Cognitive bias modification (CBM) interventions are strongly advocated in research and clinical practice.

We aimed to examine the efficiency of CBM for clinically relevant outcomes, along with study quality, publication bias and potential moderators.

We conducted two meta-analyses of randomized controlled trials of CBM interventions for clinically relevant outcomes, one for patients with mental health problems and one for all populations. We included randomized controlled trials of CBM interventions, which reported clinically relevant outcomes assessed with standardized instruments. We examined the quality of the trials, as well as possible publication bias and possible moderators.

We identified 49 trials and grouped outcomes into anxiety and depression. ESs were small considering all the samples, and mostly non-significant for patient samples. ESs became non-significant when outliers were excluded and after adjustment for publication bias. The quality of the RCTs was sub-optimal. Publication year was consistently negatively associated with ESs. More sessions were associated with smaller ES, as were the absence of participant compensation and, respectively, the non-exclusively laboratory based delivery of the intervention. The quality of the RCTs was not optimal and quality was negatively associated to outcomes for depression and general anxiety.

Our results indicate that CBM may have small effects on mental health problems, but it is also very well possible that there are no significant effects. Research in this field is hampered by small and low-quality research, and by risk of publication bias, and much of the positive outcomes is driven by extreme outliers.

The authors have not supplied their declaration of competing interest.

The PAtient SAtisfaction with Psychotropic (PASAP) scale is a self-completed questionnaire measuring satisfaction with psychotropic medication. The aim of the study was to describe its development in French and its psychometric properties.

Scale construction was based on an extensive search of the literature. The item reduction process required semi-structured interviews of psychiatric outpatients (n = 30). The final version of the PASAP is a 9-item, 5-point Likert-type scale, covering the scope of effectiveness and adherence. To assess the psychometric properties of the scale, French patients with an acute manic episode (n = 314) from a large European observational cohort completed the PASAP scale 3 months after psychotropic treatment initiation/change. Internal validity and reliability were assessed using principal component analysis (PCA). Concurrent validity was assessed using comparisons to physician-rated satisfaction with life, illness severity, mood relapse, compliance and side effects.

Participation rate was 68.4%. PCA was in favour of uni-dimensionality. Cronbach's α coefficient was 0.85 (95%CI 0.83–0.88). All five concurrent measures were significantly associated with the PASAP score.

The PASAP scale showed good psychometric properties in a large bipolar population and thus seems adequate for evaluating treatment satisfaction. Its short length and good acceptability makes it suitable for clinical research.

It is no secret that mental health system in Denmark did face (and still does) significant barriers in providing appropriate psychiatric care towards refugees/immigrants on their own language. Limited access to clinicians that speak their language decrease speed and accuracy of diagnosis and treatment. In this situation, patients receive sub optimal psychiatric care (provided via translators) that furthermore affect their compliance and make treatment more difficult and expensive.

One solution to this problem is to give refugees/immigrants access to ethnic specialists by using telepsychiatry (videoconference in real time).

5 stations have been established during this pioneer project in period 2004-2007. The equipment connect three hospitals, one asylum seekers centre and one social institution for rehabilitation of refugees/migrants.Participants involved in the project are mentally ill refugees/immigrants. Clinicians involved in the project have ethnic background that make possible to assess and/or treat refugees/migrants on their own language, without using translators.

By using the videoconference, it was possible to make reliable aassessment and/or treatment of a wide variety of psychiatric disorders. All participants answered questionnaire after the end of telepsychiatric contact. They all reported a high acceptance and satisfaction with telepsychiatry regardless their ethnicity or educational level. Furthermore, all participants would prefer contact via telepsychiatry then via translator. Reduced transport – and translator expenses presented economic benefits of the method.

Telepsychiatry can be the tool of choice when limited access to mental health professionals makes assessment and/or treatment difficult and often insufficient.

The term “subjective response to antipsychotic” (SRA) refers to changes in the subjective state experienced due to antipsychotic (AP) exposition that is independent of the therapeutic or physical side effects of these drugs. This dimension of analysis has been extensively explored in schizophrenic disorders, finding that negative SRA is an early and independent predictor of compliance as well as a successful pathway to construct current theoretical frameworks of these disorders. There is an increasing use of AP in bipolar disorders’ treatment (BD) but no reviews on the topic have been published to date in this population. The aim of this work is to review published data of SRA in BD patients and to discuss their clinical and theoretical implications.

An extensive search in online databases was performed. Reports were reviewed and included if they described SRA in BD or included instruments aimed to assess it. Reports of cognitive, sexual, motor autonomic side effects were excluded. Findings were summarized in a narrative fashion.

Nine reports fulfilled the inclusion criteria and were included in the revision, reporting data from 1282 BD patients. Among these, three were prospective studies and three explored relations between SRA and treatment compliance.

There is an asymmetry between the increase in the use of antipsychotics in BD and the lack of data regarding the SRA. Phenomenologically, SRA in BD is similar to that found in schizophrenic subjects. Some of these symptoms may be misdiagnosed as depressive symptoms. The existing data show that SRA has a strong correlation with treatment compliance as well as a promising way to develop theoretical paradigms for these disorders.

Since February 2020, the outbreak of COVID-19 has spread to several countries worldwide, including Italy, leading to an uptake of telework.

We aim to evaluate the psychopathological impact of teleworking during the COVID-19 pandemic in Italy, identifying mental health determinants among home-based workers.

804 participants completed an online survey, including the psychometric scales “Depression, Anxiety and Stress Scale – 21 items” (DASS-21) and the “Insomnia Severity Index” (ISI). Teleworkers were also asked to provide information about their current work routine, home environment and clinical history.

At the DASS-21, 30% of the participants presented pathological levels of depression, 20.8% of anxiety and 30.7% of stress. At the ISI, 5% appeared to suffer from insomnia. Respondents with psychological and physical frailties, greater social isolation or inadequate working spaces manifested higher levels of psychiatric symptoms. Moreover, we also find a correlation of these symptoms with occupations in education. Telework was broadly appreciated and 87% of respondents expressed a willingness to maintain access to this arrangement.

Our results document that about a third of our sample manifested psychopathological symptoms while teleworking during the COVID-19 outbreak in Italy. However, telework itself does not seem to be directly associated with increased psychiatric symptoms, which were instead exacerbated by COVID-19-related stressful circumstances, as well as by constitutional and social determinants of health. Going forward, authorities should promote adequate measures in order to guarantee a healthy approach to teleworking.

No significant relationships.

Theory of mind (ToM) has been proved to play a crucial role in social cognition and functioning. In our study, higher order mentalization performance of euthymic bipolar I patients were compared with that of healthy controls. The impact of demographic data, course of the disorder and patients’ current functioning were also considered while interpreting mentalization data.

The mentalizing performance (computerized faux pas task and false irony task), neurocognitive functioning, and IQ of twenty-three euthymic bipolar I patients and 31 matched (IQ, age) healthy controls were examined. In the patients group, the age at onset, the occurrence of psychotic symptoms, age, education, current employment status, and global functioning were also taken into account.

Bipolar patients scored significantly lower in false irony tasks than healthy controls (p< 0,02). The deficit in irony tasks positively correlated with the number of episodes. Among the examined variables, the performance in the faux pas task predicted most closely the functional outcome in bipolar I disorder. No correlation was found between the ToM and irony deficits and the occurrence of psychotic symptoms, the length of the bipolar disorder or neurocognitive functioning.

Our results showed impaired performance in faux pas and irony tasks, which correlates with the number of previous episodes. Additionally, the impairment of ToM functions predicts a worse functional outcome.

Few studies have investigated alterations of olfactory neuroepithelium (ONE) as a biomarker of schizophrenia, and none its association with cognitive functioning.

Fresh ONE cells from twelve patients with schizophrenia and thirteen healthy controls were collected by nasal brushing, cultured in proper media and passed twelve times. Markers of cell proliferation (BrdU incorporation, Cyclin-D1 and p21 protein level) were quantified.Cognitive function was measured using Brief Neuropsychological Examination-2. Primary outcome: proliferation of ONE cells from schizophrenic patients at passage 3. Secondary outcome: association between alteration of cell proliferation and cognitive function.

Fresh ONE cells from patients showed a faster cell proliferation than those from healthy controls at passage 3. An opposite trend was observed at passage 9, ONE cells of patients with schizophrenia showing slower cell proliferation as compared to healthy controls. In schizophrenia, overall cognitive function (Spearman’s rho -0.657, p < 0.01), verbal memory – immediate recall, with interference at 10 s and 30 s (Spearman’s rho from -0.676 to 0.697, all p < 0.01) were inversely associated with cell proliferation at passage 3.

Fresh ONE cells collected by nasal brushing might eventually represent a tool for diagnosing schizophrenia based upon markers of cell proliferation, which can be easily implemented as single-layer culture. Cell proliferation at passage 3 can be regarded as a promising proxy of cognitive functioning in schizophrenia. Future studies should replicate these findings, and may assess whether ONE alterations are there before onset of psychosis, serving as an early sign in patients with at risk mental state.

We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD).

We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilization consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual TF-P in the form of trauma-focused cognitive behavioral therapy (TF-CBT), or eye movement desensitization and reprocessing (EMDR) or TF-CBT plus EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 versus phase 1. Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded.

Fifty-nine patients were included. Compared to receiving only phase 1, patients completing TF-P showed statistically significant reductions in PTSD [t(58) = −3.99, p < 0.001], depressive symptoms [t(58) = −4.41, p < 0.001], functional impairment [t(58) = −2.26, p = 0.028], and proxy scores for CPTSD [t(58) = 4.69, p < 0.001]. There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment.

This study suggests that TF-P effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.

Psychotherapy is one of the most widely investigated and practiced forms of treatment used in the treatment of different mental health problems. However, there are some barriers in delivering this treatment, including long waiting lists, therapist shortage and lack of access to therapists in remote areas. Therefore, using alternative methods to overcome these barriers seems necessary.

The division of psychiatry at Queen's university provides different psychotherapy groups for individuals suffering from different kinds of mental health problem. We gave the participants the opportunity to choose online psychotherapy through an online clinic or the live group sessions. All the patients were assessed by different questionnaires for evaluation of the efficacy of the treatment. The online clinic was designed to facilitate the communication between patients and clinicians and the material was delivered in PowerPoint format through the online platform. All user activities were logged for security purposes.

Statistical analysis showed that this method of delivering psychotherapy significantly reduced patients’ symptoms and also decreased the number of people on the waiting list and increased the amount of compliance in patient's taking part in psychotherapy and number of people who were able to receive psychotherapy.

Despite the proven short and long-term efficacy of psychotherapy, there are some barriers in delivering this treatment. It is an unequivocal public health needs to overcome these barriers through alternative methods of therapy. With Internet use ever rising, developing an online clinic could be a new way in delivering different kinds of psychotherapy.

Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail.

In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure.

Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity.

Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.

The DSM-5 Section III proposes a dimensional-categorical model of conceptualizing personality and its disorders, which includes assessment of impairments in personality functioning (criterion A) and maladaptive personality traits (criterion B). The Personality Inventory for DSM-5 (PID-5) is a self-report, composed of 220 items, organized into 25 facets nested in five domains of personality differences, and was developed to operationalize criterion B.

This study explores the factor structure of the Portuguese adaptation of the PID-5.

The five-factor structure that has emerged in previous studies with the PID-5 (cf. Krueger & Markon) is expected to be replicated in the current study.

Exploratory factor analyses with varimax oblique rotation were conducted on a sample of Portuguese adults from the general population (n = 379, Mage = 31.49, SD = 14.16, 25.3% males, 74.7% females).

A six factor structure was retained in which the first 5 factors resemble the PID-5 domains. The model showed good fit indices (KMO = 0.897). The total explained variance was 68.25%. All the facets but four had primary loadings on the expected factor.

The similarity of results across studies and nationalities contributes to the validation of the Portuguese translation of the PID-5 and highlights the structural resemblance among the DSM-5 model and the five factor model (FFM) and the personality psychopathology-five model (PSY-5), drawing attention to the relevance of these models for the diagnosis of Personality Disorders.

The authors have not supplied their declaration of competing interest.

The aim was to determine the association between internet addition [IA] and fatigue, sleep disturbance, depression, and life style factors among school children.

A cross-sectional survey based on multistage stratified random sampling and 1188 students (73.3%) gave consent during October 2011 to December 2012. Data including socio-demographic details, lifestyle and dietary habits Internet Addiction Test (IAT), Fatigue Scale, Epworth Sleepiness Scale [ESS] and Beck Depression Inventory (BDI) test. Univariate and multiple logistic regression analysis were performed.

The overall prevalence of IA among school children was 19.8%. The proportion of IA was significantly more among males (56.4%) as compare to females (43.6%; P = 0.035), school performance (P < 0.001) and family income (P = 0.032). Those with IA had significantly less number of sleep hours (6.16 ± 0.80 vs. 6.58 ± 1.29; P < 0.001) as compared to normal. Those with IA had significantly high number of hours internet use (3.82 ± 1.64 vs. 3.03 ± 1.64; P < 0.001) as compared to normal. A significantly larger proportion of IA than normal subjects reported having headaches (P = 0.010), double vision (P = 0.037), eye hurt (P = 0.021), eye tired (P = 0.005), dizziness (34.4% vs. 27.3%; P = 0.002), fatigue, and hearing problem (P = 0.048). A significantly larger proportion of students with IA most frequently gratifying site (19.9% vs. 11.6%; P < 0.001), browsed games (38.6% vs. 29.9%; P = 0.010), chat sites (29.7% vs. 22%; P = 0.013), email (54.2% vs. 63.1%; P = 0.36), and research (61.0% vs. 69.2%; P = 0.017).

The current study confirmed the of evidence linking problematic internet use with negative fatigue, greater numbers of symptoms, anxiety, sleeping disturbances, depressive and lifestyle risk factors, among vulnerable young children.

The authors have not supplied their declaration of competing interest.

A significant part computer game players and internet users show clinical features of abuse and addiction (loss of control, withdrawal symptoms, tolerance, continuation of game play even with increasing negative consequence in social and academic life). Similar mechanisms are suggested to underlie the pathogenesis and maintenance of internet and computer game addiction and substance-related addictions.

Neuroscientific research on internet and computer game addiction is sparse, yet emerging. To review previous studies is the objective of the present project.

We aim to identify common findings regarding the neurophysiological processes underlying internet and computer game addiction. This could be helpful for establishing a sound model for these emerging disorders.

Neuroscientific studies on internet and computer game addiction were systematically searched in “Pubmed”, “Google scholar” and “PsychInfo”. Titles were examined first to screen potential articles, followed by abstracts, and then manuscripts were downloaded. The reference sections of downloaded manuscripts were examined for additional references not located in the searches.

Neuroscientific research on internet and computer game addiction is mainly located in the Asian area, probably due to a higher regional prevalence. Methodologies range from ERP, resting state EEG, resting state fMRI, VBM to PET, investigating very different concepts of addiction, including impulsivity, craving, reward processing and cue-reactivity.

Addicted internet and computer game users are overall suggested to have altered brain mechanisms similar to individuals with substance addictions. However, a sound model on the neurophysiologic alterations has not been established yet.

Sleep symptoms, depression and anxiety often coexist and tertiary students are a population group that are increasingly recognised to be at risk. However the rates of these conditions in the tunisian population are poorly understood.

The aim of this study was to evaluate sleep quality among medicine students during exam periods and identify correlations with anxiety and depression.

This is a descriptive and analytical cross-sectional study. It involved students of medicine University of Sfax during the period of exams. Each student filled out demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) to assess the quality of sleep and Hospital Anxiety and Depression scale (HAD) to screen for anxiety and depressive disorders.

The average age was 22.27 years. The sex ratio M/F was 0.66. The students were single in 96.7% of cases. The average score of PSQI was 6.67 ± 3.23. According to the PSQI, 53.3% of students had poor sleep quality. The anxiety score ranged from 0 to 7 with an average of 8.37. The depression score ranged from 0 to 16 with an average of 7.47. Anxiety and depressive symptoms were present in 26.7% of students. The PSQI score was significantly correlated with anxiety (p <0.01) and depression scores (P = 0.019).

Anxiety and depressive symptoms are common among students during exam periods. They are associated with poor quality sleep. The establishment of a helpline for students during exam time, with psychologists and psychiatrists, would help them better manage this difficult period.

The authors have not supplied their declaration of competing interest.

Depressive symptoms in pregnancy are risk factors for postpartum depression and associated to adverse child outcomes (Glover, 2014). Depressive symptoms decreases after participation in mindfulness and self-compassion based interventions for pregnant women (e.g. Goodman et al., 2014). However, apart from intervention trials, there are not studies on the relationship between mindfulness, self-compassion and depressive symptoms in pregnancy (Zoeterman, 2014).

To explore the association between mindfulness, self-compassion and depressive symptoms in pregnant women.

Four hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy completed a set of self-report questionnaires validated for pregnancy: Facets of Mindfulness Questionnaire-10 ([FMQ-10]; Azevedo et al., 2015; to evaluate Nonjudging of experience/NJ, acting with awareness (AA) and observing and describing (OD), Self-Compassion Scale ([SCS]; Bento et al., 2015; to evaluate self-kindness, self-judgment, common humanity [CH], isolation, mindfulness and over-identification [OD]) and Postpartum Depression Screening Scale-24 (PDSS-24; Pereira et al., 2013). Only variables significantly correlated with the outcomes were entered in the multiple regression models.

FMQ-10 and SCS Total scores were both significant predictors of PDSS-24 (B = –0.294,–0.272). Derealization and failure predictors were NJ and Isolation (B = –0.234; 0.384); Suicidal ideation predictor was NJ, OD and isolation (B = –0.152;–0.115; 0.334); concentration difficulties and anxiety predictors were isolation and CH (B = 0.296;–0.201); Sleep difficulties predictors were AA and isolation (B = –0.199; 0.248) (all P < 0.05).

Mindfulness and self-Ccompassion dimensions, particularly nonjudging of experience, acting with awareness, observing and describing are protective correlates of antenatal depressive symptoms. Isolation is a correlate of PD in pregnancy.

The authors have not supplied their declaration of competing interest.

Attention, working memory (WM), information processing and memory deficits are important features of schizophrenia. WM functions appear to be mediated by the dorsolateral prefrontal cortex (DLPFC). Functional imaging studies have shown a failure to activate the DLPFC during working memory tasks in patients with chronic schizophrenia. The primary aim of this study is to determine whether there are brain activation changes in the dorso-lateral prefrontal cortex (DLPFC) as a result of engaging in a randomized, controlled 12 week course of cognitive remediation therapy (CRT) in inpatients with chronic schizophrenia.

Patients with DSM IV schizophrenia are randomized to a 12 week trial of Cognitive Remediation (CR) using a Computerized CR program (COGPACK) or to a 12-week control condition. Patients receive at baseline and endpoint an fMRI scan with a cognitive task (N-back task), a neuropsychological test battery (MATRICS), functional and symptom assessments.

Preliminary results of this ongoing study show that patients after 12 weeks of CR showed (1) significantly more improvement in WM functions than patients who participated in the control group and (2) improvement in accuracy on the verbal letter 2-back task during the fMRI scan. Signal difference between 2-back and 0-back was not present or only present minimally at baseline (Pre-CR); however, at endpoint (Post-CR) there was signal difference present, which corresponds to an increase in activation in the areas of the DLPFC. This increase in activation pattern may be reflective of the effects of the exposure to the CR intervention.