Crisis resolution teams (CRTs) are a crucial component of mental health care, providing timely support to individuals experiencing acute mental health crises. This abstract delves into the concept of crisis and seeks to identify the patients who stand to benefit from these specialized services.

Defining crisis within the context of CRTs can be complex. It encompasses not only immediate emergencies but also broader mental health distress.

Research suggests that suitable candidates for CRT interventions are those facing acute mental health crises : This includes individuals experiencing suicidal ideation, severe agitation, or severe emotional distress.

La “Escala de Evaluación de Resolución de Crisis” (Crisis Resolution Team Assessment Tool, CRTAT) de Sonia Johnson es una herramienta diseñada para para medir la efectividad de los CRT y la duración de la intervención en crisis. Establece un límite de seis semanas como el período máximo durante el cual se debe ofrecer la atención en crisis.

Existen otras escalas de evaluación para medir la eficacia de la resolución de crisis:

1. 1. Escala de Intensidad de Crisis (CIS): se utiliza para medir la gravedad de la crisis y la necesidad de intervención inmediata.

2. 2. Escala de Evaluación de Crisis de Brage Hansen (BCES): se enfoca en la evaluación de crisis suicidas y evalúa la intensidad de la ideación suicida y la urgencia de la intervención.

3. 3. Escala de Evaluación de Crisis de Eriksson (ECAS): Diseñada para evaluar la intensidad de la crisis en pacientes psiquiátricos, la ECAS se centra en la agitación, la ansiedad y la angustia emocional.

- Studies have explored the effectiveness of CRTs and the perspectives of service users. Understanding how patients perceive crisis and CRT services is crucial for tailoring interventions effectively.

- CRTs play a vital role in mental health care, offering timely support to individuals experiencing crises. While defining crisis is complex, suitable candidates often include those in acute distress requiring immediate intervention. Understanding the perspectives of service users and the diverse nature of crisis experiences informs effective crisis resolution strategies.

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Cardiac surgery patients, former cardiac patients, face additional sources of stress connected with surgical intervention.

To devise the main principles of a personalized approach in psychosocial interventions for cardiac surgery patients.

We have devised these principles based on the analysis of contemporary scientific literature and the operational experience of the Cardiology Clinic of the Chuvash Republic located in the city of Cheboksary.

A personalized approach in psychosocial interventions for cardiac surgery patients is used at all levels of medical support. It implies taking into consideration in every specific patient a unique correlation of their clinic-anamnestic peculiarities, clinic-psychological risk factors of the condition’s gravity and their psychological resources. At the same time, all the psychological interventions must focus on the personality and comply with the clinic specificity of the actual somatic and mental condition of the cardiac surgery patients. The underlying principles of the personalized approach in psychosocial interventions for cardiac surgery patientsinclude the principles of accessibility, openness, continuity, collaboration, integration, differentiation, variation, participation, awareness and prevention.

Relying on the personalized approach in psychosocial interventions for cardiac surgery patientsallows working out a personalized treatment and rehabilitation course for an individual patient.

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Individual patient safety processes (such as reporting, investigating, learning and improving patient outcomes) activated following serious adverse incidents (e.g. patient suicide) are not distinct or standalone. Rather, they are embedded within a complex system of multiple interdependent processes enacted by individuals who are subject to an array of implicit and explicit influences (Nathan et al. BJPsych Advances 2022; 1-11). Although some specific elements of the response to adverse incidents have been examined, no previous empirical research has set out to study the complex interacting system within which these elements are situated.

This study’s aim was to characterise a complex patient safety system and to identify types of processes across that system that have an impact on the goal of improving patient safety.

Recorded 1:1 semi-structured interviews were undertaken with staff in a range of patient safety roles across a mental health care system to elicit accounts of the system response to serious adverse incidents. These interviews were transcribed, and the transcriptions were subject to thematic analysis using the Framework Method for qualitative research in health care settings (Gale et al. BMC Med. Res. Methodol. 2013; 13.1; 1-8).This preliminary study relates to the analysis of 8 interviews.

The following six main types of influences on the effectiveness of patient safety system responses to adverse incidents were identified:

1. 1. Differing functions/expectations of investigations into serious incidents (due to differing demands of different parties, such as the health provider, the family, the coroner, etc);

2. 2. Differing methodologies used to investigate serious adverse incidents (although system-based generally preferred, there was a noted risk that this approach may fail to identify occasional examples of poor practice);

3. 3. Relationship between incident investigation processes and patient safety processes (with a particular potential for the latter to dominate the system at the expense of the former);

4. 4. System complexity (multiple interacting processes/processors at multiple levels within the health provider and wider health system);

5. 5. Operationalising recommendations from investigations (with the potential for adverse unintended patient safety consequences)

6. 6. Influence of national directives

As well as paying attention to individual components of the safety system (e.g. investigation methodology and organisational culture), the development of an effective patient safety system is dependent on an understanding of the complex interacting processes across the system. This study sheds empirical light on key influences that act across a mental health provider system. Both researchers of patient safety and providers intending to improve their approach to patient safety should take account of such systemic influences on effectiveness.

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Millions of people have migrated because of violence, wars, disasters, and human rights violations, all of which have increased rapidly in recent years. Türkiye has hosted millions of refugees since 2010. Few studies have focused on the mental health needs of refugees or how these needs have been addressed in Türkiye.

This study examined the experiences of Syrian refugees in a community center in Turkiye as they access mental health services and receive psychiatric nursing care.

A qualitative design was adopted in the study. Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semistructured focus group interviews following Colaizzi’s phenomenological method to analyze the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews.

Three key themes related to immigrants’ experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye, and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination, and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care.

This study determined that Syrian refugees face barriers to accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centers, must facilitate the processes to eliminate these obstacles.

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The world of the third millennium is witnessing the highest levels of displacement on record. To meet the specific needs of this vulnerable population, a task-shifting approach is developed, where individuals with refugee background and lived experience are trained and supervised my mental health professionals to provide emotional and practical support to members of their communities.

The evaluation of a scalable psychosocial intervention for refugees based on the task-shifting approach.

The intervention consisted of sessions of Problem Management Plus (PM+) and peer case management delivered by a team of community psychosocial workers (trained refugees). The sample consisted of 173 participants, Arabic- and Farsi-speakers male and female, recognized refugees, and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), and Psychological Outcome Profiles (Psychlops) scales respectively. Repeated measures analysis of variance (ANOVA) was adopted to evaluate the difference in the degree of change across patients’ characteristics over the follow up period. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 26.0).

Significant decreases were found in all post-test scales, indicating diminution of anxiety, depression symptoms, and psychological distress. Large effects sizes were found in all scales.

The findings support that task-shifting approach incorporating PM+ and case management is effective for the mental health of refugees. Peer support could be included in a stepped care model for refugee mental health and well-being in high-income countries. For future research a randomized controlled trial is proposed as a study protocol.

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According to the 2023 statistical report from the Portuguese Migration Observatory, Portugal has received over 72,000 refugees since 2015, with a significant number (56,041) being displaced citizens from Ukraine. This influx includes spontaneous asylum requests. The major countries of origin for refugees in Portugal are Afghanistan, India, Gambia, Pakistan, and Morocco. Notably, refugee populations exhibit elevated incidence rates of specific psychiatric disorders, including post-traumatic stress disorder and depressive disorders. These conditions are independent risk factors for substance use disorders. Furthermore, refugees face unique risks related to their migration journey, increasing their vulnerability to substance use disorders. The prevalence of substance use disorders, especially Alcohol Use Disorder, can reach up to 36% in this population. CAR 1 (Reception Center for Refugees) is a vital social facility in Portugal dedicated to enhancing the reception and integration of asylum seekers and refugees.

Our primary objective is to determine the prevalence of potential alcohol problems and unhealthy alcohol use within the Portuguese Refugee Center in Lisbon. Our secondary aim is to comprehensively characterize the migrant population. This includes gathering data regarding demographic information, legal status, country of origin, pre-migration alcohol-related issues, psychiatric diagnoses, history of psychiatric evaluations, self-initiated help-seeking behavior, and self-perceived alcohol-related problems.

All individuals currently residing in our refugee center (approximately 70 people) will be invited to participate in a comprehensive survey and screening process. Exclusion criteria will apply to individuals with acute psychiatric conditions unable to provide reliable responses. The survey includes the Alcohol Use Disorders Identification Test (AUDIT) and the CAGE questionnaire. Quantitative data obtained from the questionnaires will be analyzed using Microsoft Excel and IBM SPSS 29 software.

We anticipate a high prevalence of positive responses to the AUDIT due to potential alcohol-related issues but expect low responses to the CAGE questionnaire due to limited awareness of alcohol use disorder and a reduced perception of the need for help.

This study could help identify and validate the prevalence of alcohol use disorders among migrants, emphasizing the need for appropriate responses. By shedding light on these challenges, we hope to promote effective responses to alcohol use disorder and encourage the utilization of alcohol screening tests in refugee centers, emphasizing the importance of seeking consultation when needed.

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It is well established that migrants have a 2 to 4 times increase in psychosis risk. However, estimates are highly heterogeneous and vary considerably depending on origin and destination country. It also seems that the relationship between migration and psychosis is complex.

In this review, we aim to explore the moderators, mediators and mechanisms behind migration psychosis.

We searched PubMed using the following terms: “psychosis,” “psychotic,” “migra*”, “immigra*”, “schizophreni*.” “pathogene*”. We limited the search to studies published after 2010 and we screened the title, abstract, and full text. We included a total of 47 studies in this narrative review.

Moderators identified in the literature were country of origin, vitamin D deficiency, male sex, and psychosocial adversity (e.g. exposure to war). Mediators were mostly social, namely discrimination, social exclusion and ethnic minority status, low ethnic density, as well as language distance, unstable housing, and unemployment. Most of the studies we retrieved found that substance use did not fully explain the increased risk for psychosis among migrants. We found that potential pathophysiological mechanisms include stress-induced alterations in dopaminergic neurotransmission, functional and structural alterations in ventral anterior cingulate cortex, as well as possible stress-resultant neuroinflammation.

This review highlights the pathway from psychosocial hardships to neurobiological alterations leading to migration psychosis. Further research is needed to translate these findings into developing preventive measures and tailoring treatment modalities to the migrant population.

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Suicide is a multifactorial phenomenon characterized by many biological, psychological, and social-cultural factors. The study of this phenomenon in migrants is complex, with no theoretical framework that can describe the available heterogeneous data. Although Italy has the fourth largest migrant population of EU, only few studies have assessed suicidal risk in migrants.

The aim of his study is to assess suicide risk factors (hopelessness; interpersonal needs; traumatic experiences) in a sample of migrant patients, and to evaluate the possible application of the Interpersonal Theory of Suicide (ITS). Moreover, suicidal ideation and attempts were compared between migrants and natives. Lastly, a wider psychometric assessment has been conducted (depressive and anxiety symptoms; autistic traits).

In this case-control study, we included 50 migrants vs. 50 natives. Data were collected during the same period by gender, age, and diagnosis. We collected sociodemographic and clinical characteristics. We administered the following tests: Columbia Suicide Severity Rating Scale, Interpersonal Needs Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory-II, Hamilton Anxiety Scale, Childhood Trauma Questionnaire, and Adult Autism Subthreshold Spectrum.

There were no differences in sociodemographic characteristics, except for ethnicity. Otherwise, there were significative differences between diagnosis (p:0.013), with native reporting more Mood Disorders, and migrants reporting more Anxiety, Obsessive-Compulsive, Trauma-Related, Eating, and Substance Use Disorders. Migrants were more prone to be on treatment with Mood Stabilizers (p:0.000). There were significative differences for interpersonal needs, trauma, anxiety, and autistic traits. Migrants show more perceived burdensomeness (p:0.05), more physical neglect (p:0.004), physical abuse (p:0.002), and sexual abuse (p:0.016), more anxiety symptoms (p:0.046), and more empathy alterations (p:0.014). No differences were found for suicidal ideation and attempts, hopelessness, and depressive symptoms.

Despite there were no differences in suicide risk, migrants showed higher rates of perceived burdensomeness (PB) and childhood traumatic experiences (CTE). Both PB and CTE represent cardinal constructs of the ITS. No differences were found for hopelessness and depressive symptoms. Migrants showed higher rates of anxiety symptoms and empathy alterations. Even if suicide rates between migrants and natives were similar, accurate assessment of suicidal risk in migrants is crucial in improving suicide prevention strategies. Suicide risk evaluation in migrants should consider the application of ITS. For an appropriate clinical evaluation of the migrant patients, anxiety dimensions and autistic traits should be investigated.

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The mental health of immigrants is a significant, yet often overlooked, aspect of public health. This case study highlights the intersection of migration and mental health, focusing on a patient with delusional disorder. It is particularly relevant for psychiatrists due to the unique challenges in diagnosing and treating mental health conditions in migrant populations, who often face cultural, linguistic, and systemic barriers in accessing care.

The primary objective of this case study is to elucidate the diagnostic and clinical challenges encountered in managing delusional disorder in a migrant patient. The case study presented aims to provide insights into how delusional beliefs can precipitate and perpetuate the process of migration.

The case study was developed through comprehensive psychiatric interviews during the patient’s stay in a Psychiatric Inpatient Unit, supplemented by a targeted literature review on PubMed using “delusion disorder” and “immigration” as keywords.

The patient, a 44-year-old Indian male, was a functional young adult until 2007 when he began exhibiting symptoms of delusional disorder. His delusions progressively evolved from local scenarios to national and eventually to a global scale. The initial delusions were focused on personal and professional conspiracies within his home country, leading to his first internal migration. As the condition worsened, his delusions expanded, fueling a belief in a widespread conspiracy that transcended national borders. This escalation of delusional beliefs became the primary motivation for the patient’s international migration. He changed countries four times, each move driven by an attempt to escape the perceived threats and conspiracies associated with his delusional disorder. The patient’s journey through various countries was a direct result of the intensifying nature of his condition.

This case study accentuates the profound impact that a delusional disorder can have as a driver and catalyst of international migration, influencing the individual’s decision-making process and shaping the migratory experiences. It emphasizes the necessity for psychiatrists to consider the unique socio-cultural contexts of migrant patients in diagnosis and treatment. The case study advocates for a comprehensive treatment approach, integrating psychiatric care with a nuanced understanding of the migrant’s experiences and challenges. This multifaceted approach is crucial in addressing the complex needs of patients with delusional disorder in migrant populations.

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In an increasingly interconnected world, migration has become a defining characteristic of the 21st century. While immigration offers new beginnings and prospects, it also presents unique challenges, particularly concerning mental health.

The experience of migrating can exert pressure on mental health through factors such as acculturation stress, discrimination, and economic hardships. These challenges can, in turn, contribute to the development of mental health issues.

To study the socio-demographic and clinical profile of immigrants hospitalized in the “C” psychiatry department, Hedi Chaker Hospital, in Sfax, Tunisia.

We conducted a retrospective descriptive study of immigrants hospitalized in the psychiatry department “C”, Hedi Chaker Hospital, Sfax Tunisia from 2011 to 2023. Socioeconomic data and clinical profiles of immigrants were collected from archived files.

The total number of immigrants hospitalized during these 12 years was 32, with an average age of 28.81 years ±7.8 years, all of them were males, as the psychiatric department “C” only hospitalizes men.

All were of African origin, of whom 21.9% (n=7) had Libyan nationality, 15.6% (n=5) had Somali nationality and 12.5% (n=4) had Sudanese nationality. Communication with them was possible in 87.5% of cases, primarily through the native Arabic language in 56.3% of instances. Illegal immigration was the most prevalent form, accounting for 75% of cases. During the immigration process, 18.8% of individuals reported experiencing violence.”

The majority of hospitalized immigrants were single (71.9%), had a primary school education (37.5%), a low socio-economic level (81.3%), and no profession (59.4%). 21.9% of them had received social assistance, and 59.4% lived in a refugee camp. Psychoactive substance consumption was reported by 53.1% of our study population.

Regarding the clinical profile of the population, 21.9% had a history of somatic conditions, 43.8% had a psychiatric history, including 9.4% who had attempted suicide, and 34.4% who had experienced traumatic events since arriving in Tunisia. The primary reason for hospitalization was behavioral disorders in 71.9% of cases and suicide attempts in 15.6%. The most prevalent diagnoses were schizophrenia (50%), and bipolar disorder (18.8%). Upon discharge, 15.6% encountered administrative issues.

Hospitalized immigrants exhibit diverse socio-demographic and clinical profiles. These findings underscore the significance of acquiring a deeper understanding of the mental health needs and existing barriers to healthcare within various immigrant communities. This is particularly crucial as immigration continues to be a central focus in Tunisia’s public policies and discussions.

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Wars and armed conflicts are known to have devastating consequences for both physical and mental health of all the people involved. Studies have shown that conflict situations cause more mortality and disability than any major disease and, among the consequences of war, the impact on mental health of the civilian population is one of the most significant.

Forced migration, compelling people to become internally displaced or refugees who have fled to other countries, is responsible for additional physical and mental health problems. Regardless of the reasons for migration, the process itself can be a highly stressful life event, leading to a higher risk of psychiatric disorders. Refugees are particularly susceptible to mood and anxiety disorders, whose prevalence rates is almost twice as high as those found among non-refugee migrants.

Since 2022, with the progression of the conflict between Russia and Ukraine, and the establishment of a real war scenario, many Ukrainians were forced to leave their homeland, to ensure their survival and security. In Europe, many countries took in Ukrainian refugees and Portugal was no exception.

In the Psychiatry Inpatient Service of University Hospital Center of São João, there were admissions of Ukrainian refugees who already had a known mental disease - at that time decompensated - and also new cases, to date without follow-up by the specialty.

In this work, we will carry out a bibliographical review on the impact of war and migration on mental health and the potential of proper medical approach, based on articles indexed in Pubmed, in the last 10 years.

Furthermore, we will present the cases of war refugees interned in our service between January 2022 and December 2023.

We will describe the psychopathological features and also the sociofamilial circumstances of these patients, as well as explain the intervention and longitudinal support developed in these cases.

As a conclusion, we point out the importance of approaching mental illness in light of the individual’s context, knowing that this context may contain the problem and also the solution. War and forced migration bring increased challenges to psychiatry and, in an increasingly globalized society, geographical, linguistic or cultural barriers cannot impose limits on our best and most appropriate medical treatment.

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Millions of people worldwide are forced to migrate to another country and nurses are the key professional for providing necessary health care to this population. Providing nursing care to refugees or immigrants requires diverse transcultural professional competencies based on standardized guidelines.

This study was aimed to examine the bibliographic characteristics of quantitative studies conducted on refugees in the nursing field.

The data were obtained from articles scanned in the Web of Science Core Collection database. The 1672 articles that were published between 1980-and 2023 and met the inclusion criteria were analyzed using VOSviewer and Microsoft 365 Excel software. The PRISMA 2020 Checklist was used for reporting.

Most publications were made in 2020. The United Kingdom, the United States, Canada, and Australia have the highest number of publications, citations, and international cooperation. Additionally, “mental health” is one of the most used keywords in the studies.

The findings show the importance of empowering nurses working in this field, especially in determining the needs related to mental health services for refugees. The increased migration rates and the growing need for refugee health care highlighted the importance of investment in nursing research within this field. Nurses and researchers should aim to establish partnerships and share best practices with the leading countries. Furthermore, nurses require specialized training to competently evaluate and provide nursing care and mental health services to this vulnerable population. Policymakers must prioritize international collaboration, equitable healthcare, and the integration of mental health services within healthcare systems to improve refugee health and reduce barriers between them and health services.

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There is growing evidence of excitation / inhibition (E/I) balance abnormalities in schizophrenia, which might be associated with abnormal gamma frequency oscillations and glutamate concentrations. However, to the best of our knowledge, only one multimodal study have examined such associations between EEG and metabolite characteristics in patients at clinical-high risk of psychosis (CHR) so far.

We aimed to investigate potential associations between GLX (glutamate + glutamine) levels and resting-state gamma-band power in CHR individuals and healthy controls (HC).

Twenty right-handed male patients (16-27 years, mean age 19.9 ± 2.7) fulfilling CHR criteria and 19 healthy male controls (16-27 years, mean age 21.6 ± 3.6) underwent resting-state EEG (16 leads; 10−20 system) and MR spectroscopy at 3T MRI scanner with voxels of 30×30×30mm located in left and right medial prefrontal cortex. Spectral analysis with estimation of gamma-band power (30-45 Hz) were conducted. MEGA-PRESS acquisitions were analyzed with jMRUi (ver. 5.1 Alpha), levels of GLX were calculated as a ratios to creatine + phosphocreatine (GLX/Cr). Gamma-band (30-45 Hz) spectral power and GLX/Cr were compared between groups. Correlations between EEG and metabolite data were analyzed with regression model including age and chlorpromazine equivalents as covariates.

Compared to healthy controls, patients showed reduced spectral gamma-band power in 6 leads (Table). No alterations in GLX/Cr were detected. Positive correlations between altered gamma-power in all leads (except Cz) and GLX/Cr in left medial prefrontal cortex were revealed in CHR (F3: r=0.51, p=0.006; F8: r=0. 54, p=0.004; C3: r=0.37, p=0.037; Pz: r=0.51, p=0.039; P4: r=0.56, p=0.009). No correlations in HC group were found. Chlorpromazine equivalents did not correlate with GLX/Cr of gamma power in CHR group.Table.

Results of between-group comparisons corrected for multiple comparisons

The findings suggest that clinical-high risk of psychosis is associated with widespread alterations in resting-state gamma-band power. Positive correlations of such alterations with GLX/Cr and absence of such correlations in HC group are presumably indicative of disturbances in the excitation / inhibition balance in CHR individuals.

This study was supported by RFBR grant 19-29-10040

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It is still being discussed whether treatment-resistant schizophrenia (TRS) is a biological subtype which differs from non-treatment-resistant schizophrenia or is it a more severe condition that affects brain worse than non-treatment-resistant schizophrenia. However, there are few and heterogeneous studies and the etiology of TRS remains quite unclear.

This study aimed to explore cortical and subcortical morphometric characteristics in TRS patients and its associations with the clinical features. The pilot stage comprises the comparison to the mentally healthy subjects.

21 right-handed male patients (mean age 28.99 ± 8.08 years) fulfilling TRS criteria and 21 matched healthy controls (mean age 29.35 ± 7.41 years) underwent T1-weighted structural MRI at 3T Philips scanner and clinical examination. Images were processed using FreeSurfer 7.1.1. Cortical thickness and area, volumes of subcortical structures and separately volumes of the amygdala nuclei and hippocampal subregions were compared between groups. The morphometry data, PANSS (Positive and Negative Syndrome Scale), CDSS (Calgary Depression Scale for Schizophrenia) and daily chlorpromazine equivalent doses of antipsychotics were included in correlational analysis. Results were considered significant if they retained significance after correction for multiple comparisons.

Compared to healthy controls, TRS patients showed decreased gray matter thickness in frontal, temporal, parietal, occipital, cingulate and insular regions (Figure 1). The temporal lobe showed the most prominent thinning of the cortex. The volumes of the amygdala, hippocampus (Figure 2) and nucleus accumbens, a number of amygdala nuclei and hippocampal subregions bilaterally were also decreased in TRS patients. The volume of the right globus pallidus, on the contrary, was increased (Figure 2). No correlations between altered cortical thickness, PANSS (positive, negative, general psychopathology scales and total score), CDSS and chlorpromazine equivalent doses of antipsychotics were found.

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The widespread gray matter cortical and subcortical loss in TRS finds confirmation in the literature. The increased globus pallidus volume is an unexpected and intriguing result. Other studies demonstrated conflicting results on that point. Some studies reported possible therapy influence, others suggested possible associations with symptoms. We did not find any correlations with psychometric or therapy characteristics. It is possible that there are non-linear relationships or relationships that exist only at a certain stage of the disease. As for therapy, patients took individual medication, consisting of various antipsychotics and drugs from other pharmacological groups, and such heterogeneity could affect the results of the study. Further research is going to be carried out.

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The fNIRS is an optical brain monitoring technique which uses near-infrared spectroscopy for the purpose of functional neuroimaging. Using fNIRS, brain activity is measured by using near-infrared light to estimate cortical hemodynamic activity which occurs in response to neural activity. In the aspect of psychiatry fNIRS is a tool that can potentially facilitate the clinical diagnostic process and identify stages of psychiatric illnesses by providing objective and quantifiable evidences of brain changes. However, this will require specific cerebral haemodynamic patterns to be validated in larger clinical populations with specific psychiatric disorders.

Our team decided to set a fNIRS system to find out the difference in prefrontocortical (PFC) activity pattern between healthy and anhedonic population. This abstract has been created for introduce our first findings about the difference in PFC activity under emotionally positively or negatively coloured stimuli in healthy population.

We have measured 5 healthy adults, non-anhedonic participants under emotionally different visual and acustic stimuli with the use of NIRX/NIRScout system with the view of our prefronto-temporo-parietal montege.

Fig 1 We devided our experimental tools into 4 individual 20 second long parts:

Passive neutral visual or acustic stimuli for baseline (watching a black dot or scilence)

Passive visual stimuli (watching a single picture)

Active visual stimuli (choosing from photo collage) to detect contrast of cortical background activation

Passive acustic stimuli (listening sounds)

In total, we defined emotionally, two neutral, four positive and four negative stimuli in our experimental setting.

Softwares: We used HOMER3 for analyzing our datas and estimate hemodinamic reponse factor (HRF) using general linear matrix (GLM) regression. We used AtlasViewer for reconstructing HRF image onto the Colin27 digitalised brain model. And we also used SPSS for statictical analysis between stimuli types and HRF means.

Fig 2 Significant HRF differences were measured in the dominant hemisphere dorsolateral prefrontal cortex (DLPFC) between the influence of each emotionally negative and positive stimuli (p<0.001). The level of DLPFC activity was positively influenced by emotionally positive stimuli (p<0.001).

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Fig 3 Our fNIRS experimental system is a suitable tool to measure and model the pattern of prefrontal cortical activity.

Based on the measured hemodynamic values, we detected a significant activity difference in the dominant hemisphere DLPFC during emotionally positive and negative stimuli, the extent of which is positively influenced by emotionally positive stimuli.

The left DLPFC appears to be a promising target for our next studies of anhedonia.

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Major Depressive Disorder (MDD) stands as a prevalent psychiatric condition within the general population. Despite extensive research efforts, the identification of definitive diagnostic biomarkers for depressive disorders remains elusive. Currently, machine learning methods are gaining prominence in the diagnosis of medical illnesses.

This study aims to construct a machine learning-based prediction model for Major Depressive Disorder (MDD) by harnessing diffusion tensor imaging (DTI) data.

The DTI datasets comprising MDD (N=83) and Healthy Control (N=70) groups were procured from the cohort study of Anxiety and Depression conducted at the National Center for Mental Health in South Korea. A machine learning method using a decision tree algorithm was employed to select relevant brain regions and establish a robust diagnostic model. Features associated with white matter (WM) tracts were chosen through recursive feature elimination.

Demographic characteristics, including age, sex, and handedness, displayed no significant differences between the MDD and Healthy Control groups. However, the total score of the Beck Depression Inventory was notably higher in individuals with MDD compared to Healthy Controls. A diagnostic model was crafted using the decision tree algorithms to distinguish between the two groups. The model demonstrated the following classification performance metrics: accuracy (65.6% ± 8.5), sensitivity (66.6% ± 12.5), and specificity (64.7% ± 13.6). Furthermore, through recursive feature elimination, specific neuroanatomical features tied to brain structures such as the inferior cerebellar peduncle, posterior thalamic radiation, cingulum (hippocampus), uncinate fasciculus, and tapetum were identified.

Despite of limited performance of classification, a machine learning-based approach could provide insights into the development of a diagnostic model for MDD using neuroimaging data. Furthermore, these features, derived from DTI-derived data, may have implications for understanding the neural underpinnings of major depressive disorder.

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Vocal and motor tics are characteristic for Tic disorders (TD) and Tourette’s syndrome (APA 2022) . Because of the pathophysiology of the disorders not being fully understood and the presence of the externally measurable symptoms; great attention has been paid to the cortico-striatal regions of patients with TD . In addition to the alterations in motor symptoms patients can experience a premonitory urge (PU) which can be felt before a tic (Reese et al. Behav. Ther. 2014; 45 177–186) . Previous studies found an impact of these urges on sensory perception, attention and social cognition as well as an involvement of the brain regions insula, anterior cingulate cortex (ACC) and the temporoparietal junction (TPJ) (Seeley J. Neurosci. 2019; 39 9878–9882, Kucyi et al. J. Neurophysiol. 2012; 108 3382–3392, Uddin et al. Brain Topogr. 2019; 32 926–942) . These findings lead to the idea of altered functional connectivity of the salience network (SN) in patients with TD.

This study aims to investigate the connectivity changes of the SN in patients with TD. We examined functional resting-state scans of patients with TD and searched for possible correlations between the tic and PU severity and the connectivity of the SN.

21 Patients (mean age: 30.9 years ± 10.0 [range = 19–57], 6 females) diagnosed with TD, and 20 healthy controls (mean age: 29.7 years ± 8.9 [range = 18–50], 5 females) underwent a resting-state fMRI scan. Functional and anatomical images were conducted on a 3T Siemens Prisma fit MRI scanner. PU and tic severity were measured by the Premonitory Urges for Tics Scale (PUTS) and the Yale Global Tic Severity Scale (YGTSS). The connectivity analysis of the resting-state scans was done using the CONN toolbox v21.a. After pre-processing and de-noising steps, a whole-brain seed-based connectivity analysis was carried out with the seeds being the major cortical nods of the SN. For the correlation analysis a linear regression of the YGTSS score/PUTS score and the brain connectivity of the seed regions was conducted.

The PUTS score was 25.3±5.4 (range 10-33) and the YGTSS total tic score was 23.1±7.9 (range 10-38) for the patients. The connectivity analysis revealed a significant difference in connectivity between the groups for the ACC, the right insula and the TPJ. A negative correlation between the YGTSS scores and the connectivity of the left insula and the right superior frontal gyrus (SFG) was shown in the correlation analysis. No significant correlation was found for the PUTS scores in the investigated seed regions.

The right SFG mediates motor urgency and inhibitory control. Since we found a negative correlation between the insula and the right SFG regarding to higher YGTSS scores of the patients, our results might shed some light on the pathophysiology regarding lower inhibitory control in patients which experience higher tic severity.

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Nonsuicidal self-injury (NSSI) is defined as deliberate and direct damage to one’s body tissues without any suicidal intent. NSSI is now recognized as a major risk factor for suicide and is prevalent among adolescents, with prevalence rates ranging from 7.5% to 46.5%, leading to increased interest in the pathophysiology of NSSI. This study aimed to examine cortical gyrification morphology, a neurobiological index of cortical folding and patterning, among unmedicated individuals with NSSI, which is prevalent in adolescents and young adults.

The main objective of this study is to compare cortical morphological abnormalities between individuals with NSSI and controls in terms of the local gyrification index (LGI), the ratio of the smooth cortical surface area at each vertex to the corresponding sulcal folds. In addition, we hypothesized that the LGI, a stable neurodevelopmental marker of cortical and subcortical circuit intergrity, would correlate with clinical measures in youth with NSSI.

A total of 101 individuals with NSSI and 100 age-, gender-, and handedness-matched controls completed self-report questionnaires and structural magnetic resonance imaging (MRI) data were acquired on a 3T Siemens scanner. A surface-based analysis was conducted using the Computational Anatomy Toolbox (CAT12) in Statistical Parametric Mapping (SPM12). Partial correlation analysis was also performed using R software to investigate the association between the LGI values extracted from the region of interest (ROI) and clinical symptoms, including depression, anxiety, emotion dysregulation, and anhedonia in individuals with NSSI.

Individuals with NSSI showed significantly increased LGI in the right insula sulcus and left superior temporal sulcus (STS), along with decreased LGI in the right calcarine and left superior parietal sulcus (SPS), compared to controls (5000 permutation correction, threshold-free cluster enhancement with a threshold of p < .05). In addition, higher LGI in left STS was correlated with greater scores of the Beck Anxiety Inventory (r = 0.22, p < .05) and of the Impulse Control Difficulties subscale of the Difficulties in Emotion Regulation Scale (r = 0.34, p < .001). Conversely, reduced LGI of the right calcarine was associated with a higher score on the Anhedonia subscale of the Beck Depression Inventory (r = -0.23, p < .05) within individuals with NSSI.

This study identified hypergyria in the right insular and left STS and hypogyria in the right calcarine and left SPS in individuals with NSSI. The former pattern was associated with anxiety and impulse control difficulties, and the latter was with anhedonia. This study is the first to alter distinct neurodevelopmental patterns of local gyrification and their correlations with clinical manifestations in individuals with NSSI.

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Autobiographical memory is known to be disturbed in schizophrenia. In addition, a leading theory of auditory hallucinations (AVH) is that they are intrusive – typically negative – autobiographical memories that are misinterpreted as perceptions.

The aim of this study was to examine the brain functional correlates of recall of negatively emotionally valanced autobiographical memories in patients with schizophrenia, with a longer term aim of comparing patients with and without AVH.

11 patients meeting DSM-5 criteria for schizophrenia or schizoaffective disorder and 10 age, sex and estimated premorbid IQ-matched healthy controls have so far taken part.

Participants underwent functional MRI in a 3T scanner while performing a task requiring them to recall autobiographical memories in response to individually tailored pairs of cue words. The cue words were based on autobiographical memories previously elicited in an interview with each patient and were designed to evoke the same memory. The cue words were presented in 10 20-second blocks interspersed with blocks where the subjects viewed cue words that did not evoke autobiographical memories. Brain activations were examined in three contrasts of interest: memory evoking words vs baseline, neutral words vs baseline and memory evoking vs neutral words.

Pre-processing and analysis were carried out with the FEAT module included in the FSL software. Statistical analysis was performed by means of a General Linear Model (GLM) approach.

In the memory evoking vs baseline contrast the patients showed hypoactivation in the medial frontal cortex compared to the healthy controls (Figure 1). There were no differences in activation between the patients and the controls comparing the memory evoking and neutral cues.

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The finding of hypoactivation in the medial frontal cortex compared to low level baseline in patients with schizophrenia suggests dysfunction in the default mode network, which is known to activate during recall of autobiographical memories.

These preliminary results suggest that recall of negative autobiographical memories in patients with schizophrenia is associated with reduced activity in the default mode network. A planned larger sample of patients and controls will be used to examine activations in patients with and without AVH.

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There is strong evidence that delusions are associated with cortical and subcortical structural alterations. However, whether these abnormalities differ in different types of delusions within schizophrenia spectrum disorders remains unclear.

We aimed at exploring structural neural patterns underlying influence/persecutory delusions across diagnostic categories within the schizophrenia-spectrum disorders.

Twenty six right-handed patients with delusional disorder (n=7) and schizophrenia (n=19), presenting with delusions were divided in two clinical subgroups. The first one was presented with persecutory delusions (n=12, 20.2-55.4 years, mean age 36.0±11.6, 2 females) and the second with delusions of influence (n=14, 21.2-47.6 years, mean age 36.7±8.4, 2 females). The control group consist of 26 matched healthy controls (20.2-53.6 years, mean age 36.3±9.9, 4 females). All participants underwent structural MRI at 3T scanner. MRI images were processed via FreeSurfer 6.0 to quantify cortical thickness (CTh) and volumes for subcortical and brainstem (midbrain, pons, superior cerebellar peduncle and medulla) structures.

Compared to healthy controls, patients with delusions of influence showed decreased gray matter thickness in 17 cortical regions (Figure, A), and decreased volumes of thalamus bilaterally (left: F(1,35)=9.0, p=0.005; Cohen’s d=−0.8; right: F(1,35)=8.0, p=0.008; Cohen’s d=−0.8), left hippocampus (F(1,35)=8.8, p=0.005; Cohen’s d=−0.8), midbrain (F(1,35)=11.0, p=0.002; Cohen’s d=−0.9) and pons (F(1,35)=8.2, p=0.007; Cohen’s d=−0.8). Conversely, patients with delusions of persecution showed decreased thickness only in 4 cortical regions of the right hemisphere (figure, B) and no alterations in subcortical volumes compared to healthy controls.

No differences in cortical or subcortical measures between two clinical subgroups survived corrections for multiple comparisons. No correlations between structural alterations and total PANSS or BABS scores were found in either clinical groups.

Figure. Clusters of decreased cortical thickness according to atlas of Desikan et al. (2006) in delusions of influence (A) and delusions of persecution (B) subgroups compared to healthy controls.

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The findings suggest that patients with delusions of influence have more pronounced cortical, subcortical and brainstem structural deficit as compared to patients with delusions of persecution. However, the limited sample size and the lack of correlations with clinical scores do not allow to conclude definitely whether the revealed structural abnormalities underlies delusions of influence, which should be elucidated via further research.

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

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