Psychological trauma is a significant public health concern with long-lasting effects on physical and mental well-being. Trauma-informed care is an approach to providing support and services that acknowledges and integrates an understanding of the pervasive impact of trauma on individuals. This review delves into the critical imperative of trauma-informed care within the realm of health services. Recognizing the pervasive impact of trauma on individuals’ physical and mental well-being, this REVIEW aims to explore existing literature, identify key objectives, and propose effective methods for implementing trauma-informed strategies in health services.

To Review Existing Literature on Trauma: Conduct an review of the literature to comprehend the varied dimensions and consequences of trauma on individuals’ health; To Identify Key Principles of Trauma-Informed Care: Explore established principles of trauma-informed care, highlighting their relevance and applicability within health service settings; To Propose Implementation Strategies: Develop practical strategies for integrating trauma-informed care into health services, ensuring a comprehensive and sensitive approach to patient care.

A review of published articles, books, and reports related to trauma and trauma-informed care to establish a foundational understanding.

Psychological trauma can have profound and multifaceted impacts on individuals, affecting their mental, emotional, and even physical well-being. The consequences of psychological trauma can vary widely based on the nature, severity, and duration of the traumatic experience, as well as individual factors such as resilience and support systems. Trauma-informed care aims to create an environment that is sensitive to the needs of those who have experienced trauma, and it is based on six key principles: safety, trustworthiness, peer support, collaboration, empowerment, and cultural competence. Healthcare providers need to understand trauma beyond the personal and acknowledge the cultural, historical, social, political, and structural trauma that impact individuals and communities across generations. This approach recognizes that there is a risk of retraumatization in social and health services, especially for minority communities.

This review underscores the pressing need for health services to adopt trauma-informed care strategies. By acknowledging the prevalence and impact of trauma on health outcomes, the healthcare sector can transition towards a more patient-centered and empathetic approach.

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Conversion disorder is characterised by symptoms that can impact sensory or motor function. The average incidence of conversion disorder is between 4 -12 per 100,000 per year. Conversion disorder has a wide variety of somatic and neurological differential diagnoses.

A 22-year-old woman was admitted to the hospital due to COVID-19 pneumonia. During the hospitalisation period, she developed progressive weakness, due to which she couldn’t move, eat or take care of herself. In terms of history, she is healthy, married and gave birth to her first child almost 9 months ago. Two days postpartum, the patient experienced an inability to connect with the child and provide care, as well as a decline in her mood. The husband reports episodes in which the patient had difficulties holding the child while being able to perform house chores, which required more physical strength. Two years prior to hospitalization, during stressful situations she experienced similar episodes and difficulty swallowing. While hospitalized, extensive testing was done, including an acetylcholine receptor antibody test, which was negative at first. Because of of the initially negative testing results a psychiatrist was called. On the first visit, the patient remained in a supine position and reported a lack of strength in both arms and legs, occasionally experiencing difficulty raising her head, however managed to stand up from the bed, walk independently for 5–6 meters, turn around, and, as soon as she reached the bed, descend into it. The staff reported her inability to walk earlier in the day. On the second visit, she notes that she feels tired but now can feed and take care of herself; however, some weakness persists in the proximal muscle groups. In between visits she received treatment with corticosteroids because of the COVID infection. After repeating the acetylcholine receptor antibody test, there was a positive result, and a diagnosis was established.

This case report demonstrates how a somatic disorder can mimic a psychiatric one because of the overlapping symptoms and initial negative test results. While receiving symptomatic therapy with glucocorticoids due to the COVID infection, the patient’s condition improved; she began to eat and walk on her own.

From the psychiatric aspect, it was associated with separation from the child— a relieving of the stress factor, due to which dissociative symptoms decreased.

Before considering a diagnosis of a dissociative disorder, a patient should be examined by other specialists according to their symptoms. A thorough neurologic and physical examination, as well as diagnostic tests, should be performed to exclude a physical pathology. Myasthenia gravis has a comorbidity with a number of psychiatric conditions and can also be very similar to a dissociative disorder, especially due to stress aggravating the symptoms of myasthenia gravis.

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Adjustment disorder is characterized by an emotional or behavioral response to a stressful event or change in life. This condition can impact a student’s academic performance, social life, and overall well-being. Adjustment disorder with the stressor is a psychological response to identifiable stressors that result in the development of emotional or behavioral symptoms. These symptoms cause significant impairment in various areas of functioning, such as social, occupational, or academic performance.

Students with adjustment disorder may experience a range of symptoms, including feelings of sadness, anxiety, hopelessness, and a lack of concentration. They may also have trouble sleeping, feel overwhelmed, and struggle to cope with daily responsibilities. These symptoms can be triggered by various factors such as academic pressure, relationships, family issues, or cultural adjustments.

This study aims to determine the prevalence of adjustment disorder among undergraduate students and investigate the potential risk factors of stress that can lead to adjustment difficulties.

Recognize the signs of adjustment disorder, how to access support, and how to create a supportive environment, therefore, students can effectively manage this condition and thrive in their academic and personal lives.

To prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

Adjustment Disorder‑New Model 20 (ADNM‑20) was used to assess prevalence of adjustment disorder among undergraduate students. It is a diagnostic tool used to assess adjustment disorder in individuals experiencing significant life stressors. The ADNM 20 is specifically designed to capture the nuanced manifestations of adjustment disorder with the stressor, enabling clinicians to make accurate assessments and develop targeted treatment plans.

Adjustment disorder is a real and impactful challenge and a common mental health condition among undergraduate students at Prince Mohammad Bin Fahd University, Al Khobar, Saudi Arabia.

Adjustment disorder can significantly affect a student’s academic performance. The inability to focus, persistent feelings of distress, and a lack of motivation can lead to a decline in grades and overall achievement. By recognizing the signs, accessing support, and creating a supportive environment, students can effectively manage this condition and thrive in their academic and personal lives. It’s crucial to prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

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It is important to prevent school dropout and to help students who have dropped out re-enroll in school. Dropping out of school is associated with an increased risk of unemployment, low salaries, and receiving social security or disability benefits. In this study, we interviewed participants in ‘Guttas Campus’ (The Boys’ Camp), which is a group-based intervention that aims to support disengaged boys from the 9th grade and through their transition to high school. The intervention consists of a two-week learning camp. The students subsequently participate in mentoring groups, with teachers and other camp participants, for a period of 18 months.

We present a study of a school dropout prevention program.

16 students were interviewed qualitatively. The interview data were analysed by drawing on the method of Grounded Theory.

When the students who have completed the learning camp were asked what they believed were the most important and useful parts of the intervention, some common themes emerged: 1) The learning camp community provided a safe environment and helped give the participants learning and coping experiences that increased their self-confidence. 2) The students brought up the method of teaching, which they described as more persistent, adaptive and encouraging than they had been used to from regular school. 3) The students also mentioned the intervention’s focus on character strengths such as willpower, self-control and optimism as central to increasing their motivation to learn.

The students that were interviewed were generally positive to the intervention, as mentioned several factors that they believed were useful in increasing their motivation and ability to learn.

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Recently, the pros and cons have been debating in Korea even before the approval of use of medical marijuana with very strict limitations. And the next controversial topic is psychedelics. In 1890, when mescaline was first isolated from peyote cactus, clinical researches began, but due to its harmful effects, it was thereafter legally prohibited in 1970 in USA. However, a pernicious debate over the medical efficacy of psychedelic drugs has begun again with the release of a study that uses psychedelic mushrooms to be effective against treatment-resistant depression, alcohol dependence, and depression and anxiety in terminal cancer patient.

To make a consensus on the medical use of these, we reviewed wild mushrooms containing hallucinogenic ingredients living in Korea.

To make a consensus on the medical use of these, we reviewed wild mushrooms containing hallucinogenic ingredients living in Korea.

Mushrooms have long been popular as a food ingredient in Korea. Psilocybin, a classical psychedelic, can be obtained from magic mushroom (Psilocybe cubensis). The psilocybin on the CNS and causes hallucinations. Intoxication symptoms include pleasant or nervousness, sudden laughter, hallucinations, visual impairment, tachycardia and hypertension, reflexes, agitation, cognitive impairment, confusion, and aggressive behavior. These symptoms last for 2-4 hours after ingestion, and most disappear within six hours.

Among 114 species of Psilocybe containing psilocybin around the world, only five wild mushrooms found in Korea that cause nervous system hallucinations are as follows: P. argentipes, P. coprophila, P. perdaria, and P. subcarulipes.

In Korea, there is acute poisoning case suffering with GI symptoms caused by mushrooms, but it is difficult to find records of abuse or dependences case caused by psychedelic mushrooms. In addition, although oriental medicine treatment is relatively active, it is not used as an herbal medicine.

Currently, the Korean government classifies psychedelic mushroom-derived substances, Psilocybin and Psilocin, as psychotropic drugs by law. If researcher intends to clinical trial with eve very small amount of it for academic purpose, it is only possible after obtaining approval from Korean FDA. In order to determine the usefulness of psychedelics, many clinical studies are needed in Korea.

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Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

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Threatened preterm labour (TPL) is associated with long-lasting neurodevelopmental challenges, independent of prematurity. For instance, it is known that infants born a TPL show delayed communication and socio-individual skills, regardless of the gestational age at birth. Furthermore, TPL constitutes an adverse prenatal event that can induce maternal anxiety or depression, even during postpartum period, which can produce a deleterious effect of the prognosis of infant’s psychomotor development.

This study aimed to explore the influence of maternal psychopathology as well as other peripartum variables on the course of psychomotor development in children born after a TPL between the ages of 2 and 6.

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Psychomotor development was assessed using the Ages & Stages Questionnaires-Third edition at age 2 and 6. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Low gestational week at birth emerged as the most relevant factor in the course of increased communication delay (p < 0.001). However, parental psychopathology during prenatal or postnatal stages was not a relevant factor in the prognosis of Communication skills or Socio-Individual development.

Gestation age at birth rather than parental psychopathology during peripartum period was the most relevant predictor of the course of psychomotor development between 2 to 6 years of age. Further studies should examine other potential modifiable predictors to moderate the impact of gestational age on psychomotor development.

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Threatened preterm labor (TPL) represents an adverse prenatal event that can impact maternal mental health in the long term. Additionally, this prenatal event can disrupt fetal neurodevelopment, primarily during the third trimester of pregnancy when neuronal connections in the fetus are established. Indeed, infants born following TPL exhibit delayed communication and socio-individual skills at 6 months of age, regardless of prematurity. Furthermore, maternal mental health during the postpartum period can also influence the offspring’s psychomotor development.

The aim of this study is to examine the impact of maternal psychopathology on psychomotor development trajectories in infants born after a TPL from 6 to 30 months of age.

This prospective cohort study recruited 117 mother–child pairs who suffered from a TPL. Psychomotor assessment was performed at 6 and 30 months of age using the communication and socio-individual subscales of Ages & Stages Questionnaires for psychomotor development. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Increased communication delays were associated with higher maternal anxiety levels (p < 0.001), elevated maternal depression scores (p= .0003), and increased cortisol levels (p = .004) during postpartum. Similarly, elevated cortisol levels after 6 months postpartum were predictive of increased Personal-Social delays (p = .0018).

Maternal postpartum psychopathology was the main determinant of the course of psychomotor developmental disturbances. Therefore, infants born after TPL, whose mothers display postpartum psychopathology, should be identified and considered for psychological treatment to improve psychomotor delays in infants.

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Infants born preterm usually show a Preterm Behavioural Phenotype, which includes mixed symptomatology characterized by lack of attention, anxiety and social difficulties, with a 3-4 times greater risk of disorders in further childhood. Critically, this behavioural pattern is also observed in infants born after a threated preterm labour (TPL), regardless of the presence of prematurity. It is known that the course of this Preterm Behavioural Phenotype shows high variability. Nevertheless, the predictors of this Preterm Behavioural Phenotype prognosis remain unknown.

This study aimed to explore the predictors of change of Preterm Behavioural Phenotype symptomatology during preschool ages in order to improve prognosis.

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Preterm Behavioural Phenotype symptoms were assessed at age 2 and 6 using Child Behaviour Checklist. Gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress were included as predictors in a regression model.

Whereas increased internalizing problems were associated with a previous trauma history (p = .003), increased externalizing symptoms were linked to prenatal and postnatal maternal anxiety (p = .004 and p = .018, respectively).

Identifying modifiable risk factors, such as the history of maternal traumas and anxiety at TPL diagnosis and postpartum is recommendable to enhance better prognosis of Preterm Behavioural Phenotype in the offspring.

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Affective temperaments can play a significant role in the development, progression and outcome of various somatic diseases, as well as in the effectiveness of their treatment. Although infertility is influenced by both physical and psychological factors, the relationship between affective temperaments and infertility treatment success remains unexplored.

The aim of this retrospective cohort study was to assess how dominant affective temperaments influence the outcome of infertility treatments.

Data was collected from a cohort of infertile women who underwent infertility treatment at an Assisted Reproduction Center in Budapest, Hungary. The study recorded treatment success defined as clinical pregnancy, detailed medical history, demographic parameters, and administered the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). TEMPS-A scores then were classified into nondominant and dominant temperaments for each scale, based on their score being above or below the mean+2 standard deviation for the given temperament. The predictive value of dominant temperaments on assisted reproduction outcomes were analyzed by multivariate logistic regression models, using age, BMI and previous miscarriage as covariates.

In the cohort of 578 women who underwent infertility treatment, besides age, BMI, and previous miscarriage, dominant depressive, anxious and cyclothymic temperament decreased the odds of achieving clinical pregnancy by 85% (p=0.01), 64% (p=0.03), and 60% (p=0.050), respectively).

The findings of this study suggest that dominant affective temperaments have a significant impact on the outcomes of infertility treatments. As a clinical consequence, creening for affective temperaments, Identifying dominant affective temperaments, stratifying high-risk patient groups, and offering personalized treatment options may enhance the likelihood of successful pregnancy and live birth for women undergoing in vitro fertilization treatment.

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Background: Maternal mental health is increasingly becoming a public health concern in developing countries because of predominant health and socio-economic inequalities. Mental well-being is essential for a woman to cope with daily life stresses and contribute positively to her community. Initiatives that empower women can enhance their well-being and improve the health of their families. However, limited evidence shows how women’s empowerment affects maternal well-being in a rural setting.

This paper explores the perspective of women’s economic empowerment in a rural Kenyan community and its effect on women’s mental well-being.

We purposively sampled women and men from the rural community who met the eligibility criteria (women who were pregnant and or with a child less than two years old and married men and residents in the community. We conducted two focus group discussions with the men and women separately, 11 key informant interviews with community stakeholders, and a four-month participant observation of 20 women participants who were pregnant and or with a child less than one year old.

The study found that economically empowered women had greater decision-making power and self-efficacy. However, cultural expectations and barriers that dictated the role of women prevented them from accessing and controlling resources and participating in important decisions such as land and property ownership. Women faced domestic violence (physical, verbal, and denial of basic needs) and inadequate support (emotional, physical, and financial) from spouses and other family members. These challenges and barriers increased their mental stress. To cope, women engaged in economic activities individually or in groups to meet the basic needs of their families.

Women’s economic empowerment can positively and negatively affect their overall well-being. Positively, women gain greater access to resources, improved decision-making, and the ability to plan and achieve their goals. Negatively, empowerment can lead to reduced spousal and kin support and an increased risk of domestic violence. Furthermore, these negative consequences can also affect women’s mental well-being. To ensure the well-being of mothers, it is crucial to engage men in empowerment programs and raise awareness in communities to address socio-cultural norms that impede women’s economic empowerment and negatively affect the well-being of women. Additionally, mental health support should be incorporated into these empowerment programs to mitigate the negative effects of women’s empowerment and improve resilience.

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Postpartum period is defined as the 12 weeks following the birth of a child as per ACOG guidelines. This period is crucial for women to physically and emotionally adapt to major changes in their lives. If concerns are not addressed properly it can result in fatal outcomes such as filicide and suicide in context of untreated mental illness with postpartum onset. Postpartum psychosis is considered a psychiatric emergency and literature shows that up to 4.5% of patients with depressive symptoms with psychosis commit filicide. However, postpartum psychosis is not recognized as a formal psychiatric disorder in DSM-5, leading to a delay in identification and treatment of the condition in a timely fashion.

The primary purpose of the case report is to inform the clinical picture and the legal implications associated with postpartum psychosis, a poorly understood and underdiagnosed psychiatric illness and to emphasize the importance of considering other psychiatric illnesses with peripartum onset that affect maternal and pediatric population wellbeing.

A comprehensive review of literature using databases, such as PubMed and Google Scholar as well as observation of the patient in the Emergency Department by the psychiatry team.

We present the case of a female in her 20s, mother of two toddlers, with a history of PTSD and postpartum depression, who was brought to our Emergency Department for stabbing her children in the context of a psychotic episode. The patient endorsed persecutory delusions and religious preoccupation, stating that she was experiencing “demonic energy inside” and that demons were speaking through her sons. Upon further assessment, it was noted that symptom onset was during the peripartum period, initially with depressed mood, and later with psychotic features. Organic causes of psychosis were ruled out with an extensive workup. Patient was transferred to an inpatient forensic unit for further stabilization. From a legal perspective, literature review shows that mothers may face the death penalty in the US in contrast with other countries such as England for instance. In the context of the current case, the plausible diagnoses are MDD with psychotic features or the first psychotic episode with peripartum onset that was left untreated resulting in a fatal health and legal outcome.

As postpartum psychosis is not currently recognized as an independent diagnosis under the DSM-5, further attention is warranted for such critical psychiatric condition that afflicts the lives and well-being of the maternal and pediatric populations globally. Postpartum psychosis affects mothers despite their past psychiatric history, socioeconomic status, educational level, and supportive network. Thus, it is essential to target proper and timely identification of symptoms and address those to prevent filicide and maternal suicide.

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Rheumatoid arthritis (RA) is a chronic inflammatory disease that significantly impacts patients’ quality of life (QOL), affecting both physical and mental well-being. QOL is predictive of morbidity and mortality, making its consideration increasingly important in treatment decisions.

This study aims to assess the Quality of Life in Female Rheumatoid Arthritis patients.

The study included 87 female patients with confirmed RA, diagnosed by an experienced rheumatologist based on the ACR 1987 or ACR/EULAR 2010 criteria. Quality of life was assessed using the World Health Organization Quality of Life assessment, short form (WHOQOL-BREF scale). The scoring ranged from 0 to 100 for each domain. Disease activity was assessed using the Disease Activity Score (DAS28), and functional disability was evaluated using the Health Assessment Questionnaire (HAQ).

The study included 87 patients with a mean age of 54.7 ± 12.2 years and a mean disease duration of 12 ± 9.1 years. The majority of patients had a medium socioeconomic level (81.6%), and a low cultural level with 31% being illiterate, 6% attending university, and 76.9% unemployed. Regarding marital status, 74.7% were married. RA was erosive in 77% of patients, deforming in 68%, and 40% were seropositive (FR and/or anti-CCP). Extra-articular manifestations were present in 34.5% of patients. Sixty-seven patients (77%) were on disease-modifying antirheumatic drugs (DMARDs), with 67.8% on methotrexate. Eighteen percent were treated with biological agents. Corticosteroids were used by 47.1% of patients, while 12.6% used non-steroidal anti-inflammatory drugs, and 6.9% used both. Disease activity varied, with 9.2% having low activity, 43.7% moderate activity, and 24.1% high activity based on DAS28. The mean HAQ index was 1.1 ± 0.8, indicating moderate to severe disability for more than 60% of patients. The mean WHOQOL scores were substantially reduced in the physical health (43 ± 16.2), psychological health (50.3 ± 14.4), social relationships (51.5 ± 18.6), and environment domains (46.8 ± 15). There was a significant inverse correlation between HAQ and the physical health (r = −0.52, p < 0.001), psychological (r = −0.57, p < 0.001), social relationships (r = −0.37, p = 0.001), and environmental domains (r = −0.45, p < 0.001) of QOL. There was no correlation between any domain of QOL and DAS28.

Patients with RA experience reduced QOL across multiple domains, including physical function, mental health, and social relationships. Functional disability, as reflected by HAQ, is the most significant factor affecting QOL in RA. The WHOQOL-BREF should be considered a valid outcome measure for interventions aimed at improving the quality of life for people with rheumatoid arthritis.

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Pregnancy and the postpartum period involve several physiological adaptations crucial for offspring care. Recent research has highlighted reproduction-related brain plasticity in human mothers. Associations with aspects of maternal caregiving suggest adaptive changes that facilitate a woman’s transition to motherhood. However, the dynamic changes that affect a woman’s brain are not merely adaptive, and they likely confer a vulnerability for the mental disorders. To elucidate the pathophysiology of psychiatric problems that occur during the perinatal period, gaining insights into the physiological changes in brain function due to pregnancy is crucial.

Although it has been hypothesized that pregnancy enhances social cognitive functions in mothers to adapt to the offspring care, there are few reports to support this hypothesis. This study aims to investigate whether social cognitive functions change during the first pregnancy, with a focus on maternal adaptation to offspring care.

The study included a first pregnancy group and a never-pregnant control group. We conducted a prospective study comparing pregnant women between two-time points (T1, T2); at less than 21 weeks of gestation [T1] and those after 30 weeks of gestation [T2]. To assess the effects of pregnancy and gestational age (< 21 weeks or 30 weeks or more), both the control (never-pregnant) group and pregnant group were evaluated at two time points with similar intervals. The Emotion Recognition Task [ERT] of the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed to examine the emotion recognition of six basic emotions in facial expressions. We analyzed a cohort of 26 participants in the pregnant group and 25 in the control group. We performed a two-way repeated measures analysis of variance with pregnancy status and gestational period (T1, T2) as independent variables.

Significant interactions between group and time points (T1, T2) were observed only for Unbiased Hit Rate Anger (p<0.01); facial recognition accuracy for anger increased with the progression of pregnancy. There were no significant interactions for Unbiased Hit Rate Sadness, Happiness, Fear, Disgust, or Surprise.

This is the first study to demonstrate that facial recognition of anger enhances with the progression of pregnancy, utilizing never-pregnant women as a never-pregnant control group. The results of this study contribute to the physiological effects of pregnancy on the brain and cognitive function and have potential for further study of perinatal mental health problems.

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Depression is a significant global mental health problem and is very common compared to how it is perceived. In 2020 alone, 264 million people globally suffered from depression and its different forms as per the World Health Organisation. It is a leading cause of disability in individuals, affecting their ability to perform their daily chores, work, study, and even maintain relationships. The impact of depression is deeper and affects families, the economy, health care systems, and so on.

In India, the problem is grave and leads to serious consequences, thanks to the stigma and unawareness attached to mental health disorders. It is estimated that India has one of the highest rates of depression in the world, but it is hardly acknowledged.

Post-Partum Depression (PPD) is the most neglected and unreported subtype of depression in India. Globally, 1 in every 7 women suffers from Post Partum Depression. India is such a diverse country in terms of prevalence varies from 15% to 25% based on region, population, cultural and social expectations, economic status, living standard, climate factors, and others.

The objective of the study is to spread awareness, identify the risk factors, root cause analysis of risk factors, possible solutions, and treatments.

This study is conducted to capture the awareness level of PPD in females across different ages, regions, income classes, cultures, working statuses, and societies. This is carried out using a detailed yet anonymous survey, it captures the demography, knowledge of signs and symptoms of PPD, personal experiences, attitudes, expected support for PPD, and awareness of possible healthcare options. The result of the study tries to understand and conclude the most common risk factors, groups at highest risk, a root cause analysis of the risk factors, and possible solutions and treatments.

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

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Women experiencing severe perinatal mental health problems require specialized services and care. Perinatal mental disorders are common and can contribute to maternal mortality, affecting neonatal, infant, and child outcomes. Home treatment can prevent hospital admissions and promote strategies within the patient’s support network.

Our aim is to describe a clinical case in perinatal psychiatry managed by a Psychiatric Home Treatment Unit.

We present a case of perinatal psychotic depression in a 26-year-old pregnant woman.

We describe the case of a patient with no prior history of mental health issues. She was 25 weeks pregnant when she first sought psychiatric help in July 2023 and was diagnosed with depressive disorder with psychotic symptoms. She reported symptoms such as low mood, psychomotor inhibition, delusional guilt thoughts, and auditory hallucinations beginning three weeks before her initial visit. Due to her clinical presentation, the patient was admitted to the hospital, where pharmacological treatment was initiated with Olanzapine 5 mg, Sertraline 50 mg, and Lorazepam 1.5 mg. She remained in the hospital for four days, during which she showed gradual improvement but did not achieve full recovery.

Considering the improvement observed, home treatment was proposed and accepted by the patient and her relatives. During home treatment, she continued to exhibit persistent depressive and psychotic symptoms, including low mood, inhibition, and delusional thoughts of ruin and catastrophe. Therefore, her treatment was adjusted, with Olanzapine increased to 10 mg, Sertraline raised to 100 mg, and Lorazepam reduced to 0.75 mg. Over time, significant improvement in her clinical symptoms was noted. Throughout the follow-up period, she reported no significant side effects from the pharmacological treatment. After a month of follow-up in our department, she was discharged with outpatient care provided by a specialized community perinatal psychiatric unit.

We illustrate the possibility of home treatment for perinatal psychiatric disorders. The potential benefits of remaining close to one’s support network and developing coping strategies can be advantageous during the course of illness. Further studies should be conducted to explore these potential benefits.

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When faced with perilous transmittable infections, individuals defend themselves or welcome them, such as the Samos Syndrome, a pathophilia (people attracted by illnesses). As borderline personality disorder (BPD), found in Samos Syndrome, becomes more common, so will people who reject primary protection from transmittable diseases and health behaviour as their choices. Pandemics would sinisterly draw pathophilies and persons with borderline personality disorder who migh surf pandemics risk as a parasuicidal behaviour.

To investigate why pandemics (HIV, COVID-19) cannot be stopped. We have conducted a long-term assessment of HIV-discordant couples where a female partner, HIV-negative, voluntarily chooses to decline any prevention during stable and consensual relationships with HIV+ve partners. We also explored sociodemographic data that could explain health behaviours and condom use in HIV serodiscordant couples at risk of pandemic diffusion, those where one of the partners, usually male, already has a transmissible disease.

We used a mix of naturalistic and ethnographic approaches to understand the dynamics of Samos Syndrome. We also utilised a questionnaire to extract salient points in the sexual prevention of HIV infection. We assessed 475 HIV-serodiscordant couples.

Pathophilia is defined as an excessive, abnormal desire to be sick, also known as nosophilia, from the Greek word ‘pathos’ indicating illness and ‘philia’, meaning attraction. Women diagnosed with BPD can become high diffusers during pandemics of transmissible diseases as suffering from pathophila, a form of parasuicidal behaviour. In the couples assessed, when the HIV-negative woman comes from a socially disadvantaged family, the couple uses condoms in 87% of cases (p<0.001); when she comes from a middle-high class, the couple uses condoms in 59% (p<0.001) of sexual relationships. Suppose the HIV-negative female partner has conflicting relationships with their parents. In that case, condom use is only in 40% (p<0.001) of cases, compared to 83% (p<0.001) of instances where she has a good relationship with parents. If the female partner with BPD has a higher level of education than the HIV+ve partner the frequency of use if 90% (p<0.001) of cases compared to 60% (p<0.001) of instances where she has the same level of education as the male partner.

The current study confirms that female persons diagnosed with BPD are at high risk of becoming high diffusers during transmissible diseases and pandemics. Parasuicidal behaviours and self-harm in BPD could increase the risk of entering into relationships with persons who are already infected by sexually communicable diseases or are at risk of diffusing viral infections (HIV and COVID-19).

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Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources.

To study the coping strategies used by women who are victims of IPV.

To study the factors associated with coping strategies among these women.

We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court.

The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused.

The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women.

The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse.

The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact.

None Declared

Domestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all.

It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide.

To determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives.

We contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022.

A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence.

122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education.

The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses.

All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children.

Almost all women (95.1%; n=116) were victims of physical violence.

Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%).

Should be noted that some women experience different forms of violence simultaneously.

Our study showed a high prevalence of physical violence with different shapes.

These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence.

None Declared

Violence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples.

To describe the characteristics of marriage between Tunisian couples where domestic violence prevails.

Our study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise.

An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage.

Our population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70.

92,6% of couples had at least one child.

Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level.

43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless.

The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity.

According to our results, there is no typical profile of a couple where conjugal violence can reign.

Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence.

None Declared