Clozapine is an atypical antipsychotic medication which is mainly used in cases of treatment-resistant schizophrenia. Although it has several advantages over other typical and atypical antipsychotic medication, such as fewer relapses and lowering the risk of tardive dyskinesia and suicide it also has a range of adverse effects which makes compliance an issue for many patients.

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis clinically characterized by painful pustules or nodules that rapidly evolve in ulcers with violaceous, undermined borders and raised periphery. The etiopathogenesis of the disease remains unclear, however PG is usually manifested in the setting of an underlying immune-mediated disease, more commonly inflammatory bowel disease, rheumatoid arthritis and haematological malignancies.

Nevertheless, in the literature there are scarce reports of drug-induced PG.

We present the case of a 56-year-old woman with a diagnosis of refractory schizophrenia on clozapine treatment for 4 months, who was admitted to the emergency department for a skin eruption localized on the trunk, genital area and extremities. The clinical examination revealed numerous, discrete erythematous macules, papules and plaques with central necrosis, and multiple, sharply marginated ulcers with undermined, red to purple border. Further physical examination disclosed no systemic findings and laboratory analyses and skin biopsy were performed.

On work-up, white blood cell count and C-reactive protein (CRP) were elevated, while blood and pustule cultures were negative. Histologic examination revealed dermal necrosis and inflammation, features consistent with the diagnosis of PG. The pathergy test was positive.

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Pyoderma gangrenosum is a rare autoinflammatory skin disorder of unknown etiology. The pathogenesis of the disease is not well understood, but drug-induced PG is considered to result from neutrophil dysfunction and dysregulation of the inflammatory response. Cases of drug-induced PG are rare and attributed to certain drugs. Clozapine is an antipsychotic medication for the treatment of refractory schizophrenia. It is suggested that clozapine alters plasma TNF-α levels and thus can modulate the inflammatory response. To date, a variety of adverse skin reactions (Stevens- Johnson syndrome, DRESS syndrome etc) have been previously described in the literature. However, to the best of our knowledge, this is the first case which strongly indicates the likely association between clozapine and drug-induced PG.

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People with severe mental health disorders and concurrent addiction problems are one of the most challenges patients to treat within mental health and addiction. They often find themselves fallen between different chairs within mental health and addiction services and between spescialist and primary care. There is a need for new ways of delivering services for this group.

The objective of this presentation is to present how Flexible assertive outreach teams (FACT) are delivered in a densly populated country and the results on changes in use of spescialist services and detension. We will also present the results of changes in quality of life before and after entering FACT and which factors that might be associated with life quality.

The establising of FACT in Norway has been extecively evaluated both in the form of official reports to the health authorities and academic research papers. We will do a scoping review of the Norwegian research on the effect of FACT teams with a spesific attention to the results obtained in densly populated areas. The review will cover the years fra 2018 up til to day.

The results so far indicate that it is possible to deliver FACT services in densly populated areas and that there is an increase in qualty of life before and after entering a FACT team. The use of hospitalization days are reduced with about 50 % and the same applies for days in detention.

FACT teams seems to be a viable way of delivering mental health care services to one of the most vulnerable groups in our society.

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Children with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system. A differentiated approach to rehabilitation will help restore mental activity with greater efficiency, and subsequently adapt the child to the familiar environment.

The aim of the study is to identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage.

210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus), admitted for treatment and rehabilitation. Clinical-psychopathological, pedagogical methods were used; additionally - diagnostic scales, questionnaires.

Depending on the level of consciousness, mental activity, 4 groups were formed:

1st group - 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech);

2nd - 67 (32%) patients had manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without emotional manifestations and understanding of addressed speech);

3rd - 95 (40%) patients had only the manifestation of physical capabilities at the exit from the vegetative status.

4th - 11 (10%) patients had a low manifestation of mental activity in the form of physical capabilities with a vegetative status.

4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.

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Schizophrenia is a severe mental disorder marked by abnormal interpretations of reality, often resulting in hallucinations, delusions, and disordered thinking that significantly impairs daily functioning and can be disabling. Lifelong treatment is necessary, and early intervention can help manage symptoms and improve long-term outcomes.

Polycythemia Vera (PV) is a chronic myeloproliferative neoplasm causing an excess of red blood cells in the peripheral blood (polyglobulia). While the disease typically presents with symptoms, it can also be asymptomatic and discovered incidentally during routine laboratory tests, leading to a diagnosis of polycythemia when no secondary cause is apparent.

While early 20th-century literature linked PV to intense neurological and psychiatric symptoms, contemporary studies rarely make such references.

The aim of this study is to explore, through a clinical case of a patient undergoing treatment for treatment-resistant schizophrenia with clozapine, and concurrently diagnosed with Polycythemia Vera, the potential causes of this condition. We seek to discern whether it represents mere comorbidities or if Polycythemia Vera is an adverse effect of antipsychotic treatment, particularly with clozapine.

A 41-year-old patient, with a history of cranial trauma at the age of 5 and 19 years of treatment for schizophrenia, also has a tobacco use disorder. While hospitalized for the management of symptomatic reactivation of schizophrenia, despite being on clozapine, the patient underwent various therapeutic combinations with no observed clinical improvement. A few months later, follow-up blood tests indicated an elevation in all blood cell lines.

An internal medicine consultation was sought, resulting in the diagnosis of Polycythemia Vera.

The evaluations conducted led us to the conclusion that there are two distinct nosological entities, with the treatment of the psychiatric condition revealing true polycythemia. Even after reducing the doses of clozapine and changing the atypical antipsychotic, all subsequent evaluations showed no effectiveness in managing the psychiatric disorder or improvement in the hematological condition.

In summary, schizophrenia is a severe and lifelong mental disorder requiring early intervention for symptom management. Polycythemia Vera (PV), a myeloproliferative disorder, typically presents with symptoms but can also be asymptomatic.

While early literature linked PV to intense neurological and psychiatric symptoms, contemporary studies seldom reference such associations. The coexistence of schizophrenia and PV in a patient underscores the need for comprehensive and interdisciplinary care to address the complex interplay between mental and physical health. Further research is needed to deepen our understanding of concurrent psychiatric and hematological conditions.

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Internet use in the adult population is growing at alarming rates. The latest statistical data show an average internet usage time of 6 hours and 58 minutes (2023), an increase of 1% compared to 2021. Research studies on the influence of the excess use of internet on attention is in its prime years, and clear steps need to be made in an attempt to clarify current hypotheses and to find effective methods for prevention. Nowadays, one of the most powerful influences on attention is the use of the internet, which, more often than not, crosses the line of addiction.

The initial hypothesis is that in the event of exposure to a high number of stimuli, the ability to switch attention to a single task may only be possible at a superficial level. The aim of this study was to assess the impact that excess internet use has on the ability to maintain attention in the adult population. The present study aims to sketch a well-established structure and direction of research in the field of attention and its effects on human functioning.

Using the DSM 5-TR diagnostic criteria for pathological Internet gaming disorder we enrolled 60 people who expressed their consent to participate in the study. We check psychiatric comorbidities using SCID II. As a method for evaluating changes in the level of attention, we used of the Stroop test. The results were analysed with the SPSS program (version 23).

The results showed a marked decrease in the ability to maintain attention, without increasing the number of stimuli. Although excessive Internet use leads to changes in attention parameters, research in this area is scarce and incomplete. Currently, most of the published studies focus on a causal relationship between the pathological use of the Internet and the appearance of attention deficit/hyperkinetic disorder, especially in children and adolescents. Although the results are promising, we cannot neglect the multitude of additional consequences of excess Internet use, which these studies targeting a single pathology overlook. Moreover, using the Internet involves exposure to an ever-increasing number of stimuli, which is why switching attention and maintaining it is currently an insufficiently researched parameter. Regarding the impact of Internet use on individual functioning, there is a relatively modest number of studies in the literature that outline a correlation between excess Internet use and various psychiatric comorbidities.

The impact of the research on the general population could be an increased awareness of negative effects and the development of prevention programs.

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The COVID-19 global crisis has resulted in significant disruptions in the lives of students in higher education, leading to negative consequences for their academic achievements and general psychological well-being.

In this study, we sought to examine the psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) among students in Portuguese higher education institutions during the initial phase of the COVID-19 pandemic and its efficacy in capturing mental health symptoms due to a global health crisis.

In this cross-sectional study, a convenience sampling method was used to enlist a total of 1522 participants. The sample consisted of 75.1% women and 79.2% undergraduate students. Participants completed an electronic survey that was designed using the Depression Anxiety Stress Scale-21 (DASS-21) — a self-report instrument measuring anxiety, depression, and stress.

The findings of the study indicated a significant occurrence of depressive symptoms [≥10] (N = 434, 28.5%), anxiety symptoms [≥7] (N = 551, 36.2%), and stress symptoms [≥11] (N = 544, 35.7%). Based on the collected data, a Confirmatory Factor Analysis (CFA) was conducted in order to examine the factor structure of the scale. The analysis revealed a three-factor solution that corresponded to the three subscales of the DASS-21. The Heterotrait-Monotrait (HTMT) correlation ratio was then used to assess the discriminant validity, with good results. Results showed that the DASS21 has satisfactory reliability indexes (Cronbach’s α > 0.90).

In light of the notable changes in living conditions brought by the COVID-19 pandemic, the present study has shown that the DASS-21 instrument has maintained its reliability and validity. Consequently, this finding supports the appropriateness of using the DASS-21 as a screening tool for assessing mental health among students in Portugal. Moreover, it is recommended that academics and healthcare practitioners use the DASS-21 as a tool for assessing the levels of psychological distress experienced by students. Additional validation studies of this scale are required, using bigger and more representative populations.

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At the beginning of the Covid-19 pandemic, respiratory expression of SARS-CoV-2 infection was the most worrying one. Later, other symptoms appeared to be more disturbing such as neurological and psychiatric manifestations, which may be due to direct or indirect effects of this virus on the central nervous system.

To assess the prevalence of neuropsychological manifestations of covid-19 in healthcareworkers and to identify their risk factors.

This is a cross-sectional descriptive epidemiological study, carried out in the teaching hospitals of Farhat Hached and Sahloul of Sousse. All healthcareworkers, having tested positive for SARS-COV 2 during the period from 01/09/2020 to 28/02/2021 were enrolled. The collection of socio-professional and medical data was based on a pre-established synoptic form completed during an interview with the participants.

A total of 953 COVID-19 patients were enrolled in this study. The mean age was 40.1 ± 10.5 years, with a sex ratio of 0.32. In our sample, 37.9% of patients had comorbidities such as psychiatric history (4.9%) and neurological history (2.4%). The prevalence of neuropsychological manifestations of covid-19 was 72.6%. The main neuropsychological manifestations were headache (50.3%), anosmia (40.7%), dysgeusia (29.9%), sleep disturbances (0.5%), dizziness (1, 2%) and paresthesia (0.3%).

Neuropsychological symptoms of long covid were dominated by memory impairment (10.7%), anosmia (8.5%), headache (7.3%), dizziness (3.4%) and sleep disturbances (3.1%).

The occurrence of neuropsychological manifestations was significantly associated with age (OR=1.6; p<10-3), male gender (OR= 0.57; p=0.03), smoking (OR=1.7; p=0.033), history of hypertension (OR=1.6; p=0.038), history of diabetes (OR=2.4; p<10-3) and hospitalization (OR=4.03 ; p<10-3).

The high prevalence of neuropsychological manifestations underlines the importance of studying their pathogenesis in order to better adapt their therapeutic protocols.

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In March 2020, the WHO declared the outbreak of SARS-CoV-2 a pandemic and Ireland went into its first lockdown. The Mental Health Liaison team at Sligo University Hospital operate 8 am to 8 pm, 7 days a week, with out of hours covered by the on-call Psychiatry junior doctors. The service has seen an increase in referrals, many of whom are known to community mental health teams.

We reviewed the numbers and trends of mental health presentations to the Emergency Department at Sligo University Hospital throughout the pandemic, including the patterns of presentations around the implementation of lockdowns.

The Liaison Mental Health Service at Sligo University Hospital gathers data relating to numbers and types of presentation to the service. Data was taken from a pre-existing database of psychiatric presentations to the emergency department at Sligo University Hospital including patient demographics, nature of presenting complaint, time period in which they presented and whether they were previously linked in with a community mental health team in the preceding six months. We also looked at the pattern of ED mental health presentations from March 2019 to August 2021. In order to compare psychiatric presentations pre and during covid, data was broken down into two groups: the twelve months preceding March 2020 and the twelve months from March 2020. Categorical data were analysed using the Chi squared test for homogeneity in SPSS.

Overall, there was a 14% increase in mental health presentations during the pandemic. There was a significantly greater proportion of presentations of psychosis during the pandemic period (p<.014) and for medication review (p=.03) and significantly less presenting with addiction (p <0.001). Of those patients seen in the Emergency Department in 2021, 54.3% were known to the CMHT in the previous 6 months. in 2019, mental health presentations made up 1.36% of total ED attendances. This increased to 1.47% in 2020. From January to August 2021, 2.62% of ED attendances were mental health presentations.

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The Covid-19 pandemic led to increased mental health presentations to Sligo University Hospital emergency department, with a significantly greater proportion presenting with psychosis and for medication review. These findings have implications around patient care and service provision. These results show that the prevalence of mental health has increased during the pandemic, particularly severe and enduring mental illnesses. New strategies must be implemented to accommodate to this increase in presentations.

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Human functioning in the physical, emotional, psychological, and social arenas is improved by contact with animals.

This study aimed to explore the affective relationship of older adults with their pets during the COVID-19 pandemic; and to assess how the affective relationship with pets contributed to older adults’ mental health.

This qualitative study included 176 participants aged 65-88 years from Portugal, the United Kingdom, and Spain. All interviews went through content analysis.

Findings indicated five themes: (1) Meaningful Emotional Relations (86%); (2) Intimacy with Partners (68%); (3) New Emotional Connections (61%); (4) Sensory Stimulation (55%); and; (5) Physical Enjoyment (23%). As for the second objective, three main themes emerged from the content analysis: (1) Decreasing Depressive and Anxiety Symptoms (73%); (2) Easing Feelings of Loneliness (68%); and (3) Reducing Mood Swings (43%).

The affective relationship between older adults and their pets was relevant during the COVID-19 pandemic, since it allowed for solidifying affection relationships with their partner and creating new ones. Additionally, it contributed for deepening the affective relationship with themselves, in terms of sensory stimulus, physical touch and physical pleasure. Owning a pet, was important for improvement in mental health symptoms, associated to depression, anxiety, and mood swings.

Keywords: Affective relationship; animal companionship; COVID-19 pandemic; mental health; older adults; pets.

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The COVID-19 pandemic has had an impact on the mental health of the population that, to some extent, may be due to the neurotropism of SARS-CoV-2. However, evidence is extremely sparse on the prospective association between serological evidence of COVID-19 infection and psychological distress.

We aimed to explore the prospective association between seropositivity and psychological distress – assessed by symptoms of depression, anxiety and stress – in the general adult population in southern Switzerland. Further, we investigated whether this association varied over time and between pandemic waves.

We used data from 305 adults who participated in the Corona Immunitas Ticino (CIT) prospective sero-survey cohort study. We tested the association between serologically confirmed SARS-COV-2 infection at baseline (June–December 2020) and depression, anxiety and stress scores as measured by the DASS-21 scale at three time points between December 2020 and March 2021, also taking into account for sociodemographic characteristics (age, gender, education level, presence of chronic diseases, smoking, obesity).

In our sample, 84.3% (mean age of 51.30, SD= ± .93) were never infected. Seropositive participants were significantly younger on average (M=46.90, SD= ±2.00, P= .04). At the first follow-up (see Table 1), seropositive participants had higher rates of mild conditions for depression (OR= .64; P= .014) and anxiety (OR= .50; P= .030), than seronegatives. Overall, after the 6-month follow-up, seropositive participants had significantly lower rates of mild conditions for DASS-21 subscales. In addition, prevalence of mild conditions for depression, anxiety and stress decreased more rapidly over time among infected vs. never infected (see Figure 1). Older age and the presence of chronic diseases were associated with mild anxiety (OR= .97; P= .013; OR=3.47; P= .001) and stress (OR= .96; P= .003; OR= 2.56; P= .010).Table 1.

Associations (Odds Ratios) between seropositive immunological status and mental health between December 2020 and March 2021 in Ticino, southern Switzerland (N=305)

Our results provide new evidence on the association between COVID-19 seropositivity and poor mental health and underline the public health implications of the pandemic because the number of infected individuals largely exceed the 770 million of recorded COVID-19 (symptomatic) cases.

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Digital interventions have been found to be successful in preventing occupational mental health concerns, however, they seem to be affected by attrition bias through high attrition rates and differential attrition. Differential attrition arises when the rates of participant dropouts differ across different treatment conditions and is considered a significant challenge to internal validity.

We aimed at systematically review and meta-analyse differential attrition of digital mental health interventions in the workplace setting.

On January 2, 2022, we performed a search in the following electronic databases: PubMed, Scopus, and Web of Science Core. We utilized a combination of terms from five distinct areas, namely mental health, intervention, workplace, implementation, and study design. The study encompassed adult employees who took part in a randomized control trial aimed at preventing mental health issues in the workplace through an online intervention. A team of six reviewers collaborated on the study selection process, while two independent researchers conducted the data extraction for the selected studies. We performed a meta-analysis of the log-transformed relative attrition rates of the included studies using a random-effects model with limited maximum-likelihood (REML) estimation to account for the degree of heterogeneity.

A total of 19 studies were included in the meta-analysis. For baseline to post-intervention, the average total attrition was 26.27% (SD = 21.16%, range = 0 – 66.3%) and the random effects model revealed a higher attrition rate in the intervention group compared to the control group, with a pooled risk ratio of 1.05 (95% CI: 1.01 - 1.10, p = .014). For baseline to follow-up measurement the average total attrition was 27.71% (SD = 20.80%, range = 0 – 67.78%), however, in this case the random effects model did not indicate a higher attrition in the intervention group when compared to the control group (pooled risk ratio = 1.05, 95% CI: 0.98 – 1.12, p = .183).

There is an indication of higher attrition in the intervention group as compared to the control group in occupational e-mental health interventions from baseline to post-intervention, however this does not seem to be the case for baseline to follow-up attrition. These results should be taken into account in the design process of studies and statistical analyses should be adapted to counteract the bias that could result from differential attrition.

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Poor mental health of university students is a growing concern for public health. Indeed, academic settings may exacerbate students’ vulnerability to mental health issues. Nonetheless, university students are often unable to seek mental health support due to barriers, at both individual and organisational level. Digital technologies are proved to be effective in collecting health-related information and in managing psychological distress, representing useful instruments to tackle mental health needs, especially considering their accessibility and cost-effectiveness.

Although digital tools are recognised to be useful for mental health support, university students’ opinions and experiences related to such interventions are still to be explored. In this qualitative research, we aimed to address this gap in the scientific literature.

Data were drawn from “the CAMPUS study”, which longitudinally assesses students’ mental health at the University of Milano-Bicocca (Italy) and the University of Surrey (United Kingdom). We performed detailed interviews and analysed the main themes of the transcripts. We also performed a cross-cultural comparison between Italy and the United Kingdom.

Across 33 interviews, five themes were identified, and an explanatory model was developed. From the students’ perspective, social media, podcasts, and apps could be sources of significant mental health content. On the one hand, students recognised wide availability and anonymity as advantages that make digital technologies suitable for primary to tertiary prevention, to reduce mental health stigma, and as an extension of face-to-face interventions. On the other hand, perceived disadvantages were lower efficacy compared to in-person approaches, lack of personalisation, and difficulties in engagement. Students’ opinions and perspectives could be widely influenced by cultural and individual background.

Digital tools may be an effective option to address mental health needs of university students. Since face-to-face contact remains essential, digital interventions should be integrated with in-person ones, in order to offer a multi-modal approach to mental well-being.

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Psychiatric care faces a significant challenge in the regular monitoring of patient states, predicting relapses, and ensuring treatment adherence. To address this, we aim to develop a mobile application tailored to individual patient needs. This application will revolutionize mental health care by offering real-time monitoring, education, evidence-based interventions, and enhanced communication between patients and clinicians.

This ongoing study seeks to develop and evaluate a mobile application for individuals with schizophrenia spectrum disorders, aiming to transform personalized mental health care by addressing critical challenges in psychiatric care.

The study follows a multi-phase approach, incorporating prototype development, a proof-of-concept trial, and a Randomized Controlled Efficacy Study (RCT). Each phase is informed by iterative stakeholder feedback, ensuring responsiveness to real-world needs and experiences. The research was approved by the Semmelweis University Regional and Institutional Committee of Science and Research Ethics (SE RKEB: 85/2023).

In the pilot phase, we have effectively tracked the daily well-being of participating patients through interactive activities and structured questionnaires. Our experiences in this phase promise to offer valuable insights for the psychiatric community, shedding light on the potential of personalized mental health care interventions.

This ongoing study represents a pivotal step towards redefining interventions for individuals with schizophrenia spectrum disorders. Early results signal a transformative potential in enhancing symptom management. As the study advances, deeper insights will emerge, emphasizing the profound impact of leveraging mobile technology in personalized mental health care.

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Behavioral disorders have been defined as a “health crisis” of modern times that has a significant impact on the parent-child relationship. In this scenario, the emotional regulation (ER) of each partner plays a central role and serves a protective factor, configuring as an area to intervene. The Connect Parent Group, an attachment-based intervention for parents, has shown evidence of effectiveness. However, its online version (e-Connect) has not yet garnered specific evidence related to emotional and physiological regulation in parents and preadolescents.

This study aimed to explore changes in the short and medium term regarding ER abilities - both self-reported and measured through physiological indices - in parents and preadolescents with behavioral disorders, building upon initial findings from an online parenting intervention.

28 parents (82.1% mothers, 17.9% fathers, M_age = 47.48, SD = 4.73) and their 28 preadolescents with behavioral disorders (M_age = 11.22 years, SD = 2.69, 35.7% girls) were recruited from child neuropsychiatry services in Northern Italy and subsequently took part in the pilot study. They were assessed at three time points: before intervention (T1), one months after the intervention (T2) and at 6-months follow-up (T3). ER were assessed with a multimethod approach: parents and children completed a self-report questionnaire (i.e., Difficulties in Emotion Regulation Scale and How I Feel, respectively) and then they interact during a stress-task in which physiological parameters (i.e., Galvanic Skin Response, GSR; Heart Rate/Beat per Minute, BPM) have been measured.

Regarding self-reported ER, mixed-effects regression models showed an improvement in parent emotion dysregulation between T1 and T3 (p=0.004), a decrease in preadolescents’ negative emotions (p=.012) between T1 and T2 and a lower emotion intensity in preadolescents between the three-time points (p=.003). Regarding physiological ER, the two overall models of GSR and BPM were not significant for both parents and children. Yet GSR correlations within three-time points were positive and significant for children (T1-T2: r=.58; T1-T3: r=.68) but not for parents, while BPM correlations between T1 and T2 were significant for parents (r=.49) but not for children.

The online attachment-based parenting program appears to have contributed to a reduction in emotional dysregulation in parents and preadolescents, which seems to persist to some extent in the medium term. The non-significant results at the physiological level may suggest that changes reported by parents and children through self-report questionnaires do not align with changes in the physiological response to interpersonal stress experienced after an online intervention. Clinical and research implications will be discussed.

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A new approach of social therapy for criminal offenders was applied in Penalty Facility in Niš, Serbia. It is based on three month peer-training focusing on recognizing of triggers for anger, understanding emotional manifestation and learning socially acceptable ways of anger expression.

To estimate how the impact of pear-based training influences the level of agression of criminal offenders in prison settings.

One hander and six prisoners were randomly assigned to program. The six previously educated inmates trained the participants through 12 work-shops. An independent professional evaluated change in aggression levels after training using Buss&Perry Aggression Scale. We compared subgroups with shorter versus longer sentences pre and post training using Student’s t test. And univariate logistic regression analysis for impacts of sociodemographic variables on aggression scores.

We found a significant higher scores of anger (6.6 ± 4.7 & 11.8 ± 4.2, p=0,043) hostility (15.5 ± 8 & 20.1 ± 6.5, p=0,029) and total aggression (32 ± 14 & 48 ± 21, p=0,023 in subgroup with longer sentences at baseline. After training anger (12.4 ± 4.8 & 15.5 ± 5.6, p= 0,0167), physical aggression (14.6 ± 51. & 17.2 ± 5.6 ,p=0,024) and total aggression score (55.5 ± 14.1 & 68.2 ± 18, p=0,0152) remained higher in the group with sentences more than five years. Lower education level is associated with undesirable outcome-higher level of aggression after training.

Three months training was not sufficient for adopting skills for better control of aggressive behavior in criminal offenders never the less the length of the sentences.

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Research indicates that psychopathy can hinder treatment success and can lead to dropout. Impulsivity is a complex construct that overlaps with psychopathic personality traits and is often targeted in forensic psychotherapy due to its relation to the risk of reoffending.

Our aim was to investigate the overlap between psychopathy and impulsivity and the influence of psychopathic traits on change in impulsivity.

We conducted a pre-post-study for measures of psychopathy and impulsivity in men imprisoned for sexual and non-sexual violent offenses. All participants took part in standardized pre- and post-treatment ratings shortly after admission as well as after an average of 19 months (n=370 for pre-rating, n=168 for post-rating). Psychopathy was measured via the PCL-R, impulsivity with the BIS-15.

We calculated two-tailed Pearson correlations for BIS-15 Pre-, Post-, and Change Scores and the PCL-R. In a second step, the BIS-15 pre-post-differences were compared using independent t-Tests, effect sizes were calculated using Cohen’s d (small, medium, and large effect sizes are d = .20, .50, and .80). Further, unpaired t-tests were carried out to compare between participants with lower and higher PCL-R sum scores (median split, mdn= 15.8, M=15.5, SD=7.9).

In the total population a significant reduction of self assessed impuslivity can be demonstrated for total impulsivity (p<.001, cohens d= .34) nonplanned (p<.001, cohens d= .39) and motor impulsivity (p=.004, cohens d= .23). In both groups, with higher and lower psychopathic traits, a significant reduction in total  and nonplannend impulsivity can be seen.

While the reduction in total impulsivity was 0.9 points higher in the group with higher psychopathy, the difference was not significant, t(147.8)= -1.1, p = .285. Also, the nonplanned impulsivity was showed a stronger reduction in the high PCL group, though the effect was not significant, t, t(166)= -1.2, p = .243.Table 1.

Correlationen between BIS-15 post-ratings and PCL-R

We demonstrate a significant correlation between psychopathy and impulsivity, especially regarding facets 3 and 4, but also for the sum score. Neither the PCL-R sum core, nor the facets correlate with the change in impulsivity during treatment progress in the STU. In both groups, with higher and lower psychopathy, impulsivity was reduced during therapy but there was no significant difference in the change scores. Our results underline that treatment progress can be achieved also in patients with higher psychopathic traits.

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Forensic psychiatric services serve a dual purpose: treatment of mental disorders and prevention of associated violent reoffending. Progression along the secure care pathway is often impeded by impaired insight, mainly as a result of treatment-resistant psychoses.

We assessed levels of insight among patients in Ireland’s National Forensic Mental Health Service before and after its relocation from the historic 1850 campus in Dundrum to a modern facility in Portrane, Dublin.

The VAGUS insight scale was used in this repeated measures study before and after the relocation at two time points 42 months apart. All inpatients were invited to participate in completing the self-report (VAGUS-SR) and clinician-rated (VAGUS-CR) versions on both occasions. Total scores of both versions were averaged to obtain a combined VAGUS insight score. Corresponding Positive and Negative Syndrome Scale (PANSS) scores were used to ascertain correlations between the insight and symptomatology scales. This study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)

40 pairs of observations were available for legal capacity to consent to medication, combined VAGUS-CR and VAGUS-SR assessments of insight (Cronbach’s alpha=0.927), and PANSS. VAGUS-CR insight and PANSS scores were progressively better from admission and high dependency wards through medium-term medium secure wards to rehabilitation and pre-discharge wards. Mean scores did not change significantly over this time interval. Those legally certified fit to give or withhold consent by their treating consultant psychiatrists scored significantly better on the VAGUS combined insight scale: 8.3 (SD 1.7) v 5.3 (2.2) at baseline, paired t=25.9, p<0.001; and also 42 months later: 8.2 (1.4) v 5.7 (3.9), paired t=5.2, p=0.022. PANSS subscales were all significantly better for those assessed as being capacitous. Change in combined VAGUS score correlated with change in all PANSS subscales. Binary logistic regression with legal capacity as the dependent variable yielded a model in which combined VAGUS score and PANSS positive symptom score were independent determinants of assessed capacity status. Receiver operating characteristic area under the curve was 0.873, 95% CI 0.760-0.986, at baseline and 0.856, 95% CI 0.720-0.991, at 42 months. A score of 7.3 yielded a sensitivity of 0.8 and a specificity of 0.8.

The combined VAGUS score is a reliable and valid measure of insight relevant to functional mental capacity to consent to treatment with sensitivity and specificity sufficient to guide but not bind clinical decision-making. It measures a quality that varies with symptom severity but is also partly independent of symptom severity; the constructive inclusion of self-reported insight is notable.

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Forensic psychiatry is a subspeciality that encompasses applying scientific and clinical expertise in legal contexts. As a field of psychiatry, forensic psychiatry has continued to evolve in various jurisdictions. Several journal publications continue to highlight the contributions and works of various psychiatry researchers in this area on scientific development and trends in practice. However, a quantitative assessment of these publications using a bibliometric analysis has yet to be done. Thus, the present study.

Provide a qualitative assessment of the bibliometrics of peer-reviewed research in forensic psychiatry.

In this bibliometric analysis, we used Web of Science (the most frequently used database) to identify research articles in forensic psychiatry from inception to December 2023. Analysis was done using citespace and VOSviewer software.

Five thousand six hundred ninety articles were identified with 115 countries, 4144 institutions and universities, and 1660 authors. The articles were published in 1022 journals (most are specific to the field), and 4707 unique keywords were used to identify relevant articles. Risk assessments, violence, recidivism, psychopathy, and schizophrenia are the main areas researched. Sixteen funding agencies have funded ten or more articles in the field. The studies were mainly from high-income countries and a relatively scant number from low-income countries, especially African countries. Publications with themes on risk assessment tools – such as the HCR-20- appeared predominant across the analyzed publications.

Research in forensic psychiatry has continued to grow over time. While many jurisdictions across the globe have embraced the field, more effort is needed to promote forensic psychiatry and research in low- and middle-income countries (LMICs). The themes or keywords that emerged from the publications included in this analysis suggest that forensic psychiatry mainly deals with offenders with schizophrenia or psychopathy.

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The Finnish forensic psychiatric service system lacks the standards and criteria guiding the quality and contents of patient care. Ensuring best recovery-oriented practices in forensic psychiatric services need to be developed at several levels.

The purpose of this research project is to develop safe, high-quality psychiatric care. The outcome of this project is the production of quality criteria for the forensic psychiatric care and service system.

The study will be executed at the Department of Nursing Science of the University of Turku during 2023-2026. The research methods include a literature review, a survey based on validated measurement questionnaires (Downes Survey, QPC-FIP, QPC-FIPS), individual and group interviews as well as the Delphi method. The research will cover the multidisciplinary employees at adult psychiatric wards in Finland’s larger hospital districts, employees of forensic psychiatric hospitals, and patients of forensic psychiatric hospitals. International specialists and specialists within Finland from various fields (nursing, medicine, psychology) will be invited to partake in the expert panel.

The research results will allow the development of the service system for forensic psychiatric patients in such a way that the identification of so-called risk patients can be improved already at the early stages of treatment, at the general psychiatric level. Moreover, the substance of care and participation during care can be created and the care following inpatient care and the patient’s transfer out of forensic psychiatric care can be developed. The research may promote the effectiveness of treatment by highlighting areas in the care chains that, when reinforced, will allow patients to receive the right kind of treatment at the right time. A proposal of standardized operating methods and quality criteria will be created for the Finnish forensic psychiatric treatment system. The research project will also reveal previously unresearched information that can be utilized in national health policy.

The project will promote equal prospects for wellbeing and a participatory society for citizens by exploring the views of forensic psychiatric patients and thus developing forensic psychiatric services. The project will promote sustainable employment by exploring the views of psychiatric personnel and increasing the quality and safety of psychiatric services.

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Systematic reviews show a high prevalence of mental distress among victims of human trafficking. In criminal proceedings in Spain, a forensic expert assessment of survivors may be ordered by the courts. Its aims are mainly, albeit not exclusively, to determine the consequences of trafficking on the physical, mental, and social health of the victims. The Institute of Legal Medicine and Forensic Sciences is the public institution providing psychiatric expert assessments in the autonomous region of Catalonia (Spain). Recently, a unit devoted to the forensic assessment of human trafficking victims has been created at the central headquarters of the Institute in Barcelona.

To describe the characteristics and the mental health status of trafficked people identified as victims in criminal proceedings.

Retrospective study of case records of victims of human trafficking at the Institute of Legal Medicine and Forensic Sciences of Catalonia (2016-2023).

Case records of 50 survivors were identified. 38 (76%) were female; mean age was 30,5 years (SD 10,42; range 17 to 69 years). All of them were foreigners, mainly from Latin America (24; 48%). Most of them were trafficked for sexual exploitation (32; 64%). 11 (22%) were assessed immediately after their rescue (emerging cases). Some of the victims had previous mental health problems, including intellectual disability (3; 6%). Among the non-emerging cases, the most frequently recorded mental disorders at the moment of the psychiatric expert assessment were post-traumatic stress disorder (PTSD; 21; 53,8%) and anxiety (12; 30,8%). Complex PTSD was observed in 1 case.

The majority of human trafficking survivors in the forensic setting suffer from persistent mental health problems as a consequence of their victimisation. A trauma-informed forensic psychiatric assessment is recommended.

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