response to the vast evidence that connect liver dysfunction to cognitive impairments, the liver-brain axis function was hypothesized.

MAFLD, NAFLD, and NASH are frequently associated with cognitive decline. The main NASH neurological comorbidity is hepatic encephalopathy, but it could also be seen in NAFLD. While Alzheimer’s disease occurs in NAFLD and NASH, more studies are needed to explain the severity-dependent association. Depression and anxiety were also reported in NAFLD and NASH.

Acknowledgements: B.I.-M. and R.M.-A. is currently supported through the Project entitled “Platformă multidisciplinară de cercetare-dezvoltare medicală în regiunea N-E” (CENEMED, code: 127606), cofinanced through the Operational Program of Competitivity, Prioritary Axis: Research, Technological development, and Inovation (CDI).

I. M. Balmus Grant / Research support from: Project entitled “Platformă multidisciplinară de cercetare-dezvoltare medicală în regiunea N-E”(acronym: CENEMED, mySMIS code: 127606), cofinanced through the Operational Program of Competitivity, Prioritary Axis: Research, Technological development, and Inovation (CDI)., M. -.-A. Robea Grant / Research support from: Project entitled “Platformă multidisciplinară de cercetare-dezvoltare medicală în regiunea N-E”(acronym: CENEMED, mySMIS code: 127606), cofinanced through the Operational Program of Competitivity, Prioritary Axis: Research, Technological development, and Inovation (CDI)., R. Lefter: None Declared, A. Ciobica: None Declared, L. Huiban: None Declared, C. Stanciu: None Declared, A. Trifan: None Declared