To evaluate the efficacy and safety of amisulpride in medical inpatients who present with delirium.

Open label prospective study with 7-day follow-up. Forty hospital inpatients with delirium were recruited, seven of whom died and two of whom refused medication. The average dose of amisulpride for delirium treatment was 200–300 mg/day. Daily assessments were performed with Delirium Rating Scale (DRS), Positive Subscale of the Positive and Negative Syndrome Scale (PANSS-P), Mini Mental State Examination (MMSE), Neurological Subscale of the UKU side effect rating scale. Variance analysis was performed through repeated measurements, with the general linear model with paired comparisons and Bonferroni correction for each measured variable.

Patients showed significant improvement on the DRS from the first day of treatment DRS = 17.55 until day 7 DRS = 7.26 (F = 92.485; p < 0.001), psychotic symptoms improved from first day PANSS-P = 18.26 to last day PANSS-P = 9.35 (F = 144.83; p < 0.001). Cognitive status showed a significant improvement from day 2 MMSE = 18.71 until day 7 MMSE = 24.06 (F = 96.56; p < 0.001), and the neurological subscale of the UKU side effect rating scale showed a significant improvement the last day with respect to baseline pretreatment level (F = 7.539; p = 0.01).

These results suggest a good response to amisulpride in the acute phase of delirium, although further randomized controlled studies must be performed.

The correlates of legally significant outcomes that have been identified in people with mental disorders are of limited value in understanding the mechanisms by which these outcomes occur.

To describe the relationships between mental disorder, impaired psychosocial function, and three legally significant outcomes in a representative sample of the US population.

We used a population survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, sample size 36,309), to identify people who self-reported serious trouble with the police or the law over the past 12 months and two lifetime outcomes, being incarcerated and engaging in violence to others. DSM-5 categories were generated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Psychosocial function was assessed using social and role-emotional function scores of the 12-Item Short-Form Health Survey Version 2.

Participants with mental disorder, but not people with no diagnosis, who reported serious trouble with the police or with the law during the previous 12 months reported significantly worse psychosocial function than those who did not report such trouble. The size of the statistical effect varied by diagnosis, moderate for some forms of mental illness and for alcohol abuse and nonsignificant for drug abuse and the personality disorders. Effect sizes were largest for diagnoses where legally significant outcomes were least common.

The effect of impaired psychosocial function, for instance in disrupting family and social networks that would otherwise protect against these legally significant outcomes, warrants further investigation in studies with longitudinal designs.

In schizophrenia, brain morphometric changes may be associated with antipsychotic medication. Only limited data is available concerning individuals with schizophrenia without antipsychotic medication. We aimed to study the associations of: use versus no use of antipsychotic medication; length of continuous time without antipsychotic medication; cumulative dose of lifetime antipsychotic medication; and type of antipsychotic medication; with brain morphometry in schizophrenia after an average of 10 years of illness.

Data of 63 individuals with schizophrenia (mean duration of illness 10.4 years) from the Northern Finland Birth Cohort 1966 were gathered by interview and from hospital and outpatient records. Structural MRI data at age 34 years were acquired and grey matter volume maps with voxel-based morphometry were analyzed using FSL tools.

Of the individuals studied, 15 (24%) had taken no antipsychotic medication during the previous year. Individuals with antipsychotic medication had lower total grey matter (TGM) volume compared with non-medicated subjects, although this association was not statistically significant (Cohen's d = –0.51, P = 0.078). Time without antipsychotic medication associated with increased TGM (P = 0.028). Longer time without antipsychotic medication associated with increased regional volume in right precentral gyrus and right middle frontal gyrus. There were no associations between cumulative dose of lifetime antipsychotic medication or type of antipsychotic medication and brain morphometry.

Unlike some previous investigators, we found no association between cumulative dose of lifetime antipsychotic medication and brain morphological changes in this population-based sample. However, longer continuous time without antipsychotic medication preceding the MRI scan associated with increased gray matter volume.

As the different affective temperament-types (depressive, hyperthymic, cyclothymic, irritable and anxious) play a significant role in the development and symptom-formation of bipolar and unipolar major mood episodes, the aim of this study was to examine these affective temperaments in persons making suicide attempts.

Using the Hungarian version of the full-scale 110-item version of the TEMPS-A questionnaire. we compared the affective temperament profiles of 150 nonviolent (106 female and 44 male) suicide attempters (121 of them have had current major depressive episode) and 717 normal controls (438 females and 279 males).

Compared to controls, both female and male suicide attempters scored significantly higher in four of the five temperaments, containing mWre or less depressive component (depressive, cyclothymic, irritable and anxious). On the other hand, however, no significant difference between suicide attempters and controls was found for the hyperthymic temperament scores. Significantly higher rate of suicide attempters (135/150=90.0%) than controls (138/717=19.2%) have had some kind of dominant (mean score + 2 SD or above) affective temperament (p=0.0001).

The findings support the strong relationship between depression and suicidal behaviour even on temperamental level, suggesting that hyperthymic temperament has no predisposing role for suicidal behaviour at least in case of nonviolent attempters. As current depression and dysregulated central serotonergic function are well-known suicide risk factors, these findings are also in good agreement with recent results on the significant relationship between the s allele of the serotonin transporter gene and depressive, cyclothymic, irritable and anxious temperaments, but not with hyperthymic temperament.

There is limited published data from long-term pediatric bipolar clinical trials with which to guide appropriate treatment decisions. Long-term efficacy and safety of aripiprazole was investigated in this patient population.

296 youths, ages 10-17 year-old with a DSM-IV diagnosis of bipolar I disorder were randomized to receive either placebo or aripiprazole (10mg or 30mg) in a 4-week double-blind trial. Completers continued assigned treatments for an additional 26 weeks (double-blind). Efficacy endpoints included mean change from baseline to week 4 and week 30 on the Young Mania Rating Scale; Children's Global Assessment Scale, Clinical Global Impressions-Bipolar version severity scale, General Behavior Inventory, Attention Deficit Hyperactivity Disorders Rating Scale, and time to discontinuation. Tolerability/safety assessments included incidence and severity of AEs, blood chemistries and metabolic parameters.

Over the 30-week course of double-blind treatment, aripiprazole (10 mg and 30 mg) was superior to placebo as early as week 1 (p< 0.002) and at all scheduled visits from week 2 through week 30 on mean change from baseline in the Y-MRS total score (p<.0001; all visits). Significant improvements were observed on multiple endpoints including the CGAS, GBI, CGI-BP, ADHD-RS-IV total score, time to discontinuation, and response and remission rates. The 3 most common AEs were somnolence, extrapyramidal disorder, and fatigue. Mean change in body weight z-scores over 30 weeks was not clinically significant.

Over 30-weeks of treatment, both doses of aripiprazole were superior to placebo in the long term treatment of pediatric bipolar patients. Aripiprazole was generally well tolerated.

Although COVID-19 has been associated with psychiatric symptoms in patients, no study to date has examined the risk of hospitalization for psychiatric disorders after hospitalization for this disease.

We aimed to compare the proportions of hospitalizations for psychiatric disorders in the 12 months following either hospitalization for COVID-19 or hospitalization for another reason in the adult general population in France during the first wave of the current pandemic.

We conducted a retrospective longitudinal nationwide study based on the national French administrative healthcare database.

Among the 2,894,088 adults hospitalized, 96,313 (3.32%) were admitted for COVID-19. The proportion of patients subsequently hospitalized for a psychiatric disorder was higher for COVID-19 patients (11.09 vs. 9.24%, OR = 1.20 95%CI 1.18–1.23). Multivariable analyses provided similar results for a psychiatric disorder of any type and for psychotic and anxiety disorders (respectively, aOR = 1.06 95%CI 1.04–1.09, aOR = 1.09 95%CI 1.02–1.17, and aOR = 1.11 95%CI 1.08–1.14). Initial hospitalization for COVID-19 in intensive care units and psychiatric history were associated with a greater risk of subsequent hospitalization for any psychiatric disorder than initial hospitalization for another reason.

Compared with hospitalizations for other reasons, hospitalizations for COVID-19 during the first wave of the pandemic in France were associated with a higher risk of hospitalization for a psychiatric disorder during the 12 months following initial discharge. This finding should encourage clinicians to increase the monitoring and assessment of psychiatric symptoms after hospital discharge for COVID-19, and to propose post-hospital care, especially for those treated in intensive care.

The satisfaction with life scale (SWLS) is a brief five-item measure of global life satisfaction rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree). It is noted as one of the most popular scales in the measurement of life satisfaction.

To test the psychometric properties of SWLS.

To create a valid measurement, easy to use for primary care and during treatment assessment in patients with diabetes mellitus (DM), emotional disorder (ED) and general population (GP).

Translation of SWLS was performed using the multiple forward and backward translation protocol. Life orientation test (GrLOT-R), Depression Anxiety Stress Scale (DASS) and Subjective Happiness Scale (SHS), was also administered to check construct validity of SWLS.

809 adults participated, 175 (21.6%) male, 634 (78.4%) female. The total scale of the SWLS had a coefficient alpha of .831. Item - total correlations where from .253-.783. Factor analysis has supported a unidimensional model with 1 factor explaining 68% of the total variance. Mean scores differed significantly between GP (M = 21 ± 6.3), DM (19.1 ± 6.2) and ED (M = 17.2 ± 6.9) (Mean differences = 1.847 and 3.723 p < .001 respectively). There was significant negative correlation with stress (r = -.297 p < .001), anxiety (-.297 p < .001) and depression (r = -.499 p < .001) and positive correlation with GrLOT-R (r = .499 p < .001).

The results of the current validation study suggest that the Greek translation of the SWLS is both reliable and valid, with good construct and discriminant validity and psychometric properties close to those reported in the international literature.

The authors have not supplied their declaration of competing interest.

Of late, highly publicized reports have revealed that approximately half of university students report moderate levels of stress-related mental health concerns including anxiety and depression. Other research reveals that university health services are only providing services to a small percentage of these students. Universities must therefore consider the use of accessible programs that address student stress and reduce resultant anxiety and depression.

A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design.

Twenty-four studies, involving 1431 students were included in the meta-analysis. The findings suggest that cognitive, behavioral and mindfulness-based interventions focused on stress reduction significantly reduce symptoms of anxiety. Further, despite variations in approaches in terms of length of intervention and specific components of the intervention (including such aspects as cognitive restructuring, relaxation and meditation) with students in different programs and in different countries, these results are remarkably consistent. Secondary outcomes included lower levels of depression and cortisol.

This review and meta-analysis provides strong support that cognitive, behavioral and mindfulness-based approaches are effective in reducing the effects of stress on university students. Given the high rates of stress-related mental health problems reported by university students, universities are advised to examine means to provide opportunities for larger numbers of students to access these interventions.

Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population.

Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations.

In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75–3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40–3.35) for strange experience to 3.36 (95%CI: 1.47–7.76) for auditory hallucination.

Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.

Childhood maltreatment is an established risk factor for incident unipolar disorder and bipolar disorder. It is separately observed that affective disorders (AD) are also associated with higher nucleoside damage by oxidation. Childhood maltreatment may induce higher levels of nucleoside damage by oxidation and thus contribute to the development of AD; however, this relation is only sparsely investigated.

In total, 860 participants (468 patients with AD, 151 unaffected first-degree relatives, and 241 healthy control persons) completed the Childhood Trauma Questionnaire (CTQ). The association between CTQ scores and markers of systemic DNA and RNA damage by oxidation as measured by urinary excretion of 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) and 8-oxo-7,8-dihydroguanosine (8-oxoGuo) levels, respectively, was investigated.

In multiple regression models adjusted for sex- and age, 8-oxodG and 8-oxoGuo levels were found to be higher in individuals who had experienced more childhood maltreatment. These associations persisted in models additionally adjusted for body mass index, alcohol, and current smoking status. Emotional abuse, sexual abuse, and emotional neglect were principally responsible for the foregoing associations.

Our findings of an association between childhood maltreatment and oxidative stress markers suggest that childhood maltreatment overall, notably emotional abuse and emotional neglect, is associated with enhanced systemic damage to DNA and RNA in adulthood. Further, individuals with AD reported a higher prevalence of childhood maltreatment, which may induce higher levels of nucleoside damage by oxidation in adulthood, possibly leading to increased risk of developing AD. Longitudinal studies are needed to clarify this relationship further.

Deterioration in general population mental health since the start of the COVID-19 pandemic has been reported, but the impact of the pandemic on people with severe mental illness (SMI) has received less attention.

To understand the impact of the early stages of the pandemic on the patients with SMI, in terms of provision of mental health care and patient outcomes.

We examined records of 34,446 patients with SMI in Oxford Health Foundation Trust between March 2016 and July 2020. We used interrupted time-series analysis to estimate the immediate and subsequent changes in weekly rates of the use of community mental health services, hospitalization, and patient outcomes (as measured by Health of the Nation Outcome Scales, or HoNOS, scores) during the weeks of lockdown between March 23, 2020 and July 3, 2020.

Mean total HoNOS scores for all patients deteriorated in the weeks subsequent to lockdown (0.060 per week; 95%CI: 0.033, 0.087). Scores for patients with a history of psychosis deteriorated immediately (0.63; 95% CI: 0.26, 1.0). There was an immediate decrease in weekly referrals to community and outpatient services (−196; 95%CI: −300, −91) and no immediate change in weekly inpatient admissions (−4.2; 95%CI: −9.9, 1.5) or weekly total contacts (−26; 95%CI: −475, 423).

Patients with SMI were negatively impacted during the early stages of the COVID-19 pandemic. Patients with a history of psychosis experienced distinct and immediate impacts. During the same period, referrals to community and outpatient services fell with no consequent impact on inpatient admissions.