SSRI-treated psychiatric disorders (STPD), such as general anxiety disorder and major depression disorder, are common psychiatric diagnoses. Serotonin-mediated effects of solar insolation are an active topic of research. Artificial intelligence (AI) could help to better examine that complex relation.

To investigate whether AI could predict the STPD relying primarily on average ambient temperature and annual solar insolation.

Data of age, average ambient temperature and annual solar insolation were employed to predict STPD status in 7,587 subjects using an AI. To simplify the data analysis, only individuals with white ethnicity were assessed. SPTD prevalence was 17.1%. The AI was conservatively tuned to maximize the positive likelihood ratio considering predicted and real STPD statuses. The free and open source programming language R was used for all the analyses. Dataset source: Wortzel, Joshua; Kent, Shia; Avery, David; Al-Hamdan, Mohammad; Turner, Brandon; Norden, Justin; Norden, Michael; Haynor, David (2018), “Data for: Ambient temperature and solar insolation are associated with decreased prevalence of SSRI-treated psychiatric disorders”, Mendeley Data, V1, doi: 10.17632/trs43ybh92.1

Predictions obtained a positive likelihood ratio of 4.850. The results were indicative of fair performance.

AI might be useful to predict STPD. Furthermore, the results of this study might indicate a moderate effect of age, average ambient temperature and annual solar insolation on the probability of STPD occurrence. Finally, the AI used in this study is freely available, allowing anyone to experiment.

Evaluate the impact of the initial health assessment service for asylum seekers provided by the Asylum Practice Service.

Examine the inputs of Asylum practice service to asylum seekers. Investigate the activities and outputs of the Asylum practice service. Identify the outcomes of Asylum practice service to asylum seekers. Assess the impact of Asylum practice service to asylum seekers.

The conceptual framework for measuring impact at the asylum practice service was based on a Logic Model to engage stakeholders and service users in order to evaluate the impact of services provided by the service. Also the Refugee Health Screener – 15 (RHS15) was used to screen the emotional distress/trauma to identify those individuals who would benefit from further mental health evaluation and treatment. Both quantitative and qualitative data were used to articulate and evidence social value performance and to tell the story of change created.

The study shows that newly arrived asylum seekers benefit from the services of asylum practice, even though the impact could be marginal in some cases.

There is a need to revisit the current Initial Health Assessment tool, as in its current form, vital information on the causes of trauma such as rape, torture, human trafficking, and witnessing the death of parents, child, and close relatives which may underpin mental health problems, may not be captured, thus preventing access to appropriate interventions.

No significant relationships.

Opioid dependent individuals frequently complain of sleep problems in withdrawal and during abstinence.

The objectives were to assess the subjective sleep parameters among buprenorphine-maintained opioid-dependent patients and to correlate it with socio-demographics, concomitant drug use and treatment related variables

Using a cross-sectional study design, 106 hundred six opioid-dependent patients maintained on buprenorphine for at least six months and on same dose in past month were interviewed. Sleep was assessed by Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale. Association between subjective sleep parameters, socio-demographics, concomitant drug use and treatment related variables was also studied.

All participants were males. Their mean age was 41.1 years (SD:14.3). The mean duration of illicit opioid use was 10 years (IQR: 5,22). About 63.2% (n=67) had PSQI scores more than 5 denoting sleep problem. The scores obtained in Epworth Sleeping Scale were in normal range. Mean subjective total sleep time of the sample was 403.5 (SD 94.8) minutes and median sleep latency was 35 (IQR 18.8, 62.5) minutes. Subjective total sleep time was significantly higher in participants who had use tobacco in the past three months (p value=0.03) and who were in moderate ASSIST risk category (p value=0.04). Subjective sleep latency was significantly higher (p value=0.04) in participants who had used opioids in last three months. It was observed that age was a significant predictor of subjective total sleep time and OST compliance was a significant predictor of sleep latency.

A sizeable proportion of opioid dependent patients on buprenorphine have sleep problems

Long-acting injectable antipsychotics (LAIs) are currently the most effective alternative for patients with schizophrenia who exhibit poor adherence. Although a recent meta-analysis reported similar efficacy between first and second-generation LAIs, these results were only based on 3 studies due to the limited number of head-to-head comparisons.

Present the preliminary results of a network meta-analysis on the comparative efficacy of LAIs in schizophrenia.

Studies were obtained from a previous study, where we carried out a systematic search from until May 2019 in various databases. Included trials of adults with schizophrenia compared the efficacy of LAI vs LAI or placebo through the Positive and Negative Syndrome Scale (PANSS). Efficacy was evaluated through the mean differences (MD) from baseline to endpoint in the PANSS total scores. Network meta-analysis was performed in MetaInsight through direct and indirect comparisons using a Bayesian approach.

from 12 studies are presented in Figures 1 and 2. All LAIs except zuclopenthixol were more effective than placebo. There were no significant differences between LAIs except for aripiprazole and risperidone, which were more efficacious than zuclopenthixol. The largest change occurred with aripiprazole LAI, but was not significantly higher than haloperidol.

Figure 1. Comparison of treatment pairs. Effect sizes are presented as MD and 95% confidence intervals (*p<0.05).

Figure 1. Overall change in symptoms

Preliminary results from a network meta-analysis also suggest that in the long-term haloperidol decanoate is equally effective in overall symptom changes compared to other LAIs. Further analyses are needed to obtain a better perspective on these drugs.

No significant relationships.

No significant relationships.

Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and high suicide rate. Although affective temperaments are considered possible mediators of outcome, their role on the course and outcome of BD remains poorly studied.

The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to verify which affective temperaments are associated with a more severe clinical picture in a sample of patients with BD.

All patients with BD referring to the outpatient units of two Italian university sites have been recruited. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments.

199 patients were recruited. 54.8% of patients had a diagnosis of bipolar I disorder. 56.8% of the sample reported at least one episode of aggressive behaviours and 30.2% of suicidal attempt. Predominant cyclothymic and irritable temperaments predicted more frequent relapses, a poorer quality of life (p<;0.05), more aggressive behaviours and suicide attempts (p<;0.01). The predominant hyperthymic disposition was a protective factor for several outcome measures, including relapses and suicidality (p<;0.01), and was correlated with a less severity of psychiatric symptoms and later age at onset (p<;0.05).

Early identification of affective temperaments in BD patients can help clinicians to identify those who could show a worse prognosis. A screening of affective temperaments can be useful to develop early targeted integrated pharmacological and psychosocial interventions.

No significant relationships.

Acute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.

To present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.

We will present a case report and a literature review.

We report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.

Stressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.

Electroconvulsive therapy (ECT) remains a valuable treatment for major depression with psychotic symptoms. However, it is necessary to pay special attention when there is a history of fractures.

Through the description of the following clinical case, we will emphasize the importance of screening for vertebral fractures within ECT and the different procedures that must be taken if that occurs.

We undertook a narrative literature review by performing a search on PubMed for English-written articles. The query used was “Electroconvulsive Therapy” AND “Vertebral Fractures”.

A 71-year-old woman was admitted with an episode of psychotic depression. Basic tests were performed and were all normal. After not responding to pharmacologic treatment, she was referred for ECT. The patient had a full recovery after 4 weeks of biweekly sessions. She was discharged and proposed for maintenance ECT. However, she started complaining of back pain after falling and did an X-ray and CT scan which revealed fractured L1 and L2. It was suggested conservative treatment with a Jewett orthosis. Within this period, the ECT was suspended and after a 4-week treatment, the fracture was consolidated. As there was no risk of neurological compression, the treatment was restarted with the same dosage of succinylcholine, and it was achieved complete muscular relaxation. The patient fully recovered without any orthopedic sequel.

Electroconvulsive therapy can be safely performed after conservative treatment of vertebral fractures, if special attention is provided to complete muscular relaxation. For this effect, the dosage of succinylcholine can be adjusted.

No significant relationships.

One of the central debates in the psychiatric community is the difficulty in distinguishing Dissociative Identity Disorder (DID) from Borderline Personality Disorder (BPD). The fact that core symptoms of these pathologies such as emotional dysregulation, alterations in sense of Self, amnesia, depersonalization, self harm, hearing voices, difficulties in maintaining relationships, are symptoms that feature in both disorders can lead physicians to a misdiagnosis, thus depriving patients with DID of adequate treatment.

To report a complex clinical case of a DID patient initially misdiagnosed as BPD.

Clinical case report.

A 45-year-old Caucasian woman with a history of childhood intrafamilial sexual abuse and domestic violence, substance use disorder, autolesionistic and suicidal behaviour with an active diagnosis of BPD presented to our ambulatory mental health care service. A more thorough examination revealed a history of emotional and affect dysregulation, depersonalization, amnesia, intrusive traumatic memories and nightmares with affective, cognitive, and sensorimotor aspects, persistent negative Self-perception. Auditory verbal hallucinations were also present described as inner space with commentary and derogatory nature with one of them being a child voice. The diagnosis of tertiary structural dissociation and DID was finally made when three Apparently Normal Personalities emerged with several Emotional Personalities, authorising for cautious partial pharmacological washout and initiation of three phase-orientated treatment approach.

DID is more common than is assumed and the overlap of core symptoms with other disorders can lead to a misdiagnosis. A careful clinical interview and evaluation of symptoms is mandatory to a correct DID diagnosis with a consequent appropriate therapy.

No significant relationships.

Reduced motivation in schizophrenia is expressed is as the reduction of activity and social functioning.

Assessment of motivation in patients with schizophrenia and development to their psychosocial treatment.

Clinical, psychometric (URICA, PSP, PANSS), statistical. Included 100 patients diagnosed with schisophrenia F.20-29(ICD-10) with various levels of deficit.

The analysis showed the connection between the intensity of negative disorders of the patients with the level of their motivations: in the group of patients with severe deficiency (pseudoorganic), a decrease in the level of motivation was found: the score of the «Precontemplation» stage of the URICA scale (56.20 ± 9.29) was higher (P <0.001). Patients with moderate deficit (diminished schizoid) changes were distinguished by high motivation, high scores on the «Action» (49.34 ± 8.22, P <0.005) and «Maintenance» scale (52.43 ± 10.51, P <0.005). A negative correlation was established between the indicators of patient motivation and the PANSS scale: will disorders (r = -0.75, P <0.01), social withdrawal (r = -0.64, P <0.01), blunted affect (r = -0.62, P<0.005), etc. High positive correlation found between motivation rating and PSP scores in socially activity (r = 0,74, P <0,005) and social relationships (r = 0,65, P <0,01). We have developed a comprehensive program of psychosocial treatment, including compliance therapy, motivational, cognitive and social skills training, destigmatization actions and an assessment of its effectiveness.

The developed rehabilitation program showed high efficiency: increasing motivation, reducing self-stigmatization, developing communication skills, improving social functioning and cognitive sphere in patients with schizophrenia.

Since ancient philosophy extraordinary creativity is associated with mental disorders, emotional and cognitive destabilization, and melancholia. We here summarize the results of empirical and narrative studies and analyze most prominent cases of highly creative persons who suffered from depression, bipolar and schizotypic disorders, drug- and alcohol addiction. Hereby, we focus on the interaction of creative processes with “bipolar” personality traits. Finally, we offer an interdisciplinary interpretation of the creative dialectics between order and chaos.

An interdisciplinary concept of the relationship between creativity and psychopathology is shown to be essential for reasonable psychopharmacological and psychotherapeutic treatment of creative individuals.

On the basis of empirical-statistical and biographical studies we offer a comprehensive concept of the interaction between creativity and psychopathology.

The exemplary cases of J. W. v. Goethe and Robert Schumann show a complex interaction of mood swings with creative achievements. Dysthymic and mild depressive phases were associated with creative efforts whereas severe depressive episodes inhibited their creativity. Mild mood swings and “bipolar personality traits” interacted constructively with their creative striving. With respect to the relationship of alcohol- and drug-abuse, we show on behalf of a detailed analysis of the life and work of prominent Pop-Icons that addiction mostly leads to psycho-social disintegration and destruction of creativity.

An interplay between cognitive coherence and incoherence, emotional stability and instability, order and chaos accompanies many creative processes. The interdisciplinary approach shows that psychopathology can motivate creative efforts. However, if expressed severely, mental disorders inhibit or even destroy creativity.

No significant relationships.

Attention Deficit Hyperactivity Disorder (ADHD) is a Neurodevelopmental Disorder characterized by persistent pattern of inattention and hyperactivity / impulsivity. There is considerable difficulty in diagnosing ADHD, mainly to discriminate what could be symptoms arising from ADHD or typical age behaviors. The decision tree model is a statistical algorithm, a predictive model built with comparisons of values for a given objective that can be compared with other constant values, placing these variables in a database at hierarchical levels.

This study aims to apply the decision tree model in directing the screening of ADHD complaints to analyze which cognitive and behavioral parameters would be better associations with ADHD accurate diagnosis

We used a database of research protocol with 202 children assessed with complaints of ADHD and a control group with 185 participants. Decision tree analyzed parameters selected from the cognitive instruments, such voluntary attention, Continuous Performance Test indexes, WCST indexes, Wechsler Intelligence indexes and behavioral scales from CBCL/6-1 and TRF/6-18.

The highlighted results points to WCST index like: “Perseverative answers” and “Perseverative errors” and “learning to learn” joint to “CPT omissions” and behavioral scales as “CBCL ADHD”, and “CBCL Problems of Attention” produces accuracy of diagnosis discrimination from 84.7% to 60% in the precision of the decision tree.

The decision tree and machine learning approaches can be effective in directing the screening of typical ADHD complaints.

No significant relationships.

This project is funded by ERA-NET of the European Union.

International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).

This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.

The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).

cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.

Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.

No significant relationships.

The call for alternatives to coercion in mental health care is growing both within the profession and among people with lived experience of coercion in mental healthcare. There is widespread agreement that coercive practices are over-used. Considerable work is warranted across the mental health sector and in communities and governments to ensure that people living with mental disorders and psychosocial disabilities uniformly have access to high-quality care and support that meet their needs and respect their personhood and human rights. The question of whether coercive interventions can ever be justified as part of mental health treatment, to protect rights holders’ own interests or on other grounds, is highly contested. WPA issued a Position Statement and Call to Action in 2020: Implementing Alternatives to Coercion: A Key Component of Improving Mental Health Care after extensive consultation and review. The purpose is (1) to recognize the substantive role of psychiatry in implementing alternatives to coercion in mental health care and (2) to support action in this regard, essential to improving mental health treatment and care in all countries. The Statement recognises the diversity of views and experiences among mental health professionals, people with lived experience and their families and carers. This initial step is the beginning of a longer-term process, which requires continued engagement with WPA member societies, people with lived experience, families and other partners to encourage and support the implementation of alternatives to coercion in mental health care. https://www.wpanet.org/alternatives-to-coercion

No significant relationships.

The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used screening instruments in child and adolescent psychiatry. Studies have shown that the parent is a better informant than the adolescent, both for externalising and internalising disorders (Goodman et al, 1997, 2000).

Aim of this study was to examine the prevalence of parent and adolescent reported internalising problems in outpatient child and adolescent psychiatry setting using SDQ and examine the differences between parent and adolescent reports.

The study group was 101 adolescents (11-17 y.o.) and their parents, in 2 outpatient psychiatric care centres in Latvia. Internalising problems were assessed using SDQ parent and self-report version. When analyzing the score, 3rd and 4th band were defined as “high”.

The mean age of adolescent population was 14,04 years (SD 1,96) and N=54 were female. 60,4% of parents and 52,5% of adolescents reported high level of peer problems, 63,4% of parents and 51,5% of adolescents reported high level of emotional problems. Parent and adolescent report results were concordant in two thirds of cases. Adolescents reported high emotional and peer problems in 9% and 14% of cases respectively, when their parents did not. And on the contrary - 22% of parents reported high level of internalising problems when the adolescent did not.

More than half of reports showed high levels of internalising problems. Every fifth parent reported a higher level of internalising problems than their adolescent. This agrees with previous findings that single informant (parent) reports might be more informative than multi-informant reports.

In emergency departments, workers regularly report unfavorable working conditions. It’s a stressful workplace with excessive workloads, high demands on patient care including exposure to violence, time pressures and overcrowding.

-Identify the prevalence of violence, psychological distress and job stress in the emergency department. -Investigate risk factors of aggression among emergency department staff.

This study is a descriptive-cross sectional analysis study conducted on emergency department staff. Data were collected through a questionnaire including sociodemographic information, circumstances of the aggression, the Karasek questionnaire, and the GHQ-12 (General Health Questionnaire).

Our study included 62 health workers. Half of the population were physicians. The prevalence of assault was estimated at 59.6%. Psychological distress was noted in 64.5% of cases. Occupational stress was estimated at 75.8%. The most common type of assault was verbal aggression (86.4%). The aggressor was most often an accompanying person. The occurrence of violence was not associated with the worker’s psychological distress or job stress. On the other hand, we noted an association between aggression and variable work schedule.

Violence against healthcare workers in the emergency department is an important phenomenon. Preventive actions should be taken to improve health professional wellbeing at work.

No significant relationships.

The therapeutic effectiveness of mindfulness-based interventions (MBIs) has been shown for various mental disorders. However, for schizophrenia spectrum disorders (SSD), only a few trials have been conducted, mostly in outpatient settings.

This study aimed to investigate feasibility, acceptability, and preliminary effectiveness of a four-week mindfulness-based group therapy (MBGT) for in-patients with SSD.

A pre-registered randomized controlled trial (RCT) was conducted at the in-patient ward for SSD. All measures were employed at baseline, post-intervention (4-weeks), and follow-up (12-weeks). The primary outcome was ‘mindfulness’. Secondary outcomes were rater-blinded positive- and negative symptoms, depression, social functioning, as well as self-rated mindfulness, depression, anxiety, psychological flexibility, quality of life, and medication regime.

N=40 participants were randomized into either four-week treatment-as-usual (TAU; n=19) or MBGT+TAU (n = 21). Protocol adherence was 95.2%, and the retention rate to treatments was 95%. ANCOVA analysis revealed significant improvements in the MBGT+TAU compared to TAU for the primary outcome and negative symptoms. Exploratory analyses showed medium-to-large intervention effects on secondary outcomes mindfulness, positive, negative, and depressive symptoms, psychological flexibility, quality of life, and social functioning for MBGT+TAU and small-to-moderate changes on positive symptoms and social functioning for TAU. No serious adverse effects were reported.

This study supports the feasibility and acceptability of MBGT for in-patients with SSD, including high protocol adherence and retention rates. A proof of concept of the MBIs and corresponding improvements on various clinical and process parameters warrant a fully powered RCT to determine effectiveness, cost-efficiency, and longitudinal outcomes of MBGT for SSD.

No significant relationships.

In the context of distance learning students have an increase in the level of stress, anxiety (Husky, Kovess-Masfety, Swendsen, 2020). There is also a problem with time management and, as a result, procrastination. The reported study was funded by RFBR according to the research project №20-04-60174.

To study the differences in the level of anxiety and procrastination depending on the type of learning.

A total of 290 students took part in the study. In the first study (before distance), 168 people took part, the average age was 19.8. In the second study (during distance) – 120 students, the average age was 19.2. The questionnaires: General Procrastination Scale, C.Lay; State-Trait Anxiety Inventory, Ch.Spielberger.

In the course of descriptive statistics, it was revealed that the level of procrastination and state anxiety have a middle score. However, the level of trait anxiety in conditions of distance learning is high, especially among 1st-year students. In a comparative analysis of the two studies, it turned out that the level of state anxiety is significantly higher (t=1,975;p=0,049) in conditions of distance learning. The correlation analysis revealed the relationship between procrastination and trait anxiety (r=0,414;p=0,0001).

These results can be used to create programs to optimize the stress manifestation in students, especially when taking online exams. The high anxiety of 1st-year students may be associated with their accumulated stress factors, such as uncertainty about the future and etc. It should be noted that the level of procrastination does not differ, which may indicate procrastination as a personality trait.

During the 1st wave of CoViD-19 pandemic there was a drastic reduction in total number of accesses, with more serious cases and a exorbitant increase in crowding, due to access block.

evaluate population who went to ED for (1) mental disorders requesting a psychiatric visit and for (2) intossication and substance abuse, between the first and second wave of the coronavirus pandemic

We enrolled all patients who went at our ED from May 1 to October 20, 2020 and during the same period of 2019. We analized: vital parameters, age, sex, exit severity codes, hospitalization rate, Crowding input factors (number of access, waiting time, priority time to doc), Crowding throughput factors (LOS: Length Of ED Stay), Crowding output factors (percentage of access block; Total Access Block Time).

The results are shown in table 1

We would like to thank all employees of the IRCCS Policlinico San Matteo Foundation for their extraordinary efforts during the pandemic.