The russian invasion in Ukraine has significantly affected the mental health (MH) of the local population while access to mental health support remains limited due to multiple reasons coming from both the provider and acceptor sides. The war obviously negatively impacts MH but has also paradoxically given an “open window” for shifting current practices both in the healthcare system and within society. Investigation of current people’s attitudes on this matter should be the primary step to address the issue and initiate any change.

5 main objectives identified to analyze within the convenience sample were: MH state and self-care behaviors during the full-scale invasion, MH stigma and self-stigma, intention to use professional MH support, beliefs on access to professional MH support, query to change current MH attitudes and practices.

This research was conducted using primary data collection. The online questionnaire consisted of 5 blocks and was designed based on PHQ-9, DASS-21, PCL-5, Brief-COPE and CAMI. 332 civilians underwent the survey in March-April 2023 and were divided by age, gender, location and situation; inclusion criteria were to be >16 y.o. being affected by war and capable of completing the survey in Ukrainian. Relevant ethical measures were applied. Descriptive and correlational analysis was used to analyze the data.

The majority of respondents rated their mental health as good. Anxiety was the most prevalent emotion, particularly among younger age groups. Different genders and age groups exhibited varying combinations of emotions, such as fatigue, peace, anger, sadness etc. Many participants felt self-reproach for not doing enough; coping strategies varied among age groups. Females were 8.14 times more likely to seek mental health support, and those inside Ukraine were 0.32 times less inclined. 66.2% never seek any MH services, with older men leading; only 8.7% consult specialists during crises, showing gender differences. Distrust in specialist qualifications is one of the barriers on access in people’s beliefs and is more prevalent among older generations. The absence of self-mental health stigma makes individuals 1.91 times more open to accessing support. Location affects openness to change, with Ukraine-based individuals being less open. Lastly, 29.5% consider alternative stress-coping methods, with 40% open to future psychological help.

Our findings show differences in populational attitudes towards MH in Ukraine during the war and therefore the importance of any potential intervention to precisely tailor certain subgroups, beliefs behaviors and needs within them to have a higher chance of being accepted and increase MH support utilization in the population overall.

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The perception that individuals afflicted with mental disorders may exhibit potential harm or unpredictability is common in the general population and, as studies have shown, mental health-related stigma is not confined to the broader public but is progressively emerging as a concern within professional circles as well, adding additional burden to patients in psychiatric settings who already encounter an array of impediments stemming from societal prejudice.

In this cross-sectional study, we aimed to investigate the attitudes of adult and child psychiatrists towards people with mental health problems in Slovenia.

The stigmatizing attitudes were measured by an internet-based, anonymous survey using the Opening Minds Stigma Scale for Health Care Providers (total score and three subscales are the following: attitude, disclosure and help-seeking, social distance).

Altogether, n=90 practitioners (n=18 males, n=72 females) completed the survey. The bifactor ESEM model showed the best model fit (RMSEA=0.060, CFI=0.970, TLI=0.939); however, exploratory factor analysis results indicated the weakness of items 1 and 11. Those participants who have a possibility to attend case discussion groups are more willing to disclose their own mental health issues or seek help (8 (7-9) vs 9 (8-11.5)); however, they prefer more social distance from their patients (9(7.5-10) vs 7(6-9)). Gender differences were found as well, women seem to keep more social distance (p=0.031). Interestingly, those practitioners who reported spending 75% of their working hours with patients kept less social distance compared to those who engage in other activities (p=0.028).

This study is the first to describe the stigmatizing attitude of psychiatric practitioners in Slovenia from their perspective, and it provides directions for anti-stigma interventions.

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The negative impact of adverse childhood experiences (ACEs) on mental health has been well documented. While most of the evidence comes from samples of adolescents and young adults, few studies have investigated whether ACEs contribute to poorer mental health among older adults. In particular, depressive symptoms are common in old age, and they display heterogeneous patterns of development across individuals. Therefore, it is important to examine if ACEs are predictive of distinct trajectories of depressive symptoms among older adults.

Using longitudinal data from the English Longitudinal Study of Ageing (ELSA), we aimed to examine if ACEs could differentiate between distinct trajectories of depressive symptoms over eight years in community-dwelling older adults.

Participants from ELSA aged 60 or above who reported no psychiatric diagnoses and completed the items of ACEs at baseline (wave 3) were included in the current study. Nine items of ACEs were subject to a principal component analysis to identify the underlying subtypes. Data of depressive symptoms from waves 3 to 7 (2-year apart), assessed with the 8-item Centre for Epidemiological Studies Depression Scale, were extracted for modelling the distinct trajectories using latent class growth analysis. The trajectories were predicted by subtypes of ACEs using multinomial logistic regression, adjusting for childhood socioeconomic status, sex, age and ethnicity.

The final sample consisted of 4057 participants (54.4% female, mean age= 71.34 (SD= 8.14)). We identified five trajectories of depressive symptoms (Figure 1): ‘low stable’ (73.4%), ‘increasing then decreasing’ (9.9%), ‘high decreasing’ (7.1%), ‘high stable’ (5.7%) and ‘moderate increasing’ (4.0%). Four subtypes of ACEs (i.e., sexual abuse, separation from natural parents, family dysfunction and physical assault) were evident. Compared to the ‘low stable’ group, higher levels of family dysfunction were reported in the ‘increasing then decreasing’ (aOR = 1.35, 95% CI [1.10 - 1.66], p = .012), ‘high stable’ (aOR = 1.59, 95% CI [1.30 - 1.96], p < .001) and ‘moderate increasing’ (aOR = 1.55, 95% CI [1.18 - 2.04], p = .011) groups. The ‘high stable’ group also reported a higher level of separation from natural parents than the ‘low stable’ group (aOR = 1.34, 95% CI [1.04 - 1.72], p = .047). Sexual abuse and physical assault did not predict any group differences.

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Distinct trajectories of depressive symptoms among older adults were predicted by family dysfunction in childhood. Our findings suggested that the negative impact of ACEs on mental health may extend beyond adolescence and young adulthood into the old age.

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While transient loneliness refers to feelings that last for a short time (less than two years), chronic loneliness alludes to feelings that last more than two years. Transient loneliness can appear after stressful life events such as retirement and loss of close social connections whereas chronic loneliness is more strongly related to maladaptive social cognition, poor social support, and lack of intimate relationships. In comparison to transient loneliness, chronic loneliness is more strongly linked to mental health problems, particularly the incidence and recurrence of depression. Therefore, understanding the specific risk factors for both types of loneliness would be of great utility in mitigating their impact on mental health.

Our aim was to test distinct measures and risk factors for chronic and transient loneliness as well as cross-sectional and longitudinal associations of transient and chronic loneliness with depression.

Responses from participants in Wave 5 (T1, 2013) and Wave 6 (T2, 2015) of The Survey of Health, Ageing and Retirement in Europe (SHARE) (N=45,490) were analyzed. The existence of clinically significant symptoms of depression was defined as reporting a value≥4 on the Euro-D scale. Loneliness was measured through 3-item loneliness scale and a single question. Both measures were tested in separate logistic regression models to identify risk factors for transient (loneliness at T1 but not at T2) and chronic loneliness (loneliness at both time points) as well as their impact on depression.

Between 47% and 40% of the cases of loneliness became chronic, according to the UCLA scale and the single question, respectively. Risk factors for both loneliness courses were being female, not being married, having a low educational level, having a poor physical health, having a poor social network and living in a culturally individualistic country. Risk factor for chronic loneliness were stronger, particularly those related to health status and social networks. Chronic loneliness showed also a strong association with depression both cross-sectionally and longitudinally, while transient loneliness showed a weaker cross-sectional association and markedly lower probabilities in the longitudinal association.

Risk factors for chronic loneliness and measures of the temporal dimension of loneliness should be considered in psychosocial interventions designed to prevent mental disorders.

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In Ontario, Canada, patients may be admitted to the hospital involuntarily if they are deemed to be suffering from symptoms of a mental disorder that may result in imminent serious bodily harm to themselves or others, or that may cause serious physical impairment to themselves (e.g., inability to keep themselves safe and warm in the winter). This measure can be life-saving. However, in addition to ethical and human rights considerations, resorting to coercive admissions may be an indication that those who are suffering from mental illness are not able to access or receive timely and appropriate intervention. While recent studies have suggested that the rate of involuntary hospital admission may be increasing, data on social determinants of involuntary hospital admissions are limited.

We examined social factors associated with involuntary admissions using a Canadian provincial database.

Binary logistic regression models were conducted to examine the associations between social factors (low income, indigeneity, rurality, housing type) and involuntary admissions, controlling for age, sex, and psychiatric diagnoses. Data from March 2019 to March 2021 was extracted from the Ontario Mental Health Reporting System admission dataset, comprising of a sample of 9,848 patients admitted to eight psychiatric hospitals in Ontario. Odds ratios and 95% confidence intervals are reported.

In 2021, the proportion of involuntary patients increased significantly by 6.8 percentage points to 55.7% compared to the previous year (48.9%). Indigenous status (First Nations, Metis, Inuit) [1.75 (1.38-2.21) **], living in rural areas [2.78 (2.48-3.12)], living in assisted residence [1.41 (1.21-1.64) **], homelessness [1.63 (1.38-1.91) **], male sex [1.21 (1.10-1.33) **] and younger age [0.99 (0.98-0.99) **] were associated with involuntary admissions, while income was not a significant factor. Compared to a diagnosis of a psychotic disorder, substance use disorders [0.11 (0.10-0.13) **] and mood and anxiety disorders [0.32 (0.29-0.36) **] showed decreased odds of involuntary admission, while neurocognitive disorders increased the odds of involuntary admission [3.86 (2.91-5.11) **].

Consistent with other findings, involuntary psychiatric hospital admissions in ON, Canada, have increased recently, which may in part be related to the pandemic. Rurality, indigenous status, and unstable housing have been found to be associated with involuntary admissions. The study findings support the need for better preventive and intervention strategies to serve vulnerable psychiatric patients, including addressing the social determinants of health such as housing, and increasing access to culturally competent and safe community-based mental health supports and services.

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The study aims to explore the utility of BDNF Val66Met polymorphism as a potential biomarker in Indian bipolar disorder patients and its correlation with clinical characteristics.

Genotyping Val66Met in BDNF gene

Exploring its association with bipolar disorder (BD).

150 consenting BD patients and matched controls were recruited using a case-control study design. BD severity was assessed using Young’s mania rating scale and the Clinical Global Impression - Severity (CGI-S) scale. BDNF Val66Met polymorphism was identified through real-time PCR after DNA extraction. Data was tested for normal distribution. Genotype frequencies between two groups were compared and the Hardy-Weinberg equilibrium assumptions were tested using Chi-Square tests. Clinical-genotypic associations were explored using the Kruskal-Wallis test and confirmed using hierarchical regression.

Our sample had more males (60%) than females (40%) with mean age of 35.05 years. Most patients had established bipolar disorder and were severely ill (CGI: 38.75, YMRS). Val66Met SNP genotype frequency differed significantly between cases and controls. Val66Val genotype and Val allele were higher in cases. Results consistent with Hardy-Weinberg equilibrium.Table 1.

Genotype frequencies of BDNF (rs6265) in cases and controls

Our study found that Val66Val genotype and Val allele were higher in cases and could be a potential biomarker for bipolar disorder (BD), which is consistent with previous research conducted on the European population. However, further investigations are required to gain a more comprehensive understanding of its impact on BD, including its association with serum BDNF levels, treatment outcomes, and a more diverse study population.

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Pharmacogenomic testing in psychiatry is an emerging area with the potential clinical application of guiding medication choice and dosing. However, this has not been adopted widely due to a combination of barriers that include a varying evidence base, clinician and patient familiarity and acceptance, uncertainty about cost-effectiveness, and regulatory requirements.

This review aims to examine recent updates in this field and provide a contextualised summary and recommendations for Asian populations. The recommendations serve to guide healthcare professionals in the utility of pharmacogenomic testing in psychiatric practice.

A review of recent literature about current evidence and guidelines surrounding pharmacogenomics in psychiatric practice was carried out with particular attention paid to literature evaluating Asian populations. Literature was reviewed for the different classes of psychotropics with supplementary information about Asian populations included where available. Existing evidence about combinatorial pharmacogenomic panels was also reviewed.

In line with the available body of evidence, we recommend that pharmacogenomic testing should be employed as an augmenting tool to guide medication selection and dosing in certain clinical situations, and not as part of standard or routine clinical practice. Pharmacogenomic testing should also be mainly limited to the known drug-gene pairs such as the anti-depressants and CYP2C19 or CYP2D6. Clinicians should also be aware that many of the gene-drug associations have not been evaluated for clinical outcomes. Combinatorial pharmacogenomic panels are not presently recommended as there is limited and inconclusive available evidence on clinical outcomes.

Pharmacogenomic testing in psychiatry is not recommended as standard or routine clinical practice. Exceptions may include concerns about drug concentrations (due to metaboliser status) or potential severe adverse drug reactions/ Pharmacogenomic testing should be mainly limited to the known drug-gene pairs such as the anti-depressants and CYP2C19 or CYP2D6.

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Although suicide claims more lives than war and homicide, we still have no sufficient and effective methods either for its prediction or for its prevention. Our screening methods are laborous and subjective both on the side of the patient and on the side of the clinician. Understanding the genetic background of suicidal behaviour would help identify biomarkers for screening as well as pathways as potential targets for novel intervention and prevention approaches. However, in spite of a number of GWAS studies, results are few and rarely replicate, and generally accurate phenotyping and sufficient consideration of environmental stressors is also missing.

In our present study we performed a genome-wide analysis study for suicidal ideation in interaction with early childhood traumas in a deep-phenotyped general population sample.

Our analysis used data from 1800 volunteers in the NewMood project. As outcome phenotype the suicidal ideation item of the Brief Symptom Inventory was used. A modified version of the Childhood Trauma Questionnaire was used to assess early adverse experiences. A genome-wide association analysis was performed with Plink 1.9, including a total of 3,474,641 variants after quality control steps, followed by genome-wide by environment interaction analyses. Our models included control variables for sex, age, and the top 10 genomic principal components. Functional annotation of SNPs was carried out using FUMA v1.5.6, gene-based tests were performed using MAGMA v1.08.

7 SNPs met suggestive significance in main effect analyses, of which 2 reached genome-wide significance including rs79912020 (p=3.21E-10, β=0.746) and rs10236520 (p=1.71E-08, β=0.484), with no significant findings in gene-based tests. Interaction analyses with childhood adversities yielded 31 SNPs that met genome-wide significance, including rs7983955 (p=2.28E-11, β=0.182), rs141039461 (p=3.90E-11, β=0.0541), rs12692827 (p=3.69E-10, β=0.0612) as the top SNPs. In interaction with childhood adversities, 31 genes showed a significant association in gene-based tests, including RBFOX1 (p=1.09E-10), GRM7 (p=1.20E-10), MTCH1 (p=5.59E-09), and CDH13 (p=6.60E-09) as the most significant findings.

Our results indicate several important novel SNPs associated with suicidal ideation when considered in interaction with the effect of childhood adversities. Furthermore, gene-based analyses replicate several genes playing a key role in central nervous system function such as GRM7 (encoding metabotropic glutamate receptor 7) or previously implicated in association with suicide (CDH13) or suicide-related factors such as aggression (RBFOX1).

Funding: NAP2022-I-4/2022, K143391, 2019-2.1.7-ERA-NET-2020-00005, TKP2021-EGA-25

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Addressing mental and physical health problems and promoting wellbeing in educational settings is a global priority. Teachers present a high risk of stress and burnout, which negatively impacts their professional performance as well as their mental and physical health. Compassion-based interventions have been found effective in promoting psychosocial and physiological wellbeing.

The current paper presents preliminary findings of the impact of a 6-module Compassionate Mind Training intervention for Teachers (CMT-T) on immunological markers and the Conserved Transcriptional Response to Adversity (CTRA; a gene expression signature that involves a group of 53 genes: pro-inflammatory genes, type I interferon response and genes related to antibody synthesis).

A pilot non-controlled study was conducted in a sample of public-school teachers in Portugal (n=36). Participants were assessed at 4 time-points: 1) Extended Baseline Control_M0, in order to establish a within-subjects psychological and biophysiological baseline (8 weeks before the start of the CMT-T); 2) Pre-intervention_M1 (8-weeks after M0); 3) Post-intervention_M2 (8-weeks after M1); and 4) Follow-up_M3 (3 months after the CMT-T end). In all assessment moments, participants completed a set of psychological self-report measures and were assessed in immunological and epigenetic biological markers through the collection of blood. After M1, teachers completed the 8-week group CMT-T intervention and given access to its resources and materials. They were instructed to practice daily and incorporate the teachings in their personal and professional lives. All assessments and the CMT-T intervention took place at the schools.

Preliminary data on the impact of CMT-T on Immune Response Profiling revealed that teachers’ Natural Killer (i.e., NK) cells were decreased after the CMT-T intervention. In regard to the CTRA gene expression, results showed that type one interferon response genes (e.g., IFI16, IFI27L2, IFITM2, IFITM3, IFITM4P) were decreased after the intervention. In addition, we observed that the gene c-Jun, a pro-inflammatory gene, had a decreased expression after the CMT-T intervention.

These preliminary findings seem to corroborate previous studies involving the type one interferon response, the pro-inflammatory genes and antibody synthesis genes in a signature involving 53 genes previously described as the CTRA gene signature. Furthermore, our results suggest that cultivating compassion using a compassion focused intervention may have a positive impact on markers of the immune system response, associated with how our bodies respond to stress, infection and cancer, as well as, on reducing the expression of genes related to our bodies’ response to stress and inflammation.

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ASCL1 (Achaete-scute homolog 1) is a neuron-specific transcription factor involved in CNS maturation in the mammalian brain. It has been shown to be associated with schizophrenia (SZ), Parkinson’s disease, and the development of brain tumors. ASCL1 is expressed in the neuroblastoma cell line SH-SY5Y, which is a widely used model for the study of neurodevelopmental diseases, including SZ.

The aim of this work was to study the effect of functional ASCL1 knockout on the transcriptional landscape of SH-SY5Y cells in undifferentiated and neuron-like phenotypes.

For ASCL1 deletion, SH-SY5Y was sequentially transduced with two lentiviral vectors. One pLV-rtTA-Cas9-(nls)-pCMV-eGFP-PuroR-T2A-rTetR (derived from pCW-Cas9 and pEGFP-Puro) construct encoded Cas9. Stably transduced lines were selected for 3-5 days on puromycin (2 g/L). The inducibility of Cas9 expression was checked after adding the inducer oxytetracycline to the culture medium. The second construct (based on pLK05-tagRFP) encoded, a pair of guide RNAs targeting the start and end of the ASCL1 gene. The sgRNA construct was transduced into the SH-SY5Y-Cas9 cell line in parallel with a nontemplate control (NTC gRNA) as a negative control. Cas9 expression was induced with oxytetracycline for 2 days. Individual clones were obtained by serial dilutions. ASCL1 partial deletion in the clones was confirmed by PCR followed by Sanger sequencing. Disruption of ASCL1 protein synthesis was confirmed by western blot analysis. SH-SY5Y differentiation was induced by retinoic acid (RA). The transcriptomes of mutant clones and NTC controls before and after RA-induced differentiation were sequenced using Illumina technology.

RNAseq data show that a wide range of genes are differentially expressed between control NTC gRNA and wild-type SH-SY5Y. This can be explained by insertional mutagenesis of lentiviral vectors and/or cellular response to the presence of lentiviral constructs. Therefore, we compared the transcriptomes of the ASCL1-del line with NTC control. Differentially expressed genes (DEGs) are predominantly associated with the pathogenesis of SZ, bipolar and depressive disorders. DEGs in ASCL1-del are involved in cell mitosis, neuronal projection, neuropeptide signaling, and formation of intercellular contacts including the synapse. During RA-induced differentiation, ASCL1 activity is restricted to the regulation of a small subset of genes involved in neuroplasticity.

We have established a valid cellular model to study ASCL1-mediated mechanisms associated with SZ. ASCL1 dysfunction promotes SZ development predominantly before neuronal differentiation begins, slowing cell proliferation and preventing the formation of neuronal signatures.

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Medical students face an enormous amount of stress (Dyrbye LN et al. Ann Intern Med 2008; 149: 334-41). They suffer from higher rates of depression, anxiety, and suicide compared to the general population. Despite experiencing more mental health problems, there is a lack of research exploring ways to improve their mental health. Although there are a few small sample studies investigating the effectiveness of Mindfulness-Based Stress Reduction (MBSR) on medical students, there is no study comparing its effectiveness against an active intervention group in the literature (van Dijk I et al. Acad Med 2017; 92: 1012-1021)

We aimed to compare the effects of the Mindfulness-Based Stress Reduction (MBSR) and the Cognitive Behavioural Based Stress Reduction (CBSR) group interventions on depressive and anxious symptoms and perceived stress of medical students.

323 medical students applied to participate in one of the group interventions and were assessed with the Mini International Neuropsychiatric Interview. Of these, 253 (77% female, mean age=21.9 ± 2.9 years) were allocated into online MBSR (n=127) and online CBSR (n=126) groups after randomization. Their anxiety and depressive symptoms and perceived stress levels were assessed at baseline and after 8 weeks of interventions. 33,2% of participants (MBSR: n=39; CBSR: n=45) completed the protocol by attending five or more sessions. Both intention-to-treat (ITT) analysis and per-protocol (PP) analysis were used to assess outcomes. In the ITT analysis, we used multiple imputation to address missing values. All assessments and group interventions were done online.

In the ITT analysis, both MBSR and CBSR were found to be slight to moderately effective in reducing symptoms of depression (MBSR: d=.50; CBSR: d=.40), anxiety (MBSR:d=.73; CBSR: d=.52), and perceived stress (MBSR: d=.48; CBSR: d=.42), but they were no superior to each other. In the PP analysis, both interventions moderately to strongly improved the symptoms of depression (MBSR: d=1.03; CBSR: d=.74), anxiety (MBSR: r=-.74; CBSR: r=-.72), and perceived stress (MBSR: r=-.80; CBSR: r=-.68). While there was no statistically significant difference between them in reducing depressive symptoms and perceived stress, MBSR was found to be significantly more effective than CBSR in reducing anxiety symptoms (u=469, z=-2.756, p=0.006).

Both MBSR and CBSR improve symptoms of depression and anxiety in medical students after 8 weeks of interventions. Completing the protocol or attending more sessions may increase the effectiveness of the interventions. While the interventions did not show superiority to each other in terms of effectiveness in reducing depressive symptoms and perceived stress, MBSR appears to be more effective in reducing anxiety symptoms compared to CBSR in the group that completed the protocol.

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Humanitarian workers (HWs) face significant challenges while providing aid to those in need, often leading to psychological exhaustion and the risk of primary or secondary trauma.

Our study aimed to validate and adapt the Greek version of the Brief Resilient Coping Scale (BRCS) for HWs in Greece.

We conducted a cross-sectional study between September and December 2022. Participants were recruited through a self-administered questionnaire distributed via social media to humanitarian groups. Additionally, the questionnaire was sent via email to these groups’ members, who then forwarded it to their respective networks. The questionnaire included the BRCS, a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner. A score of 4-13 points indicates low resilient copers, 14-16 points medium resilient copers and 17-20 points high resilient copers. Cronbach’s alpha was used to assess internal consistency. Confirmatory Factor Analysis (CFA) was employed to evaluate model fit. Adequate or good fit criteria included a χ2 test p-value ≥ 0.05, Root Mean Square Error Approximation (RMSEA) ≤ 0.08, Standardized Root Mean Squared Residual (SRMR) ≤ 0.05, and a Comparative Fit Index (CFI) or Tucker–Lewis Index (TLI) ≤ 0.90. Statistical analyses were performed using STATA and SPSS software.

A total of 151 humanitarian workers (76% females), with a mean age of 39.3±10.6 years participated in the study. The mean BRCS score was 65.6/100. Participants were categorized as follows: 34.6% as low resilient copers, 38.6% as medium resilient copers, and 26.8% as high resilient copers. Cronbach’s alpha for the BRCS was 0.84, indicating good internal consistency. CFA results supported the one-factor solution proposed by the original researchers, with acceptable global fit indices: Chi-square p-value = 0.303, SRMR = 0.028, RMSEA = 0.036, CFI = 0.991, TLI = 0.974.

The findings of our study show that the Greek version of BRCS is a valid and reliable tool that can be used to evaluate resilient coping among humanitarian workers in Greece.

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Recent advances in artificial intelligence (AI) have recaptured and revised the essential roles of death in life and mind. However, their prospects and risks require further study. Because of the development of digital technologies (for example, AI-based chatbots), the process of bereavement may have become complex, immersive, and even addictive. Furthermore, AI-enabled generation of medical notes can ease the administrative burden for healthcare professionals; however, the clinical application of generative AI remains largely speculative.

This study aimed to illuminate the emerging concept and experience of death, bereavement, and addiction associated with cybernetics, thereby expanding their cognitive and ethical aspects.

In this preliminary review, we performed a literature search to identify the current state-of-the-art literature on AI and Internet addiction. We also inspected the possible adaptations to pursue mental well-being with the modified death concept. We mainly searched the PubMed and Web of Science databases using relevant keywords. All retrieved studies were assessed for eligibility to reduce the selection bias.

Current cybernetics have meaningfully recontextualized death that allows interaction with deceased individuals (for example, scholars and artists) to establish their virtual, besides biological, existence using AI-based chatbots. Furthermore, AI consistently provides evidence-based answers to public health inquiries; nevertheless, it may offer unsuitable advice rather than referrals that can sometimes facilitate suicide or harm (instead of help) people in grief, thus requiring more fine-tuned governance. Accordingly, the maladaptive use of existing AI-related communication (such as metaverse characters) can increase Internet addiction prevalence and further complicate autonomy and self-motivation. In addition, excessive internet access is frequently associated with reduced self-control, cognitive flexibility, and exaggerated automatic processing.

We are challenged to acknowledge the tradeoffs of AI and consider ways to compromise by employing flexible perspectives. The emerging concept of death affects or improves the conventional one. The potential advantages and pitfalls of AI-related technology must be carefully weighed against the profound effects they may have on people’s identities, relationships, and mental health. These issues require continued monitoring and assessment in light of the AI/cybernetic-related studies. We hope these results will inspire further research into the appropriate use of AI and palliative care, including suicide prevention, euthanasia, and grief management.

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The transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users.

This paper aims to evaluate the changes in quality of Life status, resilience, and personal recovery of individuals with mental health challenges recently discharged from acute mental health care into the community.

Data for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample t-test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire.

A total of 306 service users were recruited, and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks (p > 0.05).

The study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patients leave inpatient care is adequate to promote full recovery.

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Burnout, marked by persistent workplace stress without effective management, is particularly pertinent for psychiatry nurses, considering the nature of their work environment and its potential impact on the quality of care they deliver.

To assess the prevalence of burnout among psychiatric nurses and to identify the socio-demographic and clinical factors associated with it.

Cross-sectional, descriptive, and analytical study conducted over the course of one month from October 11th to November 8th 2023. Participants included were psychiatric nurses working in Razi Hospital, Tunisia. We collected data using pre-established questionnaire which included socio-demographic and clinical data of the participants. The assessment of Burnout was conducted using the Maslach Burnout Inventory (MBI), validated in Arabic. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) in its 25th version.

We collected data from 55 nurses working in Razi psychiatry hospital during the time of the study. Among them, 80% (n=44) were female. Their median age was 35 (Min=25, Max=62). Most of participants were married (81.8%, n=45) and 70.9 (n=39) had kids. In our sample, 5.5% (n=3) and 23.6% (n=13) had respectively personal psychiatric and somatic history. Some addictive behaviors were identified among our participants, especially smoking (14.5%, n=379) and alcohol use (3.6%, n=2).

Regarding working conditions, 81.8% (n=45) were assigned shift work. They worked in the men’s ward (43.6%, n=24), the women’s ward (34.5%, n=19), or in both (21.8%, n=12). Furthermore, 45.5% (n=25) reported witnessing a suicide attempt during their work, and 74.5% (n=41) were victims of aggression, primarily by patients (82.5%, n=33). Sixty percent (n=33) said expressed a desire to transfer.

According to the MBI, 49.1% (n=27) had high emotional exhaustion, 27.3% (n=15) had high depersonalization and 67.3% (n=37) had low personal accomplishment.

A significant association was found between low personal accomplishment and the desire to transfer to another department (p=0.026). No further links were found with other clinical data.

Our findings provide a thorough examination of burnout among psychiatric nursing professionals, underscoring the critical need for specific interventions tailored to their unique challenges.

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In recent times, there has been a growing emphasis on the significance of fostering intergenerational learning and interaction. This involves individuals from diverse age groups engaging in purposeful and mutually beneficial activities aimed at enhancing their knowledge, skills, and values.

This systematic review was undertaken to explore the psychosocial consequences of intergenerational learning experiences among primary school-age children and older adults.

In accordance with the PRISMA guidelines, a comprehensive review of both quantitative and qualitative data was conducted. Electronic databases such as PubMed, Scopus, and ERIC were meticulously searched up to July 26, 2022, using the following Population (P) - Exposure (E) - Outcome (O) criteria: primary school-age children and older adults (P), participation in intergenerational learning (E), and psychosocial effects (O). Additionally, we extensively scrutinized the reference lists of included datasets and pertinent review articles (Figure 1). To evaluate the quality of the eligible studies, we employed the Mixed Methods Appraisal Tool (MMAT). Data analysis was structured around a narrative synthesis approach.

A total of seventeen studies were deemed eligible for inclusion in this review. The findings regarding the psychosocial consequences of engaging in intergenerational activities for both children and older adults predominantly underscored positive improvements in their attitudes, well-being, happiness, and various other aspects of their social and psychological well-being, although certain methodological limitations were identified (Figure 2).

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Promoting intergenerational interactions and learning experiences holds promise as a means to enhance the overall quality of life and well-being for both younger and older members of our communities.

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Antisocial behavior in older adults is a problem for their relatives and health care providers Antisocial behavior may present differently in the older population which makes it more difficult to diagnose adequately and apply therapeutic interventions. This literature review provides an overview of diverse conceptualizations of antisocial behavior in older adults and the way it affects recognizability of diagnostic categories and the applicability of interventions.

To gain insight into the various manifestations of antisocial behavior in older adults.

A systematic review design was performed. In this review, an extensive manual and electronic literature search was conducted for papers published from 1980 to 2023. For this purpose we used the electronic databases PubMed and Embase. The review will include empirical and quantitative studies of older adults with antisocial behavior.

The results from the literature indicate that antisocial behavior does probably not decrease with age nor the burden on their social environment. Rather, the manifestations of antisocial behavior change as this population ages. Personality disorders are determined by several dimensional trait domains. The domains which are highly predictive for antisocial behavior include antagonism and disinhibition.

These findings challenge the notion of antisocial behavior decreasing with age. This review underscores the need to shift from traditional personality disorder categories to a dimensional trait perspective. Therefore, specific interventions are needed for older adults.

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Very late onset schizophrenia-like psychosis takes the 3rd place among late-life psychosis, after dementia and affective disorders associated psychosis. It’s still unknown the real place of this psychosis.

to investigate the clinical and psychopathological features and short-terms outcomes of late-onset schizophrenia and schizophrenia-like psychosis

45 patients, mean age 70,6 ±8,70 years, median age of manifestation psychosis - 68 [61; 75] years with late-onset schizophrenia (n=19, 42,2%), late-onset schizoaffective disorder (n=9, 20%), late-onset delusional disorder (n=7, 15,5%) and late-onset organic schizophrenia-like disorder (n=10, 22,3%) underwent clinical examination. Psychopathological, psychometric (PANSS, HAMD, CDSS, MoCA) and statistical methods were applied.

3 clinical groups were allocated. The 1st group included 15 patients (33%) and was characterized with severe polymorphic psychotic symptoms, included catatonic and paraphrenic signs with mental disorganization. They had the highest score of PANSS (105,46±17,99, p=0,002) and the lowest score of MoCA (14,2±2,16, p=0,05) in compare with 2nd and 3rd groups. They also had symptoms of depression (CDSS 6,28±5,29), compared with the 3rd group (HAMD 21,00±5,92, p=0,05). In short-terms outcomes was formed negative symptoms and cognitive impairment with decreasing social and daily activity. The 2nd group (22 cases, 49%) included patients with prevalence of delusions of persecution, more rare auditory hallucinations and more often acoasms. They had medium score PANSS (90,22±16,79), with minimal cognitive declare (MoCA average score 20,33±4,27). The short-term outcomes were characterized with formation of residual positive and negative symptoms, that impact on daily and social activity. The 3rd group included 8 patients (8%) with prevalence of delusion symptoms, such as misidentification, persecutory and reference delusions, which were mood-congruent. They had medium PANSS score (89,75±18,90) with more severe depressive symptoms by HAMD scale in compare with 2nd group (22,00±10,00, p=0,07) and minimal cognitive declare (MoCA average score 25,00±1,00, p=0,05) in compare with 1st group. This group was characterized with high level of reduction of productive symptoms and restoration of premorbid social and daily activity in short-term outcomes.

features of clinical characteristics, including the nature and severity of cognitive impairment at the onset of disease, are significant for prognosis and outcomes of disease. The data obtained could be served for the development of personalized therapeutic approaches that take into account the syndromic features and course of late-onset psychosis.

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Sexual satisfaction is relevant to aging well, throughout the lifespan.

This study aims to compare the perspectives of sexual satisfaction and adjustment to aging in three age cohorts, across the life span; and to analyze whether sexual satisfaction influences the perceptions of AtA.

This cross-sectional study comprised participants from three different age cohorts (18-44; 45-64; and 65+ years). Four measures were used to meet the defined objectives: (a) Adjustment to Aging Scale (ATAS); (b) New Sexual Satisfaction Scale (NISS-S); and (c) sociodemographic, health and lifestyle questionnaire. Data were subject to One-way ANOVAs and hierarchical regression analyses.

Social support emerged as the most relevant dimension in the multifactorial nature of AtA. Generational differences were found in sense of purpose and ambitions [F (2, 616) = 14.203, p = .000], social support [F (2, 616) = 10.65, p = .000] and body and health [F (2, 616) = 8.73, p = .000]. Participants aged 65 and older showed significantly lower levels of sense of purpose and ambition, body and health, and social support. Younger participants showed the highest score for body and health. Age-related decreases in sexual satisfaction were also found, as younger participants showed statistically higher levels of sexual satisfaction, followed by middle-aged and older participants. Sexual satisfaction predicts all the dimensions of AtA, exception made for aging in place and stability, where age is the main predictor. Ego-centered sexual satisfaction positively predicted sense of purpose and ambitions (β = .212, p < .05) and social support (β = .311, p < .001); while partner/sexual activity centered sexual satisfaction was a positive predictor of zest and spirituality (β = .255, p < .01), body and health (β = .239, p < .001), and social support (β = .168, p < .05).

Sexual satisfaction decreases with age and is positively related to all dimensions of AtA, hence gerontological interventions and program policies with older people would strongly benefit of including sexual satisfaction as a relevant variable for aging well.

Keywords: sexual well-being; sexual satisfaction; adjustment to aging; generational groups; lifespan.

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While chronic inflammation and enhanced imbalance of pro- and antioxidant, including glutathione-dependent, systems contribute substantially to pathogenesis of mental disorders in old age, extent of oxidative stress and degree of inflammatory processes severity are varying among patients with late onset schizophrenia.

Revealing various phenotypes in patients with late onset schizophrenia basing on measurement of activity levels for blood glutathione-dependent enzymes and inflammation markers and analysis of their links with clinical features of the patients.

Of 59 studied women patients 34 were with late onset (after 40 years) and 25 with very late onset (after 60 years) schizophrenia or schizophrenia-like psychoses (F20; F22.8; F25; F23; F06.2 by ICD-10). 34 mentally healthy women elder than 50 years comprised controls. Glutathione reductase (GR), glutathione-S-transferase (GST), neutrophil elastase (NE), and α1-roteinase inhibitor (α1-PI) activities were measured in blood. PANSS, CDSS and CGI-S were used to assess the severity of psychotic symptoms, depression and treatment effectiveness.

In the whole group of patients, GR was lower (p<0.05), and α1-PI was higher (p<0.0001) than in control group. Clustering the patients by their biochemical and immunological signs revealed two clusters (C1, n=34, and C2, n=25) significantly differing by GST (p<0.0001), NE (p<0.0001), and α1-PI (p<0.001) activities. As compared with controls, GST and α1-PI were higher (p<0.05 and p<0.0001), and NE was lower (p<0.05) in C1. As compared with controls, GR activity was lower (p<0.05), NE activity was higher (p<0.001), and α1-PI activity was much higher (p<0.001) in C2. Patients of C1 and C2 did not differ in age, diagnosis, severity of the disease, but differed in clinical features of the course of the disease: significantly more patients with very late onset schizophrenia (76%) were met in C1 (χ2=13.41, p<0.001). Also, different clinical-biological correlations were found in these clusters. Particularly, negative correlations of baseline NE activity with PANSS general psychopathology subscale scores (R=-0.39, p<0.05) and with total PANSS scores (R=-0.39, p<0.05) were found in C1. Positive correlation of GST activity with PANSS positive subscale score was found in C2 (R=0.43, p<0.05).

The revealed clusters differ in the extent of the glutathione antioxidant system impairment and in levels of the immune response markers. The revealing of the patient subgroups on the basis of biological markers reflecting impairments in metabolic and immune systems can represent interest in the search for individual treatment approaches.

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