Use of prescription psychostimulants and nootropics for non-medical purpose is a growing trend, especially in academic environment. Seeing the risks of neuroenhancement we decided to investigate situation in Lithuania.

Analyze the use of cognitive enhancers among medical students in Lithuania.

1. Determine the prevalence of cognitive enhancement. 2. Figure out what drugs are mostly used and reasons for the usage. 3. Evaluate the contributing factors.

A cross-sectional survey study was performed in Vilnius University and Lithuanian University of Health Sciences. Students were asked to fill anonymous paper questionnaires consisting of 13 items concerning prevalence of substance use to enhance cognitive performance, reasons, and correlates during lecture time.

Results are summarized in Table 1. A total of 8.1% of responders indicated that they had used cognitive enhancers. Nootropics were the most frequently mentioned: 59.6%, while psychostimulants were mentioned less frequently: 38.3% (including modafinil, methylphenidate and amphetamine derived drugs), and 23.4% indicated other substances. Improvement of concentration and increased studying time were predominant purposes (55.3% and 48.9% of users). Male students reported 3 times higher prevalence rates than females (14.6% vs. 5.1%, P < 0.05). Prevalence were also higher in students, who knew someone using these substances as compared to those who did not (17.3% vs. 5.1%, P < 0.05); it was the most associated factor with cognitive-enhancing drug taking behavior (Table 1).

In Lithuania, 1 of 12 medical students admits to having used neuroenhancing drugs. Nootropics were the most used drugs. Knowing user was the most important factor for usage.

The authors have not supplied their declaration of competing interest.

Given the undesired metabolic side effects of atypical antipsychotic medication it is important to understand the neuronal basis related to processing of appetite regulation in patients affected by schizophrenia.

Here we used functional magnetic resonance imaging (fMRI) to assess brain activity in response to food cues and neutral stimuli in twenty patients with schizophrenia and eleven healthy individuals. In addition to clinical and dietary habits assessments, we collected, in patients, measurements of fasting glucose, ghrelin, leptin, insulin, prolactin and lipids blood concentration and we correlated the cerebral activity with clinical and metabolic measures.

Both groups engaged a common neuronal network while processing food cues, which included the left insula, primary sensorimotor areas, and inferior temporal and parietal cortices. Cerebral responses to appetitive stimuli in thalamus, parahippocampus and middle frontal gyri were specific only to schizophrenic patients, with parahippocampal activity related to hunger state and increasing linearly over time. Antipsychotic medication dosage correlated positively with a cognitive measure reflecting food cravings, whereas the severity of the disease correlated negatively with a cognitive measure indicating dietary restraint in eating habits. These cognitive variables correlated, in turn, with parahippocampal and thalamic neuronal activities, respectively.

We identified a specific neural substrate underlying cognitive processing of appetitive stimuli in schizophrenia, which may contribute to appetite dysfunction via perturbations in processing of homeostatic signals in relation to external stimuli. Our results also suggest that both antipsychotic medication and the disease severity per se could amplify these effects, via different mechanisms and neuronal networks.

The current study investigates the cognitive and emotional abilities of psychopathic individuals. To assess whether psychopathic individuals show decision-making impairment, group differences are mirrored by correlations between cognitive and emotional measures and psychopathy.

Twenty psychopathic individuals and a comparaison group, as defined by DSM-IV criteria for antisocial personality disorder and the Psychopathy Cheklist Revised (PCL-R), were tested a standardized psychometric measures of alexithymia and cognitive empathy (LEAS), a facial emotion recognition (RME). We also examined these patients with procedure designed to measure decision-making (Iowa Gambling Task) and standardized neuropsychological tests were applied to assess their cognitive intelligence, executive functioning, attention as well. Their results were compared with those of 20 controls subjects.

Compared with controls, psychopathic individuals were characterized by a selective impairment for cognitive flexibility, cognitive empathy and decision-making. These results are interpretated with reference to amygdale dysfunction and to somatic markers hypothesis. Moreover, the psychopathic individuals show defective performance and absence punishment learning on the gambling task, who mimicked the gambling behavior of orbitofrontal patients.

Our findings suggest that emotional and social functioning is critically tied to on-going experience of autonomic arousal state. Furthermore our results extend the link between dysfunction of ther orbitofrontal circuit, but also dorsolateral prefrontal circuit, and psychopathy. The implications of these results for models of psychopathy are discussed.

Somatic diseases have been associated with an increased risk for subsequent schizophrenia; however, it is unknown whether prior somatic diseases negatively affect early treatment outcomes after a first-time schizophrenia diagnosis.

We included all individuals born in Denmark after January 1st, 1977 and first-time diagnosed with schizophrenia between January 1st, 1996 and December 31st, 2015. We identified all life-time somatic hospital contacts and all prescriptions within the year before the first-time schizophrenia diagnosis and followed patients for up to five years regarding risk for schizophrenia (re)-hospitalization (relapse). We performed Cox regression analyses calculating hazard rate ratios (HRR) including 95%-confidence intervals (CI) and adjusted for relevant confounders.

We followed a total of 11,856 patients with a first-time schizophrenia diagnosis (58.7% male, mean age 23.1 (SD = 4.7) years) for 39,033 person-years, whereof 5506 (46.4%) had relapse with schizophrenia re-hospitalization during 5-year of follow-up. Somatic hospital contacts ever before (95.4%; HRR = 1.30; 95%-CI = 1.07–1.59), and specifically during the year before schizophrenia diagnosis (42.5%; HRR = 1.36; 95%-CI = 1.11–1.66) were associated with an increased risk of schizophrenia relapse as were a greater number of prior somatic hospital contacts (p < 0.001). Individuals with up to four different prescriptions for somatic medications showed a trend towards a slightly lower risk of relapse.

Somatic diseases and health seeking patterns might have an impact on the course of schizophrenia, where severe somatic comorbidity, specifically during the year before first-time schizophrenia diagnosis, seem to negatively affect early treatment course, whereas previous somatic medication use may indicate a better compliance and help-seeking behavior.

The aim of this study was to test the assumption that there seems to be association between depression and lifestyle choices. The hypothesis was that unhealthy lifestyle will have an association with increased score on BDI II.

Czech version of BDI II was used and a questionnaire of lifestyle was distributed among Czech economically active population. Combination of interviews (for older population) and questionnaires (for younger population) was used. Stepwise multiple linear regression was applied to test whether and to what extend is lifestyle associated with depression.

In total data from 1027 participants was collected; 675 persons aged 25–50 years and 352 persons aged 51–65 years. The model explains 31% of variance of depression and the model is highly significant F (8,1018) = 57.66, P = 0.001. Lifestyle choices that were found to be associated with depression were sleeping habits, regular eating and drinking habits and generally conscious adherence to healthy lifestyle.

Overall, an association was found between depression and certain lifestyle choices. Importantly it was also found conscious maintenance of healthy lifestyle is an important factor. This study thus confirmed the hypothesis that there is an association between depression and lifestyle. The most important factor of lifestyle in this study was shown to be regular sleeping pattern lasting at least 6 hours. Regular eating and maintaining drinking regime during the day were also found to be crucial.

The authors have not supplied their declaration of competing interest.

In previous works we demonstrated the utility of the REF scale for the assessment referential thinking (Rodríguez-Testal et al., 2001) although it wasn't specific for patients with psychotic disorder (Rodríguez-Testal et al., 2008).

We analyzed the psychometric properties of reliability and validity of the REF scale. We compared the differences in referential thinking between subjects with and without psychopathology. In the patient group we will not obtain differences in referential-thinking between diagnosis types of Axis I, Axis II, or patients with diagnoses on both axes.

Participants: 120 subjects, 70 patients attending a private center of clinic psychology, 64.3 % women, mean age = 35.21 (SD = 10.5) and 50 controls selected from the normal population, 54 % women, mean age = 33.48 (SD = 10.83).

It was applied a cross design for a correlation method of comparison between groups. All the analysis were accepted at p< .05.

We reached adequate internal consistency (Cronbach's alpha= .90, split-half reliability= .83 and .82). The test-restest reliability was significant (mean interval of 44 days). There are significant differences in referential thinking between subjects with and without psychopathology (t=3.8; p=.001). There are significant differences in referential thinking between types of diagnoses (F=3.99; p=.001).

The REF scale has adequate psychometric properties (reliability and validity). It discriminated between patients and no-patients, and between the different types of diagnoses, especially for those who suffer psychotic disorders.

Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly acknowledged as critical tools for enhancing patient-centred, value-based care. However, research is lacking on the impact of using standardized patient-reported indicators in acute psychiatric care. The aim of this study was to explore whether subjective well-being indicators (generic PROMs) are relevant for evaluating the quality of hospital care, distinct from measures of symptom improvement (disease-specific PROMs) and from PREMs.

Two hundred and forty-eight inpatients admitted to a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardized generic PROMs on well-being, symptom improvement was assessed using standardized disease-specific PROMs, and experience of care using PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of providing treatment using adapted PREMs items.

Change in subjective well-being (PROMs) at discharge was significantly (p < 0.001), but moderately (r2 = 28.5%), correlated to improvement in symptom outcomes, and weakly correlated to experience of care (PREMs) (r2 = 11.0%), the latter being weakly explained by symptom changes (r2 = 6.9%). Patients and clinicians assessed the experience of care differently.

This study supports the case for routinely measuring patients’ subjective well-being to better capture the unmet needs of patients undergoing psychiatric hospital treatment, and the use of standardized patient-reported measures as key indicators of high quality of care across mental health services.