Cannabinoid Hyperemesis Syndrome (CHS) is distinguished by a pathognomonic cyclic pattern of hyperemesis characterized by recurring episodes of severe vomiting every few weeks to months, as well as obsessive thoughts and compulsive behavior, such as a proclivity to take frequent hot baths or showers. It is largely accepted as the most commonly used illicit drug in the United States, with estimates ranging from 42% to 46% lifetime consumption. Despite greater awareness of CHS, practitioners continue to lack comprehension, resulting in an unfortunate delay in patient identification and treatment.

The aim of this article is to bring attention to CHS in order to enable clinicians, and more specifically, addiction medicine specialists and psychiatrists, to diagnose it as quickly as possible and thus avoid unnecessary additional invasive examinations and investigations. This will save the patient’s time, prevent financial burdens and mental health stresses, and increase their overall quality of life.

A thorough screening and data extraction of the relevant articles was conducted using PubMed, Cochrane, and Embase. Databases were used to search for articles on CHS published between January 2021 and September 2023, yielding relevant articles. Keywords used were “hyperemesis”, “cyclical vomiting,” “cannabis” and “cannabinoid”.

We present a case of 20-year-old teens who came to emergency with severe dehydration and vomiting of more than 40 episodes at home. He had multiple admissions for abdominal pain, nausea, and vomiting in the past and was evaluated and diagnosed with gastritis, PUD, and H. pylori infection. A more detailed medical history revealed a frequent use of cannabis over the past few years and symptoms manifestation and worsening is associated with the use of cannabis. After the complete cessation of cannabis, there have been no new symptomatic episodes reported in the patient and the patient is stable clinically.

Cannabinoid Hyperemesis Syndrome (CHS) is a serious health hazard that requires immediate discovery and treatment. Despite the widespread use of cannabis, CHS is often misdiagnosed, resulting in unnecessary medical treatments and complications for patients. Given their special knowledge of linking chronic cannabis use to this syndrome, this case report and literature review highlight the critical role of addiction medicine experts and psychiatrists in quickly detecting and treating CHS. Early detection and treatment, particularly complete cannabis abstinence, are critical in alleviating symptoms, minimizing recurrent hospitalizations, and ultimately improving patients’ overall quality of life.

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Recently there have been increased acceptance of complementary and alternative medicine (including traditional medicines) not only among laypersons but also various medical specialities. Ayurveda is one such, that originated at least in 3000 BC in the Indian subcontinent. Ayurveda aims at not only treating diseases but also maintaining optimum health. Psychiatry branch of Ayurveda recommends the use of both medicines and psychotherapy. Past papers on Ayurvedic psychotherapy have limitations in terms of semantics, conveying relevance and practical implementation. To tide over such limitations, we review concepts of psychotherapy in the Ayurveda texts Charaka Samhita (CS), Sushruta Samhita (SS), Ashtanga Hridaya (AH) and their commentaries from the original Sanskrit texts, in light of RDoC framework. The approaches derived can be used not just for therapy but also as mental health promotion.

1. 1. To delineate approaches to psychotherapy from Ayurveda classics and their commentaries, which are useful for both mental health promotion and therapy.

2. 2. To view the components of Ayurvedic psychotherapy approaches in terms of RDoC constructs/subconstructs.

Relevant chapters were scanned in the texts CS, SS, AH and their commentaries for descriptions of psychotherapy. Consequently, its components were compared with the definitions of constructs and subconstructs of RDoC to identify similarities.

Only CS and AH had descriptions on psychotherapy, among which, one out of the four described in CS and the only one in AH was suitable for our purpose. The components of these models with relevant counterparts (single or combined) are tabulated in Table 1.Table 1

Thus, CS and AH provide a 5-dimensional and a 3-dimensional approach to psychotherapy respectively (with its components having correlates with few RDoC constructs or subconstructs) which can be explored clinically and evaluated, for therapy and mental health promotion purposes.

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Monthly extended-release injectable risperidone is the new antipsychotic formulation of risperidone available in doses of 75 mg and 100 mg, approved for the treatment of schizophrenia. It contains microcrystals of risperidone that are deposited following intramuscular injection. A fraction of the active ingredient of risperidone is already solubilized and rapidly enters the bloodstream, providing plasma levels similar to oral risperidone on the first day. The microcrystals continue to release risperidone steadily over a period of 4 weeks. No oral supplementation or loading doses are required.

The objective of this study is to demonstrate the effectiveness of treatment with monthly extended-release injectable risperidone in patients with schizophrenia who are followed up as outpatients from the Mental Health Center. The study aims to show that this treatment improves symptoms associated with schizophrenia, leading to an enhancement in the quality of life for these patients.

Analysis and evaluation were conducted on 9 patients diagnosed with Paranoid Schizophrenia and treated with monthly extended-release injectable risperidone from a Mental Health Unit and the Hospital Emergency System during the months of January to April 2023. Among the nine patients, six were previously on oral risperidone treatment exceeding 4 mg, and three were on doses less than 4 mg. The first group received a monthly injectable dose of 100 mg of risperidone, while the second group received 75 mg.

All nine patients showed improvement in positive and anxious symptomatology. Seven of them exhibited improvement in affective and cognitive profiles. None of the patients experienced significant metabolic alterations, and only one of them reported akathisia as a side effect. Furthermore, all patients improved their sleep patterns, and the seven who had behavioral disturbances with a tendency towards aggression no longer exhibited these behaviors.

Monthly extended-release injectable risperidone is beneficial in reducing positive and affective symptoms in patients with schizophrenia. It also improves anxious, cognitive, and behavioral symptomatology. It is considered effective, safe, and well-tolerated for long-term treatment of this disease, regardless of its initial severity. Therefore, it is advisable to consider it as the first therapeutic option in patients with schizophrenia who have responded well to oral risperidone previously.

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Klippel-Feil abnormality (KFA) is an association of bone defects characterized by a triad: fusion of the cervical vertebrae and consequent short neck, low hairline and a limited motion in the neck. KFA may be a feature of another disorder, such as MURCS association. Familial mutations in the GDF6 (KFS1 8q22), MEOX1 (KFS2 17q21), GDF3 (KFS3 12p13) and MYO18B (KFS4 22q11) genes cause inherited KFA.

The aim of this study was to report dysmorphic features and psychological burdens in two sisters with Klippel-Feil condition.

Two sisters with amenorrhea and dysmorphic clinical features were examined at our genetic counselling. Assessment of dysmorphic and behavioral features and karyotyping using RHG banding were performed.

Familial history revealed consanguineous parents and seven other healthy sisters. Physical examination shown typical triad of KFA. Karyotyping showed 46,XX formula in both patients. The first 22-year-old sister had body asymmetry with size difference between the two sides at the level of bones, pectus excavatum of the sternum, an ascent of the left scapula, scoliosis, dental position abnormalities and facial dysmorphism. The second 28-year-old sister had size difference between the two legs and scoliosis, vitiligo and facial dysmorphism. Anxious and depressed, the two sisters had normal learning abilities but shared many personal psychological concerns regarding their physical appearance and their amenorrhea. They were also exposed to significant discrimination and stigma making them feel excluded and ignored because of their visible difference.

Physical appearance has a profound impact on a person’s life. To our knowledge, there is no reports that describe specific psychological burdens of KFA. Self-esteem, body image, and quality of life is negatively impacted in the case of dysmorphic physical appearance, always associated to social discrimination. Patients with KFA should be assessed not only for associated congenital defects but also for psychological distresses.

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This retrospective study analysed the clinical efficacy, tolerability and treatment satisfaction of patients who switched from receiving palmitate paliperidone monthly (PP1M) to palmitate paliperidone six-monthly (PP6M) after 12 months of follow-up. A total of 48 patients (31 men and 17 women) with recently diagnosed schizophrenia were included.

To assess the clinical efficacy, tolerability and treatment satisfaction in a sample of recently diagnosed schizophrenic patients who switched from receiving palmitate paliperidone monthly (PP1M) to palmitate paliperidone six-monthly (PP6M)

The sample included a total of 48 recently diagnosed schizophrenic (1-5 years) from three Mental Health units in the province of Toledo (Spain). The inclusion criteria were a diagnosis of schizophrenia (based on the ICD-10 criteria), the start of treatment with Long Acting Injectable Paliperidone Palmitate six-monthly (previously with palmitate paliperidone monthly), and the non-utilization of another neuroleptic treatment. A series of demographic variables were recorded, PANSS scale was used to to identify the presence and severity of psychopathology symptoms and the CGI scale was used to assessed the severity of the symptoms finally time to relapse was measured (primary outcome). The scales were again applied at baseline, 3 and 6 and 12 months after the start of treatment

N=48 patients (31 males and 17 females), with a mean age of 31 years. 4.3 years of evolution of illness. During the follow-up period only 2 patients (4%) relapsed. Results showed an improvement in PANSS (baseline 50.8, 3 months 41.9, 6 months 37.3, 12 months 26.1), likewise and improvement in CGI was observed (baseline 4.1, 3 months 3.4, 6 months 2.9, 12 months 2.5).

In terms of tolerability, no secundary effects were reported after treatment change, suggesting a good safety profile and predictable tolerability of PP6M. Patient satisfaction with treatment also improved over time. The study reports that 87% of patients accepted the switch from PP1M to PP6M, with reasons for switching including reduced frequency of administration and increased comfort. Most patients (95%) received antipsychotic monotherapy.

In conclusion, this study suggests that switching from PP1M to PP6M in patients with recently diagnosed schizophrenia was associated with maintained clinical stability, good tolerability and improved patient satisfaction with treatment. These findings support the efficacy and clinical utility of PP6M as a convenient and effective treatment option for patients with schizophrenia.

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Bulimic behaviors (BB) are a major public health problem, due to their prognosis and serious psychological, somatic, and social consequences. The exact etiopathogenesis of BB is still poorly understood, and the literature suggests the interaction of multiple factors.

The aim of our study was to estimate the prevalence of BB in the Tunisian general population and to identify the associated risk factors.

We conducted a cross-sectional, descriptive, and analytical study of Facebook group members, using an online questionnaire, from February 17, 2023, to May 26, 2023. All respondents over the age of 18 were included in the study. All participants filled out a socio-demographic questionnaire. Body mass index (BMI) was calculated from weight and height. The Bulimic Investigatory Test, Edinburgh (BITE) was used to screen and assess the intensity of bulimic behaviors.

A total of 528 responses were included in the study. The mean age of the sample was 33.3±11.95 years, and the M/F sex ratio was 0.41. Subjects were unmarried in 63.4% of cases, of low socio-economic status in 19.5%, with a university education in 75.2%, and with a psychiatric history in 25.6% of cases. The mean BMI was 25.15±4.98. The mean BITE score was 10.76±6.85, and 6.6% of our population were at high risk of developing BB.

In the bivariate study, female gender (p<0.001), unmarried marital status (p=0.001), university education (p<0.001), and the presence of a psychiatric history (p<0.001) were significantly associated with a high risk of developing BB. Moreover, the BITE score was negatively correlated with age (r=-0.231; p<0.001) and positively correlated with BMI (r=0.307; p<0.001).

This study highlighted the magnitude of the risk of bulimic behaviors in the Tunisian general population and the need to set up programs to prevent and control these disorders.

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Treatment-resistant depression (TRD) lacks a universally consistent definition due to varied interpretations despite attempts to define it based on inadequate response or remission despite sufficient antidepressant treatment. There’s a crucial demand for a uniform definition and staging to streamline its effective management amid diverse treatment options and the complex nature of resistance. Five methods have emerged to define and classify treatment resistance reliably.

The aim of this study is to compare the five staging methods (Thase&Rush SM (T&R), European Staging Method (ESM), Maudsley Staging Method (MSM), Massachusetts General Hospital Staging Method (MHG-s), Conway Staging Method(Conway)) in assessing treatment resistance within a single sample.

Retrospective analysis involved medical records of inpatient psychiatry clinic admissions at Hacettepe University between October 2012 and October 2014. Patients with a primary diagnosis of bipolar affective disorder, schizophrenia, other chronic psychotic disorders, dementia or cognitive disorders, alcohol and substance use disorders, and those with missing data were excluded.

Initial screening yielded a total of 115 patients. 64 patients were included in the study, 13 patients were excluded due to missing data, and 38 patients were excluded due to comorbidity.

There is no universally agreed-upon definition for treatment resistance. In this sample, different definition and staging methods were employed to examine the similarities and differences in the clinical and treatment related characteristics of groups with TRD identified with each. The reasons and possible implication of concurrence and discordance between the methods will be discussed.

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During adolescence the brain is dynamically changing. Destabilization and acceleration of the normal adolescent synaptic pruning process is likely a contributing factor to the neuropathology of schizophrenia. Details on whether normal pruning effects weaker synapses more or uniformly all synapses with different strengths, needs to be further evaluated. Widespread impairment in structural connectivity in schizophrenic patients involving several cortical and subcortical areas, has been previously described. In this computational study, we investigated a stochastic percolation process in interdependent networks, motivated by pathological synaptic pruning. We examined preferential decay in the connectivity decremental process, as well as differential pruning in interconnected subnetworks. Finally, the speed of the percolation process, as well as the potential for pharmacological interventions of percolation in random networks was explored. Statistical structural properties of decaying networks pinpointed several network attributes which the disintegration and phase transitions qualitatively depended on.

The following objectives were explored: 1.) Apart from a random percolation process, we investigated preferential decay of the connections. We introduced different percolation rules for various connection types. 2.) Based on previous experimental results, we assumed that different interconnected neural subpopulations prune differently, therefore we explored differential pruning process in the subnetworks. 3.) The speed of the percolation was studied and the pharmacological synaptic connectivity change was also analyzed.

We considered two inter-connected randomly connected networks, where the connections were removed during the percolation process. Simulations were partially performed using Octave on a Lenovo Thinkpad running the Linux operating system and partially performed on a supercomputer at UPPMAX (NAISS Small Compute 2023 Dnr: NAISS 2023/22-102).

We found that the coupled network system shows rich percolation behaviors with phase transitions for various coupling strength and coupling patterns. The phase transitions of both layers are altered qualitatively between discontinuous, mixed and continuous. Recursively developing percolation in interdependent networks can cause complete fragmentation of these networks, resulting in cascadic failure which might be related to schizophrenia symptoms.

This computational study analyzes the pruning-mediated percolation in interdependent neural networks. Consequences of the pathological overpruning were related to the attributes of the interdependent network properties. Implications for schizophrenia development and predictions for compensatorial iatrogenic percolation was also pinpointed and discussed.

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Apathy in endogenous depressions is a complex mental phenomenon (it is characterized by indifference and loss of interests, reduced incentives and motivation, decreased mental and physical activity). Apathy becomes the cause of pronounced social maladaptation and untimely seeking medical help. Different depressions vary in psychopathological features of apathy, in addition, there are also different dimensions of the general dynamics of endogenous disease.

Study of the features of the course of schizophrenia, in which apathetic depressions develop with episodic and persistent type of dynamics

The study included 36 patients (15 men, 21 women, average age 34.9 years) with schizophrenia. In 17 cases, apathetic depressions occurred as short-term episodes, in 19 cases, depression took a persistent (close to chronic) course.

Schizophrenia with an episodic type of dynamics of apathetic depressions was characterized by: the predominance of cases with early onset of the disease; alternation of apathetic and other type depressions; equal occurrence of mono- and bipolar types of desease; low severity of negative symptoms and slight changes in social and labor functioning. Apathy has always been present during the whole lenght of depression, its picture was dominated by a motivational decline. The studied cases were prognostically favorable. The features of the course of schizophrenia with chronic apathetic depression were: hyperthymic (10 out of 19 observations) and sensitive schizoid (6 out of 19 observations) premorbid personality; bipolar forms of the disease (94.7%, p < 0.05); the predominance of apathetic depression over other depression types, atypical form of depression; short duration of remissions; frequent course of the disease with the presence of only apathetic depressions (12 out of 19, 63.1%, p < 0.05); significant severity of negative symptoms. Apathy occupied only as a part of the duration of the state, as a rule, after anxiety depression. The picture of apathy was dominated by a decrease in initiative or motivation. This clinical group is the most prognostically unfavorable.

Schizophrenia, occurring with the presence of persistent forms of apathetic depression, has a greater impact on the functioning of patients and has a less favorable prognosis.

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Familial adenomatous polyposis (FAP) is a condition characterised by multiple polyps inside the colon or rectum, leading to colorectal cancer in all patients who do not perform prophylactic colectomy and a higher risk of cancer in other organs. Nevertheless, it has been reported that 14-48% of patients do not comply with regular endoscopic surveillance, which seems to be related to the lower levels of emotional distress observed in these patients. Also, APC gene polymorphisms have been described as being related to neurodevelopmental disorders, such as autism.

To study the prevalence of alexithymia, autistic traits and emotion regulation strategies in patients with FAP.

We conducted a cross-sectional study of patients with a genetic or clinical FAP diagnosis and assessed for alexithymia, autistic traits and emotion regulation using psychometric tests - Toronto Alexithymia Scale - 20 items (TAS-20), Autism-Spectrum Quotient Test (AQ) and Emotion Regulation Questionnaire (ERQ), respectively. The control group were patients with Lynch Syndrome. Statistical analysis was performed using SPSS vs.26.

We recruited a total of 20 patients (10 with FAP vs 10 with Lynch Syndrome). Nine patients were male (45%) versus 11 female (55%). The mean age was 53,35 years (SD 18,4). Half the sample presented a low educational level (equal or inferior to 4th grade).

The overall prevalence of alexithymia was 65%, with an 80% prevalence in FAP patients and 50% in Lynch Syndrome. TAS-20 total score was higher in FAP patients (69,0 vs 60,7; p=0,68). Externally-oriented thinking subscale score was statistically higher in FAP patients (p=0,024).

The overall prevalence of autistic traits was 25%, and the mean AQ score was higher in FAP (23,4; SD 4.97) compared to Lynch Syndrome patients (20,2; SD 5.57), but there were no statistically significant differences between the diagnoses (p=0,192).

A moderate positive correlation exists between Total AQ and Total TAS (r=0.51; p=0.020).

Concerning the scores obtained on the ERQ scale, most participants (14; 70%) use Expressive Suppression as a regulation strategy. Patients with Lynch Syndrome had higher scores than those with FAP, both in the Cognitive Reappraisal (4.22; SD 1.58 vs 4.28; SD 0.90) and Expressive Suppression (4.58; SD 1.08 vs 5.15; SD 1.03) domains.

The average AQ score for patients who mostly use expressive suppression is significantly higher than for those who use cognitive reappraisal (23.86 (3.63) vs 17.00 (6.6); p=0.039).

The preliminary results of this study point to high levels of alexithymia and autistic traits in this population, and a higher tendency to regulate emotions by expressive suppression.

The main limitation of the study was the small sample size, which reduced the power of the study to find statistically significant differences. Also, in future studies, a different control group should be considered.

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Public safety personnel (PSP) encounter traumatic events in their workplace, elevating the likelihood of mental health issues. Delivering efficient, evidence-backed interventions, like supportive SMS text messaging programs, can significantly enhance PSPs’ mental well-being, garnering high user satisfaction rates.

This study evaluates users’ satisfaction, receptiveness, and perceptions of the supportive SMS text messaging intervention (Text4PTSI).

Participants enrolled in the Text4PTSI program and received one-way cognitive behavioural–based supportive text messages for six months. They participated in a web-based survey delivered through SMS text messages at enrollment, six weeks, three months, and six months after enrollment. The participants’ perceptions and receptiveness of the program were evaluated through a 5-point Likert scale. Data were represented as categorical variables, and overall satisfaction with the Text4PTSI program was assessed on a scale ranging from 0 to 100.

Of the 131 Text4PTSI program subscribers, 81 participants responded to the survey, yielding 100 responses across the three follow-up time points. The average satisfaction score was 85.12 (SD 13.35). A significant portion of respondents, constituting 79%, agreed or strongly agreed that Text4PTSI helped them manage anxiety. Additionally, 72% reported relief from depressive symptoms, and 54% (54 out of 100 responses) felt less lonely. Moreover, the majority (84%) of participants expressed that Text4PTSI connected them to a support system, improving their mental well-being, felt more hopeful about managing concerns about their mental health or substance use (82%), and helped enhance their overall quality of life (77%). The data also revealed that most participants consistently read the supportive text messages (84 out of 100 responses, 84%), took time to contemplate each message (75 out of 100 responses, 75%), and revisited the messages more than once (76 out of 100 responses, 76%).

PSP participating in the 6-month Text4PTSI intervention expressed significant satisfaction and gratitude in the follow-up surveys. Their positive feedback indicates a promising path towards increased service utilization, potentially enhancing its effectiveness and impact on end users.

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Cariprazine is one of the most recent innovations in neuropsychopharmacology, with evidence for its efficacy in affective and psychotic spectrum disorders.

To present a case that highlights cariprazine’s potential use outside the regulatory approved indications.

Case report using CARE guidelines and a narrative review.

We present the case of a 41-year-old male readmitted to a psychiatric inpatient unit due to three months of mutism and withdrawal. At admission, the patient did not communicate verbally or in writing, but he complied with simple orders, and his consciousness remained unimpaired. He scored 11 points on the Bush-Francis Catatonia Rating Scale (BFCRS), indicating immobility, mutism, staring, withdrawal, ambitendency, and automatic obedience. We observed psychomotor retardation and indirect signs of a depressive mood, including the omega sign. His medical history included ongoing psychiatric treatment since the age of 30, with two prior admissions to an acute inpatient unit. At the time of admission, he was treated with olanzapine 20 mg/day, lorazepam 2 mg/day (recently downtitrated), venlafaxine 150 mg/day, and bupropion 150 mg/day. At the start of the current episode, the patient’s diagnosis was uncertain, with previous descriptions of psychotic, affective, and catatonic features. Due to suspicion of catatonia, we administered a high dose of lorazepam (8 mg/day), resulting in a partial response with a 4-point reduction in the BFCRS. We discontinued bupropion, increased venlafaxine to 225 mg, and switched from olanzapine to cariprazine using a taper, washout, and switch strategy. Psychotic symptoms briefly appeared when the patient was not taking a dopamine D2-receptor modulatory drug. We identified mild possible adverse drug reactions, including akathisia, transient insomnia, and daytime sleepiness. At a dose of 6 mg/day of cariprazine, we observed complete remission of catatonia (BFCRS=0) and significant improvement in affective and psychotic symptoms. The patient was discharged home with diagnoses of catatonia and schizoaffective disorder, prescribed 6mg/day of cariprazine, 225mg/day of venlafaxine, and 2,5mg/day of lorazepam. At the 6-month follow-up, the patient continues to exhibit clinical stability.

This case emphasizes the safety and potential effectiveness of cariprazine in treating catatonia within the context of schizoaffective disorder. We consider that the partial agonist properties of cariprazine could theoretically reduce the risk of exacerbating catatonia, a risk typically associated with full D2-receptor antagonists. Other mechanisms of action, such as D3 partial agonism, may also contribute to the improvement or at least the non-aggravation of catatonic symptoms. Cariprazine’s mood-stabilizing properties make it a promising off-label choice for treating schizoaffective disorder, especially when catatonic features are present.

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Hyponatremia (hypoNa) is a potentially serious adverse event of treatment with antidepressants. Previous research suggests that risk of drug-induced hyponatremia differs between antidepressants.

This meta-analysis sought to determine the risk of antidepressant-induced hypoNa, stratified by different compounds and classes.

PubMed and Web of Science were searched for studies reporting on incidence or risk of hypoNa in adults using antidepressants (PROSPERO, CRD42021269801). We modelled random-effects meta-analyses to compute overall incidence and risk of any and clinically relevant hypoNa for each compound and class, and ran head-to-head comparisons based on hypoNa incidences. We conducted subgroup analyses for geriatric populations, study context and sodium cut-off value.

Thirty-nine studies (n = 8,459,033) revealed that exposure to antidepressants was associated with significantly increased odds of hypoNa (OR = 2.82 (1.79 – 4.45)). The highest event rates were found for SNRIs (7.17%), SSRIs (5.20%), and TCAs (2.26%); the lowest for mirtazapine (1.02%) and trazodone (0.89%). The highest odds ratios were found for MAOIs (4.12 (1.92 – 8.86)), SNRIs (3.16 (1.77 – 5.67)), and SSRIs (2.78 (1.57 – 4.91)); the lowest for mirtazapine (2.82 (1.87 – 4.21)) and TCAs (1.85 (1.28 – 2.69)). Compared to SSRIs, SNRIs were significantly more likely (OR = 1.27 (1.13 – 1.42), p < 0.001) and mirtazapine significantly less likely (OR = 0.61 (0.39 – 0.96), p = 0.032) associated with hypoNa.

Our meta-analysis demonstrated that, while no antidepressant can be considered completely risk-free, for hypoNa-prone patients mirtazapine should be considered the treatment of choice and SNRIs should be prescribed more cautiously than SSRIs and TCAs.

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Koro, also known in Cantonese as Shook Yang, which literally translates to “shrinking penis”, has its roots in a cultural belief that a mythological figure would steal the penis of his victims. Predominantly reported in Southeast Asia, it involves an acute fear of genital retraction, often accompanied by the belief that this retraction may lead to death. Over the last two centuries, Koro has undergone several attempts to establish its definition and classification, without a true consensus having been reached.

This study aims to explore the cultural nuances surrounding Koro and reflect on the various conceptualizations that modulated its definition and nosological classification, from Ancient China until the present.

A non-systematic literature review with the keywords “koro” and “culture” was conducted.

Koro was only introduced to the Western world during colonial expansion, drawing the attention of several psychiatrists who, in Asian territory, reported numerous cases in natives, making the very first attempts at a nosological classification, whether as an anxiety neurosis, or as an obsessive-compulsive disorder. The literature reveals significant cultural variations in the manifestation of Koro, challenging the traditional psychiatric understanding rooted in Western diagnostic categories. Cultural factors, including societal beliefs, religious practices, and regional variations, emerged as influential contributors to the prevalence and presentation of Koro. Additionally, the study identified instances of Koro evolving in response to cultural shifts and globalization, emphasizing the dynamic nature of this syndrome.

This review underscores the need for a comprehensive understanding of Koro that acknowledges its diverse conceptualizations across cultures. Its occurrence, not only in multiple parts of the world, but also in close relation with various comorbidities, has contributed to the dissolution of its primary identity as a culture-bound syndrome, turning Koro into a moving target.

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Anxiety disorders are one of the most common mental illnesses, and a consistent increase was observed after the COVID-19 pandemic. Mindfulness refers to a process that leads to a mental state characterized by nonjudgmental awareness of the present experience. Mindfulness can be considered both a skill and a practice. The stronger is the ability to adopt a mindful state, the less suffering one will experience. While Mindfulness-based Psychotherapies have shown efficacy in their treatment, they have not yet been thoroughly studied in Italian public mental health services. In Detached Mindfulness, negative thoughts are acknowledged and avoided by turning them into actions using a standardized, time-limited, metacognitive intervention.

The purpose of this study is to examine the efficacy and cost-effectiveness of Detachment Mindfulness for twelve patients with Generalized Anxiety Disorder (GAD) not being treated pharmacologically.

We enrolled 12 patients diagnosed with GAD according to DSM-V in an 8-session program of Detached Mindfulness Psychotherapy (once a week). The Generalized Anxiety Disorder - 7 Scale (GAD-7) and the Kellner Symptom Questionnaire (SQ) were used to assess anxiety symptoms at baseline (T0), after 4 sessions (T1), and at the end of treatment (T2). The Client Satisfaction Questionnaire (CSQ-8) was used to assess treatment satisfaction.

The GAD-7 score showed consistent reductions in generalized anxiety symptoms after Detached Mindfulness treatment (mean decrease of -42% at the end of the program). As measured by SQ, patients also reported improvement in physical well-being, relaxation, and somatic symptoms significantly respect to baseline. As for treatment satisfaction, ten out of twelve patients rated their treatment as satisfactory. As reported by patients, mindfulness can become a powerful and effective means to relate to one’s own internal experiences such as anxiety or fear, learning to recognize them, staying with them and avoiding their consequences.

These results showed that detached mindfulness was an effective and cost-effective intervention for GAD, given the short amount of time it requires and the ease with which it can be implemented. For its extensive use in the public mental health system to be further supported, studies on larger populations are needed.

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The COVID-19 pandemic and the Ukrainian war appear to have adverse mental health effects. These global crises have raised concerns about the long-term psychological well-being of individuals across different demographic groups.

The objective of this study was to evaluate the cumulative mental health effects of the COVID-19 pandemic and the Ukrainian war, emphasizing the relationship between demographic factors and mental health outcomes.

This was a cross-sectional online survey using convenience and snowballing methods of recruitment. A sample of 170 participants completed demographic questions and Likert-scale assessments using a range of psychometric scales for measuring general psychological distress, perceived stress, personal resilience, traumatic life events, emotional and social effects of trauma, and potential growth after trauma. Participants were requested to respond to the traumatic experiences of the COVID-19 pandemic and the Ukraine war.

Gender differences were evident, with women reporting higher levels of psychological distress and post-traumatic growth.  Family size had a negative correlation with psychological disturbance. Family status exhibited a positive correlation with traumatic event recall. Specifically, individuals who were either unmarried or divorced demonstrated increased memory recall for such events and levels of psychological distress. Conversely, participants in married or cohabiting relationships displayed diminished recall and lower psychological distress levels.Financial strain strongly correlated with compromised psychological well-being.

These findings highlight the association of demographic factors with cumulative stressors, underscoring the importance of personalized psychosocial interventions. Such interventions can enhance mental well-being and resilience in adversity, ultimately promoting improved psychological health.

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Little research has been conducted on outcomes in mental health care by intensity of level of service.  Mental health care has evolved in the United States to psychiatrists or psychiatric nurse-practitioners overseeing medications in 15-minute appointments while non-physicians provide the psychotherapy.

We wished to compare these two models when one psychiatrist worked in two settings, providing the medication management alone model in one setting and the medication + psychotherapy model in the second setting.

All patients were seen by the same psychiatrist at (1) a community mental health center (CMHC) and (2) a private practice (PP) providing services to the same type of patients over 2 years. Patients were assessed with the My Medical Outcomes Profile (MYMOP2) and the Brief Psychiatric Rating Scale (BPRS). In the CMHC, patients were seen for a 15 – minute visits every 1 to 3 months. Patients were offered psychotherapy, ranging from 1/2 hour monthly to 1 hour every other week. Some patients received weekly psychotherapy due to an interest by the clinician. In the PP, patients were seen every 1 to 4 weeks by the psychiatrist who also provided psychotherapy when that was desired. Visits ranged from 15 to 75 minutes. Other practitioners could have also provided psychotherapy. Analysis was conducted for patients who completed at least four outcome ratings. Multi-level modeling techniques as implemented in SPSS were used to determine if patients improved over time.

There were no differences in age, socioeconomic status, type of insurance, and type of diagnosis among the two groups. Follow-up occurred for two years. On average, no improvement occurred in outcome measurements in the CMHC setting while statistically significant improvement occurred in the PP setting. The cost of care was statistically significantly greater in the CMHC setting, due to the facility fees billed and collected for each patient (and approved by the government) of $176 additional per visit.

Further work can be done on establishing minimal levels of service delivery that can produce improvement for large populations in community settings. Since it is unlikely that we can generate control groups of no treatment, perhaps analyses like this one, comparing treatment models, can establish a benchmark from which we can understand the necessary level of treatment. The PP setting may have afforded more attention for patients than the CMHC setting, though at a lower cost to the government. The psychiatrist believed that he wanted patients to improve equally in both settings, but he could have been more enthusiastic in the setting in which he also did psychotherapy and therefore had better relationships with patients. On the other hand, this may be the point – better relationships with patients may be associated with better outcomes.

None Declared

Nomophobia, a neologism derived from the combination of “no mobile,” “phone” and “phobia,” represents one of the syndromes of today’s digital and virtual society. By this term, we refer to the discomfort, anxiety, nervousness, and distress generated by the individual’s loss of connection to his or her cell phone or other technological medium that allows connection to the Internet. No study has attempted to evaluate the impact of disconnection syndrome on a clinical sample of patients with Severe Mental Illness (SMI).

Our study has the objective of characterizing subject affected by SMI with nomophobia.

Our study is conducted on inpatients (>16 years) referred to our Psychiatric ward in Ancona (Università Politecnica delle Marche, Italy). The following rating scales were administered to these subjects: Nomophobia Questionnaire (NMP-Q), Smartphone Addiction Scale - Short Version (SAS-SV), Multidimendional State Boredom Scale (MSBS), Intolerance of Uncertainty Scale (IUS), Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), Coping Orientation to the Problems Experiences-new Italian version (COPE-NVI).

Most of the subjects included in the study tested positive for nomophobia (99%; n=97). The mean score scored on the NMPQ is 69.2±27.9, while the mean score obtained at SAS-SV is 25.1±12.7. Gender has no influence on the scores obtained at the NMPQ (p=0.823), as well as the type of SMI (p=0.376). Those not in a relationship scored a higher mean score than who has a relationship (p=0.02). Patients who suffer from insomnia scored higher mean score on the NMPQ (p=0.21). A linear univariate regression between SAS-SV and NMPQ was observed (R2=0.575, F=129.731, p<0.001). A multivariate linear regression was observed between the NMPQ (R=0.556, R2=0.2830, F=12.057, p<0.001) and the IUS (B=1.343, p<0.001), the irritable temperament subscale of the TEMPS (B=1.293, p=0.003) and the inattention subscale of the MSBS (B=-1.029, p=0.033). In the men-only sample, a multivariate linear regression was observed between the NMPQ (R2=0.437, F=9.847, p<0.001) and the IUS (B=1.361, p<0.001), the anxious temperament subscale of the TEMPS (B=1.687, p=0.005) and the inattention subscale of the MSBS (B=-1.465, p=0.002).

Patients with higher intolerance to uncertainty, irritable temperament and lower inattention have higher risk to develop nomophobia. In men with SMI, nomophobia is associated with higher intolerance to uncertainty, anxious temperament, and lower inattention. Further study have to be conducted to expand data and results.

None Declared

Various mechanisms have been identified to explain the relationship between gender-based violence, screening, and cancer. Biological mechanisms, primarily related to chronic stress and allostatic load, have been associated with high rates of chronic diseases among victims of violence, impairing the functioning of the immune and endocrine systems. Victims of abuse simultaneously show less initiative for screening exams, such as mammograms, as they perceive them as invasive and retraumatizing. They also demonstrate a greater tendency toward maladaptive coping behaviors and unhealthy lifestyles, such as abusive substance use. A significant number of these patients develop psychosocial dysfunction and body image disturbance during breast cancer treatments.

This work aims to provide a descriptive and narrative analysis of body image and psychosocial changes in women breast cancer survivors with prolonged experiences of violence, supported by a non-systematic literature review on the central aspects under study.

For the introductory literature review, a search was conducted on search engines such as Google Scholar and PubMed, with no date limitations, using the following terms (or combinations): “intimate partner violence,” “violence AND cancer,” “body image AND psychossexual adjustment AND breast cancer.” Additionally, a narrative analysis of body image and psychosocial changes in women breast cancer survivors with prolonged experiences of violence was conducted. For this purpose, participants were asked to complete two validated scales in the Portuguese language, and first-person testimonials were collected.

The analysis of scale results and participant testimonials highlights a consensus on the significant impairment of psychosocial functioning and the experience of sexuality. There is evidence of avoidance behaviors in terms of affectionate and sexual contact due to feelings of fear, shame, and discomfort. The breast is valued as a sensual, erotic, and essential sexual element, and impactful changes in body image persist. However, in some cases, these changes are experienced as transformative and liberating, fostering a more generous view of the body, identity, and femininity.

Women with breast cancer should be screened for the possibility of being victims of violence, as this context predicts a higher likelihood of emotional difficulties during surgical treatments, including psychological distress, post-traumatic stress, body shame, and self-blame. A significant number of women, including those in this study, consider the approach to self-image and sexuality in oncology consultations deficient. Psychological programs and interventions should be developed to empower patients to adjust to the sexual changes arising from treatments and disease progression and to promote positive intimate relationships and effective communication.

None Declared

Psychological help-seeking attitudes are influenced by various factors, including self-stigma, mental health literacy, and levels of depression and anxiety. Several studies have examined the relationships between these variables and help-seeking attitudes, shedding light on the predictors of seeking psychological help. Self-stigma, or the internalization of negative attitudes towards seeking psychological help, has been found to significantly impact help-seeking attitudes. Individuals who experience higher levels of self-stigma are more likely to hold negative attitudes towards seeking help. Additionally, mental health literacy, which refers to knowledge and understanding of mental health issues, has been identified as another important predictor of help-seeking attitudes. Individuals with higher mental health literacy are more likely to have positive attitudes towards seeking psychological help. Depression and anxiety, two common mental health concerns, have also been found to influence help-seeking attitudes. Research has shown that individuals with higher levels of depression and anxiety symptoms are more likely to express intentions to seek counseling for psychological and interpersonal concerns. These mental health concerns can serve as motivators for individuals to seek professional help. Furthermore, cultural and demographic factors can also play a role in shaping help-seeking attitudes.

This study was planned to examine the variables predicting psychological help seeking attitudes: self-stigma, mental health literacy, and depression/anxiety

The sample of the study was determined by purposive sampling method. The study was conducted with individuals who willing to participate the study and above 18 years age.

Individuals who saw the online advertisement and click on the study’s link were be brought to the study’s home page on Online Surveys. Should they wish to proceed, they will be brought to an information page detailing the purpose of the study, how their confidentiality and anonymity will be preserved and how their data will be treated.

Socio-Demographic Data Form, Mental Health Literacy Scale, Self-Stigma of Seeking Psychological Help Scale and Attitudes Towards Seeking Psychological Help Scale were used. Data analyses was planned to run via Statistical Package for the Social Sciences version, 27.0.

The analysis of the data is still ongoing in detail by the researchers. The findings and relational implications of the study will be presented.

In conclusion, self-stigma, mental health literacy, and levels of depression and anxiety are important variables that predict psychological help-seeking attitudes. Understanding these factors can inform the development of interventions and strategies to promote help-seeking behaviors and reduce barriers to seeking psychological help.

None Declared