Violence in psychiatric settings poses significant challenges for healthcare professionals, particularly nurses. This study examines psychiatric nurses’ perceptions of violence and its impact on the quality of care they provide.

The primary objective is to assess the influence of violence on the quality of care in psychiatric settings, with a focus on the experiences and perspectives of nurses.

We employed a questionnaire-based survey administered to 30 psychiatric nurses working in both inpatient and outpatient psychiatric units of the Razi hospital Manouba. The survey gathered information on the prevalence of violence, types of violence encountered, and the impact on nursing practice.

Of the 30 respondents, 75% identified as female and 25% identified as male. Most of them had more than five years of experience. The primary results revealed that all the psychiatric nurses reported experiencing at least one incident of violence during their psychiatric nursing careers. Regarding exposure to verbal violence, the results indicated that 52% encountered it sometimes, 22% often, 17% very often. Regarding physical violence, 30% experienced it rarely, 26% sometimes, 13% often, and 13% very often. For sexual violence, 56% reported never experiencing it, 8% rarely, 26% sometimes, and 8% very often. These incidents had varying effects on nurses’ emotional well-being, job satisfaction, and the quality of care they were able to provide. 53% of nurses reported experiencing emotional distress and feelings of anxiety as a result of violence, 13% felt anger and frustration. One nurse declared he was not affected emotionally. Most of the respondents (75%) indicated that their job satisfaction had been negatively affected by violent incidents. 40% of respondents stated that violence has a negative impact on their relationship with patients, but they make efforts to maintain care quality. Whereas, 20% found ways to strengthen connections despite challenging experiences.The most commonly endorsed strategies to cope with violence included attempting to master their emotions by remaining calm and patient (78% of respondents), seeking assistance or the presence of other healthcare team members (65%), and maintaining a safe distance from patients (69%). Fewer participants reported raising their voice and adopting a position of authority (30%), while a minority indicated engaging in additional training on the management of violent situations (20%). These results illustrate the diverse range of personal coping strategies.

Violence in psychiatric settings has a multifaceted impact on psychiatric nurses, affecting both their emotional well-being and the quality of care they provide. Strategies for managing and preventing violence, as well as supporting nurses in coping with these challenges, are essential for maintaining high-quality psychiatric care.

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Alcohol addiction can lead to withdrawal seizures, but most patients do not develop epilesy. In some cases a permanent complication occurs - symptomatic epilepsy. In other cases epilepsy precedes alcohol addiction. Comorbidity may pose serious chalenges to treating clinicians. There are conflicting data regarding relationship between alcohol use, seizures and epilepsy (Scorza CA et al.,CLINICS 2020;75:e1770). Other factors like brain trauma may have impact in genesis of epileptic states as well.

Evaluation of interplay between seizures, epilepsy and brain trauma in patients with alcohol use disorder.

Analysis of a case series in a hospital setting and review of relevant literature.

In our series of cases the number of patients who have suffered epilepsy before the onset of alcohol use is small. In most of the hospitalized patients epilepsy occurred after the development of alcohol use disorder. In this group we observed that head and brain trauma play role in genesis of seizures and epilepsy and in some instances the reverse happens.

Our data indicate the potential role of brain trauma as predisposing and complicating factor in patients who developed seisures and epilepsy. Seizures sometimes increase the risk of brain trauma. Seizures and trauma are important factors in typology of Lesch (Lesch et al. 2011) and a serious evaluation in this direction is improtant, because its diagnostic, therapeutic and prognostic implications. Further clarification in this field is necessary.

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There is emerging evidence that people with schizophrenia (SCH) struggle to form romantic relationships and are often dissatisfied with their sex lives. Intimate relationships are perceived as normalizing and related to a person’s recovery and better medication adherence. Nevertheless, this area remains scientifically unaddressed, and patients with SCH generally do not feel adequately supported in terms of their sexual health.

The study aims to assess whether challenges in establishing sexual relationships could be connected to: a) decreased salience of sexual intimacy and/or b) compromised ability to detect, recognize, and react to signals of sexual interest.

Forty-three patients with SCH (29 males and 14 females) and a control group of twenty-four participants (11 males and 13 females) were exposed to our first experiment, the Circular attention task. This task was designed to evaluate the salience of erotic stimuli compared to neutral ones. At the beginning of each trial, a black fixation circle appeared in the middle of the screen. When a fixation of 250 ms or longer was detected within the circular area of interest (AOI) around the fixation circle, the fixation circle disappeared, and a pair of erotic/neutral pictures appeared. During the experiment, the eye movements were measured using the eye-tracking device Eyelink 1000plus. For data analysis, we used Wilcoxon signed-rank test to assess the differences between the mean latency to first fixation, mean duration of first fixation, and mean proportion of time spent gazing at the stimulus both for sexual and neutral pictures in the whole sample regardless of sex and patient status. More detailed analysis was performed using 2 (sex: male, female) x 2 (status: patient, control) two-way ANOVA.

Considering the whole sample there was a significant difference in mean latency to first fixation (W = 707, p = 0.007, rrb = -0.379) and mean duration of first fixation (W = 1923, p < 0.001, rrb = 0.739). There was a shorter latency to first fixations towards sexual pictures (M = 952.33 ms) than to neutral pictures (M = 1005.30 ms). First fixations were longer for sexual pictures (M = 280.96 ms) than for neutral pictures (M = 243.73 ms). There was an effect overall in the sample towards the sexual pictures, but it was not different for participants based on their sex or patient status.

Findings revealed that interest in explicit sexual stimuli does not differ based on sex or patient status. Patients with SCH appear to find explicit erotic signals sexually salient, suggesting their interest in sexual intimacy. Our study will further investigate whether persons with SCH are able to interpret, recognize and respond to signals of sexual interest. Based on our results, the guidelines for sexological remediation will be developed.

The study was supported by the Charles University, 1. LF project GA UK No. 56123.

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Antipsychotics are psyschotropic medications that are indicated for the treatment of physchosis and mood disorders. Due to minimal side effects and their efficacy (affecting many receptors) compared to standard antipsychotics, today atypical antipsychotics are being used more and more as first-line treatment.

The aim of this study is to show the efficacy of asenapine and its tolerability as opposed to other atypical antipsychotics.

1. 1. What are the side effects identified?

2. 2. Side effects and efficacy of asenapine vs other atypical antipsychotics?

It is a comparative, regular, clinical study, an examination case of a 53-year old female diagnosed with Schizoaffective Disorder 27 years ago and treated outside of hospital with atypical antipsychotics, such as: risperidone, olanzapine, quetiapine, aripiprazole, amisulpride. The study covers the timespan of 2010-2022.

The results showed that asenapine sublingual 15 mg had fewer side effects than other atypical antipsychotics. They were mouth dryness, headache, fatigue.

The other atypical antipsychotics caused: metabolic disorders, like considerable weight gain, cholesterol and glycaemia increase, extrapyramidal side effects, hyperprolactinemia.

Asenapine sublingual 15 mg was not as effective in treating Schyzoaffective Disorder as risperdal 5mg, olanzapine 15 mg, aripiprazole 20 mg, amisulpride 600 mg.

The efficacy of asenapine sublingual 15mg was the same as quetiapine 400 mg.

This study showed that asenapine has minimal side effects but its efficacy in treating Schyzoaffective Disorder as monotherapy is lower than other atypical antipsychotics.

antipsychotics, schyzoaffective disorder, side effects, efficacy

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The intricate and multifaceted nature of the link between epilepsy and psychiatric diseases is evident. Patients diagnosed with epilepsy frequently exhibit concurrent psychiatric illnesses, including but not limited to depression, anxiety, psychosis, and attention-deficit disorders. Gaining a comprehensive understanding of the fundamental mechanisms and implementing efficacious ways to effectively address this co-occurring medical condition is crucial in order to achieve the most advantageous results for patients.

The objective of this study is to examine the frequency, neurobiological bases, and consequences for treatment of psychiatric comorbidities in patients diagnosed with epilepsy. The study aims to offer a thorough understanding of the subject and promote interdisciplinary collaboration.

A systematic review of literature was conducted, focusing on clinical studies, neuroimaging findings, and neurochemical changes in patients with both epilepsy and psychiatric disorders. Additionally, best-practice recommendations for the clinical management of this patient population were identified.

The results suggest that the coexistence of epilepsy and psychiatric diseases may be affected by neuroinflammation, abnormalities in neurotransmitters, and shared genetic factors. In addition, the implementation of integrated therapy techniques that include both neurological and psychological components has demonstrated encouraging findings in enhancing patient outcomes.

The identification and proficient management of psychiatric comorbidities in individuals with epilepsy are of utmost significance. The establishment of interdisciplinary collaboration between neurologists and psychiatrists, supported by continuous research, is necessary in order to provide comprehensive treatment and enhance the overall well-being of individuals affected by these conditions.

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Non-suicidal self-harm, i.e. the intentional self-infliction of bodily harm without apparent suicidal intent, is a powerful risk factor for suicidal ideation and behavior [1]. Although non-suicidal self-harm and suicidal behaviour are distinct concepts, the two forms of deliberate self-harm frequently coexist and share key instrumental functions, such as escaping aversive internal states, reducing dysphoria or communicating distress, especially in patients with personality disorders. [2]

Some individuals also report using non-suicidal self-harm to ameliorate suicidal thoughts or urges [2].

To assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed at the Arrazi psychiatric hospital in Salé.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria and the Beck suicidal intentionality scale to assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.

The inclusion criteria were as follows: both sexes with a diagnosis of borderline personality disorder according to DSM 5 criteria.

Exclusion criteria were current psychosis and severe intellectual disability.

We collect 63 participants.

The average age of the participants was 23, and they were predominantly female (89%). About 85% were single and 97% had no occupation. The majority of participants had a substance use disorder.

All participants had a history of non-suicidal self-harm and 36% had a history of suicide attempts.

Suicidal intent was strong in 45% of participants who had already attempted suicide.

Approximately 46% of participants reported that non-suicidal self-harm was intended to alleviate suicidal ideation and approximately 27% of participants reported having experienced suicidal ideation shortly after non-suicidal self-harm.

Non-suicidal self-harm is very common in patients with borderline personality disorder often considered to have a mitigating effect on the internal stress of these patients and sometimes even neglected. The relationship between non-suicidal self-harm and suicidal ideation is an important one, and may reduce suicidal ideation in the short term but subsequently encourage further self-harm, thereby increasing the risk of suicide.

Particular attention must be paid to these patients and their self-harm, and specialised, comprehensive care is required.

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Anhedonia (loss of ability of experience pleasure) is a transdiagnostic symptom which is presented as a prominent complain in several psychiatric disorders, such as depressive disorders, schizophrenia, bipolar disorder, addictive disorders, certain personality disorders etc. Specific instruments for assessment of anhedonia have been published in the international literature but their Hungarian versions are not available so far, however, the prevalence of affective disorders and suicide are also high in Hungary. The Snaith-Hamilton Pleasure Scale (SHAPS) is an instrument developed in 1995 (Snaith et al. Br J Psychiatry1995;167:99-103) which purposley has been constructed with items that can be easily translated into other languages.

The aim of our study was to translate the 14 items into Hungarian and analyse its reability and sensitivity in a Hungarian sample consists of patinets and control persons. Further aim was to explore the differences of anhedonia profiles among diagnostic categories and subgroup of major disorders.

We recruited 170 subjects (101 controls and 59 patients; 78 men and 82 women; mean age=37,9±6,1y) into our study. Among the patients there were 27 subjects with major depressive disorer (MDD), 10 subjects with bipolar disorder (BD), 9 patients with schizophrenia (SCZ), 6 patients with addictive disorder (AD) and 7 patients with anxiety disorder (ANX)±. We created two major subgorups from the dfferent diagnostic categories: affective and psychotic subgroups to compare the anhedonic profiles. Differences of mean values between case and control, men and women and subgroups were analysed by t-tests and diganostic categories by ANOVA tests performing in SPSS 20.0 software.

Among the MDD, the BD, the SCZ, the AD and the ANX groups, patients with MDD produced the highest score (6.9±3.5; 3.9±2.4; 5.9±3.9; 2.8±2.7;2.3±1.8, respectively), while controls prohibited 1.6±1.3. The case group scored significantly higher on the SHAPS than the control group (5.3± 3.6 vs. 1.6±1.3; p=0.0001). The means of SHAPS did not differ significantly between the affective subgroup and the psychotic subgroup (6.0±3.7 vs. 4.8±3.2; p=0.24). Among the subgroup of women, the age was significantly associated with the SHAPS score (p=0,04), however, this association has been not detected in men.

The Hungarian version of the SHAPS detected marked difference between cases and controls with good reliability and sensitivity. The instrument can be useful in daily clinical routin becuase subjects could fill it easily and quickly. In case of patients with pronounced anhedonia, treatments with spcifically targeting anhedonia can be preferred (e.g. rTMS as it was demonstrated in our earlier publications, see Lazary et al. Sci Rep 2021,11:8867; Elemery et al. Front Psychiatry 2022, 13:806731). This study was supported by the grant EFOP 5.6.2.

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Schizophrenia is a chronic mental illness that has a lifetime prevalence worldwide of about 1% regardless of culture, social class and race. This implies that it affects a large number of families. Family therapy has been used for years as a promising approach to intervene with people suffering from such pathology. It has been shown that families with a high level of hostility, critical comments and over-involvement are related to a higher number of relapses in the family member diagnosed with schizophrenia.

The objectives are to examine whether systemic interventions could help to decrease the emotion expressed in these family members and thus decrease the number of relapses of patients as an alternative to pharmacological treatment.

A case report and a literature review on the impact of family therapy in patients with a diagnosis of schizophrenia. The search strategy included keywords such as “family intervention”, “schizophrenia” and “systemic therapy”. Selection criteria included randomized controlled trials (RCTs) and meta-analyses published between 2010 and 2021. Studies focused on the impact of family intervention on symptom management, relapse prevention and general functioning were included.

The findings consistently demonstrated the effectiveness of family intervention in improving outcomes for people with schizophrenia. These interventions generally involved psychoeducation, communication skills training, problem-solving techniques, and emotional support for family members. Results showed significant reductions in symptom severity, decreased relapse rates, improved adherence to pharmacological treatment, and better overall functioning among people who received family intervention compared with those who received only standard care. In addition, family intervention was associated with reduced caregiver burden, improved family communication, as well as increased knowledge about schizophrenia and its management.

Family intervention has become a valuable adjunctive treatment for people with schizophrenia. The findings of this review highlight its positive impact on symptom management, relapse prevention, and overall functioning. Family intervention offers a holistic approach that recognizes the importance of involving and supporting the family system in the treatment process. This intervention provides families with the tools and resources necessary to effectively cope with the challenges associated with schizophrenia and promotes a supportive and nurturing environment for the individual. Future research should focus on long-term outcomes and implementation of the family intervention in routine clinical practice.

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Relapse prevention is crucial in patients with schizophrenia, as repeated episodes can worsen psychopathology and functionality. There is strong evidence of antipsychotics efficacy in preventing relapse; however, non-compliance rates in patients with schizophrenia are very high. Long-acting injectable antipsychotics (LAIs) are an important treatment option but remain underutilized.

Aripiprazole once-monthly is a long-acting intramuscular injectable formulation of aripiprazole indicated for the maintenance treatment of schizophrenia in adult patients stabilized on oral aripiprazole.

If one injection start regimen is adopted, on the day of initiation, an injection of 400mg Aripiprazole once monthly should be administered accompanied by 10mg to 20mg of oral aripiprazole per day for the successive 14 days New treatment regimen: On the day it begins, inject 400 mg Aripiprazole twice at different sites and provide one 20 mg dose of oral aripiprazole

The main aim of this study is to evaluate the efficacy and tolerance of Aripiprazole long-acting injectable (ALAI) in stable patients with schizophrenia.The initial dose was administered according to the new regimen (Two injection Start).

The secondary objective is to compare hospitalizations and emergency interventions during 24 months before (retrospective) and after (prospective) switching to ALAI.

The study included 15 patients diagnosed with stable schizophrenia (DSM 5 criteria) who underwent treatment with ALAI. The beginning dosage was administered using the new regimen (Two Injection Start).

Over an 24-month follow-up period, the Clinical Global Impression-Schizophrenia scale (CGI-SCH), treatment adherence, concomitant medication, hospitalizations, emergency assists, and reported side effects were evaluated every three months.

Mean initial scores were 4.24 (±0.83) on GCI-SCH.

After 24 months, the mean scores varied from baseline by -1.21±0.74 (P<0.01) on the ICG-SCH.

The percentage of patients who remained admission-free at the end of the 24 months was 73%.

The treatment adherence rate for ALAI after 24 months was 66%.

The most frequent side effect with an incidence of 20% was transient mild insomnia. None of the patients who started ALAI after the 2-injection start regimen experienced severe adverse effects or severe adverse effects.

There were 20 hospital admissions during the 24-month period prior to the switch to ALI, which fell to 5 hospital admissions 24 months following the switch.

Similarly, there were 38 emergency assists during the 24-month period before the switch to ALI, which dropped to 9 emergency assists 24 months after the switch.

We found of Aripiprazole long-acting injectable (The starting dose was administered following the new regimen (Two injection Start)) is effective, safe, and well tolerated in clinical practice conditions

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Patients with chronic kidney disease (CKD) may choose to undergo dialysis. Factors that may have led patients to prescribe psychological interventions related to dialysis are poorly understood in the literature. The purpose of this study was to explore multi-level factors surrounding dialysis modalities such as Diagnosed Mood Disorders, Existential crises, Triggering events, Social support, and Distrust towards the process of dialysis.

The study aims to investigate the psychological battle of the client while going through the process of dialysis. The study reveals multiple mood disorders and existential crises leading to depression among chronic kidney disease patients. Therefore the study was conducted with the aim of providing a therapeutic guide line in future once the factors are investigated in detail.

Semi-structured qualitative interviews were conducted in a dialysis clinic in Karachi where 19 participants participated in this qualitative study. The age ranges from 40-76. Initiating with informed consent followed by surveys assessing demographic and clinical information were administered to participants following their interviews.

Qualitative findings suggested that patients were dealing with Clinical Mood Disorders without being provided treatment. Moreover, the cohesive family support enabled them to continue with daily living activities; however, the patients with low support triggering adverse events in life lost their lives in follow-up sessions. Furthermore, nephrology care doesn’t seem sufficient as they are dealing with existential crises of hopelessness, regret, condemnation, and elevated death anxiety. In CKD the misinterpretation of dialysis by cognitively substituting it as End of life increased the clinical symptoms of Mood disorders. Thus the risk factors increase disturbing the quality of life.

Findings point to broader factors affecting dialysis modalities with Mood disorders. The low social support and adverse triggering events precipitate the risk factors of dialysis treatment. Furthermore, distrust towards dialysis and existential crisis are recommended for therapeutic interventions

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Psychological factors, such as emotional regulation strategies, play a crucial role in the management and care of chronic somatic health conditions among adolescents. In the existing literature, catastrophising has been associated negatively with health-related quality of life in the context of chronic health conditions in general. However, there is limited knowledge about its role in specific illness types.

We aimed to evaluate the impact of catastrophising on the health-related quality of life in two distinct illness groups: diabetes and oncology, within a Hungarian sample.

A cross-sectional study using self-report measures was carried out, involving a total of 273 adolescents (mean age: 14.72 years, SD: 1,82 years; 50.2% females) in the two paediatric samples. The diabetes group consisted of 171 participants, while the oncology group was comprised of 102 individuals. No significant differences were found between the two chronic condition groups in terms of gender (χ2 = 116.51; p = 0.50), or mean age (F(-0.82; 0.77) = 1.66; p = 0.19). The short-version of the Cognitive Emotion Regulation Questionnaire (CERQ-short) was used to assess the cognitive emotional regulation strategies of the children, specifically focusing on the catastrophising subscale. Health-related quality of life was measured using the 4.0 version of the PedsQL, which included subscales for Physical, Emotional, Social, and School Functioning.

A Hayes-moderation analysis with an interaction effect was conducted, controlling for gender, age, and the duration of the illness. A significant interaction effect was observed between catastrophising and the illness groups, impacting School Functioning (F(1, 243) = 4.17; p = 0.04), Physical Functioning (F(1, 245) = 4.67; p = 0.03), Social Functioning (F(1, 245) = 4,23; p = 0.04), and Emotional Functioning (F(1, 245) = 4.20; p = 0.04). The association between catastrophising and health-related quality of life remained stronger in the oncology group.

Catastrophising appears to be a risk factor that affects the quality of life of children facing oncology illnesses. Therefore, addressing catastrophising in interventions tailored to this paediatric illness group may be beneficial.

Keywords: catastrophising, health-related quality of life, adolescents, chronic somatic

This study was supported by the Hungarian National Research, Development and Innovation Office (K143764).

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The professional quality of life for psychiatry residents is a complex and multifaceted aspect of their careers. However, the demanding nature of their work can place significant stress on their own psychological well-being. Balancing the need to care for patients while also managing personal and professional responsibilities can be challenging. Nevertheless, psychiatry residents have the opportunity to make a profound impact on the lives of their patients and find fulfillment in their work.

To assess the prevalence of burnout (BO) and secondary traumatic stress (STS) among psychiatry residents.

We conducted a descriptive online cross-sectional survey in January 2022 among psychiatry residents practicing at Hedi Chaker University Hospital in the Sfax region in Tunisia. Professional life quality was evaluated using The Professional Quality of Life Scale - 5 “ProQOL-5”.

The total number of residents was 34, of which 91.2% were female. Their mean age was 27.94 years±2.43. They were single in 67.6%. They were residents in adult psychiatry in 61.8% and in child psychiatry in 39.2%. For 91.2% of them, the specialty of adult or pediatric psychiatry was their own choice. The individuals had been practicing psychiatry for an average of two years. They reported a personal medical or surgical history, a personal psychiatric history, and a family history of psychiatric disorders in 32.4%, 8.8%, and 50%, respectively.

On the ProQOL-5 scale, we found that 88.2% of the residents had a moderate level of compassion satisfaction, 67.6% had a moderate level of burnout, and 52.9% had a moderate level of secondary traumatic stress.

Our study showed a moderate professional life quality among psychiatry residents, hence the importance of implementing intervention strategies.

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Mental health resilience is crucial to professional wellbeing and productivity, being that 57% of company employees are reporting burnout. Additionally, early-stage preventive mental health interventions are not common, and typically employees only have access to mid-stage professional care.

The aim of this project is to provide employees with a preventive self-coping tool, enabling open and inclusive care. Specifically, the aim is to assess the receptivity, usability and impact of the usage of a mobile app that provides coping strategies based on positive psychology and a burnout-risk screening.

A mobile app was used with the purpose of being accessible to everyone, independently of their financial capacity. The app also promotes inclusiveness, by aggregating several approaches and methods for mental health coping, which are recommended given the needs of each user. The app was released to a large Portuguese company with 700 employees, in which employees could download it voluntarily.

After 7 months, the results showed 37% receptivity rate, 24% improvement on anxiety levels, 36% improvement on workplace wellbeing, 23% increase on mental health self-coping skills, and 21% improvement on burnout-risk levels. These metrics were acquired via app’s back-end, self-reporting, and our model for burnout-risk screening.

First results showcase the positive impact of adding such a mobile solution to the employees’ mental healthcare. Next steps will be conducting a longer study, adding control groups and productivity assessment.

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Older individuals constitute a significant portion of the population, and concerted efforts are underway to enhance the quality of this life stage by minimizing health issues and maximizing opportunities.

This study aims to investigate the impact of psychosomatic exercises, including practices like yoga, meditation, and tai chi, as an alternative approach to promoting healthy aging and ultimately enhancing the quality of life among elderly individuals.

The study comprised 84 participants, with 51 individuals engaging in various forms of psychosomatic exercises and 33 serving as the control group, having no prior exposure to such practices. Data collection was carried out electronically, with the initial section gathering socio-demographic information and health-related details about the participants. The second part consisted of the WHOQOL-BREF quality of life scale, consisting of 26 questions, which assessed six domains: Overall Quality of Life and General Health, Physical Health, Psychological Health, Social Relationships, and Environment. Statistical analysis was performed with SPSS 26.

The average age of the participants was 66.7 years. A statistically significant positive correlation was identified within the first subscale of the tool, “Overall Quality of Life and General Health,” with scores of 74.3/100 for those engaging in psychosomatic exercises and 66.7/100 for those who did not (t(82) = -2.513, p = 0.014). However, no statistically significant differences were observed in the remaining subscales.

Psychosomatic exercises, including yoga, meditation, and tai chi, hold promise as a means to improve the overall quality of life and general health of elderly individuals. These practices could serve as valuable components of strategies aimed at promoting healthy aging. Further research is needed to explore their effects in greater detail and across various dimensions of well-being.

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Dementia can present with psychiatric symptoms even before the cognitive impairment, which makes difficult to establish an adequate diagnosis. There have described symptoms of this type in vascular dementia, frontotemporal dementia, Alzheimer disease and Lewy bodies dementia. Frontotemporal dementia has a prevalence of 9-20% and it`s the third in frequency among degenerative dementia. It appears before the age of 65 years old and is more common in men. Two variants have been described, linguistic and behavioral. The behavioral one has usually an initial psychiatric presentation, with behavioral disorders, disinhibition and personality changes. Therefore it`s important to make an adequate differential diagnosis with late onset bipolar disorder.

To review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder.

We carry out a literature review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder, accompanied by a clinical description of one patient with behavioral disturbance and language disorder.

A 59-year-old female was admitted to the short-term hospitalization unit from the emergency department due to behavior disorder. She had no relevant personal or familiar psychiatric history up to two years before when she received diagnosis of bipolar disorder. She presented behavioral disorganization, psychomotor restlessness, verbal aggressiveness, verbiage, insomnia and decreased intake. Psychopathological examination became difficult due to her language disorder since she presented an incoherent speech with paraphasias and loss of the common thread. Neurological study guided diagnosis to frontotemporal dementia even though they left the psychopharmacological treatment to our discretion. Olanzapine 5 mg twice a day was initiated, and behavioral improvement was observed. However, the patient maintained a significant functional impairment.

Psychiatric presentation is frequent in dementia, even before cognitive failures which makes essential an exhaustive differential diagnosis. It`s important to consider the diagnosis of frontotemporal dementia in those patients who debut with behavioral disturbance in the 50s. Psychopharmacological treatment is only symptomatic so functional recovery should not be expected.

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Anhedonia is a transdiagnostic psychopathological phenomenon that is considered a key feature for several disorders, primarily affective spectrum disorders. It exhibits a significant association with social and occupational maladjustment, reduced quality of life, and increased suicidal risk among psychiatric patients.

The aim of this study is to identify recommendations for psychotherapeutic assistance for patients with affective spectrum disorders.

A total of 26 patients with affective spectrum disorders (ICD-10 code - F33, F31) and the phenomenon of anhedonia were examined. We utilized neuropsychological methods aimed at investigating a wide range of cognitive functions (Dynamic praxis; Color interference test; Arithmetic Tasks; Number of skips and impulsive errors; Reverse and straight rows; Verbal fluency; Design fluency; Rey-Osterritz figure) and psychometric methods designed to diagnose various types of anhedonia (consummatory (TEPS), anticipatory (TEPS), social (RSAS), and physical (PAS)).

Among patients with depression, the consummatory type of anhedonia was the most pronounced. A relationship was found between anticipatory anhedonia and phonetic verbal fluency (r = 0.487; p < 0.01). Additionally, there were correlations between immediate (consummatory) pleasure experience and Rey figure errors (r = -0.349; p < 0.05). Social anhedonia was associated with phonetic verbal fluency productivity (r = -0.509; p < 0.01) and performance in visual fluency productivity (r = -0.473; p < 0.01).

The obtained results allow us to hypothesize that anhedonia is associated with difficulties both in evaluating and imagining possible positive stimuli, which leads to a lack of emotional response to the current stimulus. Thus, the availability of current pleasure may be linked to memory accessibility and regulatory function. When these domains are weakened, the respondent loses the ability to associate the current stimulus with positive past experiences, making it challenging to generate an emotional response in the current stimulus situation and disrupting the anticipation of pleasure. Based on the results, we propose the effective use of behavioral activation and work on the actualization of past experiences. Behavioral activation can be implemented by gradually introducing behaviors associated with past pleasures into the patient’s life, followed by cognitive restructuring aimed at focusing the emotional response on past and current stimuli. In addition to this, from a neurocognitive perspective, an additional element of therapy could involve training various types of cognitive functions, with an emphasis on the auditory modality.

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Rates of high expressed emotion (EE) towards patients with schizophrenia have only indirectly been compared between families and community residential facilities, since studies including patients in both settings are unfortunately lacking. High EE rates in staff-patient studies are typically lower than in families, with negligible rates of high emotional overinvolvement (EOI). However, indirect comparisons can suffer from many biases.

This study directly compared patients with schizophrenia living in halfway houses or with their families on the EE of their caregivers, adjusting for patient- and caregiver-related confounders.

We included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the EE of the caring staff (N=22 nurses) or parents (N=56), respectively, through Five Minutes Speech Sample interviews. Each nurse rated 1-12 inpatients and each inpatient was rated by 2-5 nurses, totaling 155 nurse ratings. Each outpatient was rated by one or both parents. Due to the multilevel structure of EE ratings, generalized linear mixed models were fitted. We first adjusted only for differences in patient-related confounders between groups and then added basic caregiver-related demographics.

Compared to outpatients, inpatients were older (p=0.001), less well educated (p=0.002), had a longer disease duration (p=0.047), more hospitalizations (p=0.012), lower severity of psychotic (p=0.027) and, specifically, negative symptoms (p=0.015), and lower perceived criticism (p=0.001). Nurses were younger (p<0.001) and better educated (p=0.001) than parents. After adjusting for patient-related confounders only, EOI was significantly higher in parents (p=0.027) while criticism did not significantly differ between groups. However, after also adjusting for caregiver demographics (age, gender and education), criticism was significantly higher in nurses (p=0.027) while differences in EOI became non-significant.

Differences in EE, when directly compared between parents and professional caregivers, may be explained by differences in patient-related characteristics, caregiver demographics as well as other caregiver characteristics to be investigated in future studies.

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Interleukin-15 is a cytokine that induces or enhances differentiation, maintenance, or activation of several T-cell subsets (including NK, NKT, Th17, Treg, and CD8+ memory cells) and also plays an important role in regulating visceral (intra-abdominal or interstitial) fat breakdown and myofibrillar protein synthesis (hypertrophy). It is also involved in modulating serotonergic activity in the brain by modulating the transmission of GABA and serotonin, which may be the basis for mood and memory disorders, as well as activity levels, sleep, and thermoregulation. Both anorexia nervosa (AN) and schizophrenia (SCH) represent two distinct and serious psychiatric disorders in which some of these symptoms may overlap and where neuroinflammation plays an important role which is yet to be precisely determined.

This article summarizes recent findings and highlights interleukin-15 as a possible link between anorexia nervosa and schizophrenia.

A review of the current literature in the field of psychoneuroimmunology.

In recent years, research has shown elevated levels of IL -15 in the serum of patients suffering from anorexia nervosa and schizophrenia.It is also interesting to note that IL -15 has structural similarities to IL -2, which previous studies have also shown to be elevated in patients with schizophrenia.

These associations, so far suggesting an important role of inflammation and its mediators, need further investigation in light of possible genetic overlap between anorexia nervosa and schizophrenia identified in genome-wide association studies (GWAS).

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Lithium is an important treatment option for individuals with mood disorders, but its use has been linked to the development of chronic kidney disease (CKD). Existing studies on this association have reported conflicting results.

The aim of this study was to examine the risk of developing CKD with lithium use adjusting for common comorbidities.

This was a retrospective cohort study that included all individuals in Iceland receiving lithium therapy between 2008 and 2018. Lithium use was defined as at least one dispensed prescription for Lithium or at least one serum lithium concentration above the detection limit. Patients with affective disorders (ICD-10 codes F30-F39) attending the outpatient clinics of Landspitali–The National University Hospital Mental Health Services in 2014-2016, without lithium exposure, served as controls. CKD stages 3-5 were defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines for CKD as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. The eGFR was calculated using the serum creatinine (SCr) based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Acute kidney injury (AKI) was defined according to the SCr component of the KDIGO criteria for AKI, and other comorbid diseases were defined based on ICD-9 and ICD-10 codes. Individuals with fewer than 2 SCr measurements during the study period and those with CKD stages 3-5 prior to 2008 were excluded. Cox regression analysis with time dependent variables was performed to assess the risk of CKD.

The study included 2046 individuals exposed to lithium, of whom 221 (10.9%) developed CKD in the study period. Among the 1220 control subjects, 39 (3.2%) developed CKD. Lithium use was associated with CKD (hazard ratio [HR] 1.93, 95% confidence interval [CI] 1.37–2.74) after adjusting for sex, age, and comorbid diseases. Other significant risk factors were age (per year, HR 1.03, 95% CI 1.02–1.04), initial eGFR (per mL/min/1.73 m2, HR 0.92-0.96, 95% CI 0.90–0.99), presence of diabetes (HR 1.73, 95% CI 1.15–2.48) and history of AKI (HR 1.89, 95% CI 1.32–2.70). When compared to the control group not exposed to lithium, the risk (HR) of CKD was 1.24 (95% CI 0.81–1.89), 2.88 (95% CI 1.97–4.20) and 5.23 (95% CI 3.31-8.26) for groups with a mean lithium concentration of 0.3-0.59, 0.6-0.79 and 0.8-0.99 mmol/L, respectively.

Long-term lithium therapy seems to increase the risk of CKD in a concentration-dependent manner in individuals with bipolar and unipolar mood disorders. To mitigate this risk, it is essential to monitor blood levels carefully and use doses of lithium as low as possible for adequate mood stabilization and treatment.

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In the field of Alzheimer’s disease disease-modifying therapy, there has been a shift in diagnosis from the later dementia stages towards the earlier stages, with the potential for pre-symptomatic diagnosis. The development of truly ‘disease-modifying’ therapies that target the underlying mechanisms of Alzheimer’s disease has reached late stages of human clinical trials. The primary targets include beta-amyloid, whose presence and accumulation in the brain is thought to contribute to the development of Alzheimer’s disease, and tau protein which, when hyperphosphorylated, results in the self-assembly of tangles of paired helical filaments also believed to be involved in the pathogenesis of Alzheimer’s disease. Therapeutic strategies aimed at preventing Aβ formation, blocking its aggregation into plaques, lowering its soluble levels in the brain, and disassembling existing amyloid plaques are among the main strategies employed to slow the progression of AD. First anti-amyloid antibody treatments have proven effective in late-stage clinical trials and are now being approved for clinical use in some countries, initiating a new are of treatment. In terms of blood-based early diagnosis, the development of in vivo biomarkers has shifted the diagnosis of Alzheimer’s disease from the later dementia stages of disease towards the earlier stages and has introduced the potential for pre-symptomatic diagnosis. Recent study shows promising results for blood tests that could be used to identify Alzheimer’s changes in the brain before the onset of any symptoms, which could result in preventative treatments being used before any memory loss. This presentation will highlight the most exciting development of the past year in the Alzheimer’s disease therapy and diagnosis arena.

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