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.

Hikikomori: Japanese term which means 'being confined, pulled inward”, translated as 'social withdrawal” in Western cultures. Cultural, social, familiar and educational features predispose to it. Diagnostic criteria include home-centred lifestyle, refusal to attend school or work, symptoms persistence for at least six months, exclusion of schizophrenia, mental retardation or other mental disorders and lack of personal relationships.

We searched 'hikikomori” keyword on Pubmed and Scopus, and selected papers written in English, Italian or Spanish. We found 54 results:14 articles were excluded for being written in Japanese or French, and one paper for being unrelated to the topic. We also searched Google Scholar and PsychInfo, founding one additional relevant study.

Generally, hikikomori is an Asiatic, and specifically Japanese, phenomenon. Nevertheless, social withdrawal cases similar to hikikomori have been recently described in Western Countries (United States, Australia, Spain, Italy)

Typically, the hikikomori subject is male, described as apathetic, nihilistic, disillusioned, estranged from school and society, the young adult eldest son of a family with a good socioeconomic background. The low rate of suicidality among hikikomoris needs to be emphasized.

Internet represents an “emergency exit” to the difficulties that adolescents and young adults face: therefore, they choose social withdrawal to preserve themselves from the risk of being ashamed by their own inadequacy.

Hikikomori is more than a medical and psychiatric disease. Scientific literature regarding both epidemiological and psychopathological issues is still lacking and more scientific researches are required.

Traumatising experiences have been shown to be important in suicide ideation and attempt. A prolonged and continuous exposure to stressing interpersonal events can have more complex consequences. Therefore, the concept of Complex Post-Traumatic Stress Disorder (C-PTSD) has been emerging.

Our goal is to relate the symptoms of C-PTSD with suicide attempt and to evaluate the differences between C-PTSD and PTSD on those patients. Moreover, we compared our findings with a control population without prior suicide attempts.

Fifty patients that had been hospitalised in the Psychiatry ward following a suicide attempt were evaluated one week after the event with the ICD-11 Trauma Questionnaire (PTSD and C-PTSD). The same evaluation was performed on a control population without known suicide attempts.

There is a statistically significant relationship (P < 0.001) between the symptoms of C-PTSD and PTSD and suicide attempt, which effect is higher for C-PTSD. These symptoms are almost absent in the control group.

C-PTSD seams to be a more relevant risk factor for suicidal attempts. This aspect is important to define preventive and treatment programs and for suicidal attempts follow-up. The importance of traumatic events and of traumatic stress symptoms as moderator factors should be considered in future research.

The authors have not supplied their declaration of competing interest.

Emotional Dysregulation (ED) is the decreased capacity to experiment and differentiate an ample range of emotions, as well as to monitor, evaluate and modify intense emotional states. the Difficulties in Emotion Regulation Scale (DERS) was developed for adults, has good internal consistency (Cronbach's α = 0.93), and test-retest reliability.

To translate and determine the psychometric properties of the Spanish version of the DERS (DERS-E) in a non clinical Mexican adolescent's sample.

455 students of a public high school in the Mexico City participated; the mean age was 13.1 + .95 years old. the scale was administrated in groups of 40 students, who concurrently answered the Spanish version of the following measures:

1. i) Self-injury schedule;

2. ii) Beck depression inventory;

3. iii) Beck anxiety inventory; and

4. iv) Plutchik's Impulsivity scale.

The first confirmatory factorial analysis (CFA) showed that the data didn’t replicate the original 6 factor structure (Chi2 = 22339.4, fd = 6, p < 0.05). An exploratory factorial analysis showed that the data adjusted with a 24 items and 4 factors model (corroborated with a second CFA: Chi2 = 259.729, fd = 230, p > 0.05); the subscales Cronbach’ α were from .85 to .68. the validity through contrasted groups and the correlation with concurrent scales showed significant results (Pearson's r of .51. to .76, p < 0.05).

The DERS-E didn’t replicate the factorial structure of the original scale, but showed a similar and multidimensional structure of 4 factors and showed good psychometric properties, with respect to internal consistency and concurrent validity.

We have noticed in our clinical practice a few patients with psychoses whose mental health was affected by the use of Benzylpiperazine related compounds. Benzylpiperazine and related compounds were sold legally in the UK until March 2007 when they were declared illegal. They are still legal in New Zealand whilst it is classified as a Class one drug along with LSD, cocaine and cannabis in the USA, Sweden, Denmark and Greece.

To understand the effect of Benzylpiperazine based party pills on the mental health of a patient who already had a diagnosis of Schizophrenia.

We followed up the clinical psychopathology of the patient while he was in our acute Psychiatry ward in 2007 during an admission precipitated by the use of Benzylpiperazine based party pills. Also we went through his previous notes to find out the symptomatology during all his previous admissions and outpatient appointments.

Use of Benzylpiperazine based party pills resulted in manic symptoms in this patient with Schizophrenia who did not have these symptoms until he started using the party pills.

Benzylpiperazine based party pills have mood elevating properties and also induce insomnia in users. From our anecdotal experience it is seen that in patients with mental illness this leads to non compliance with medications and may also induce manic symptoms. Benzylpiperazine based drugs of abuse have been less well researched compared to other drugs of abuse.

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.

Oxidative stress (OS) and inflammation are processes known to be implicated in neurodegeneration. Moreover, risk factors for dementia (depression, obesity, sedentary lifestyle, diabetes, etc.) are associated with up-regulation of pro-inflammatory cytokines. OS has been found in animal models to contribute to cerebral amyloid angiopathy. However, investigations of the associations between OS, inflammation and MCI, typically in small clinical samples have produced mixed results.

Clarify associations, between OS, inflammation and MCI in a large cohort of community-living individuals.

Cognitively healthy individuals (n = 211, 44% female, 75.2 years) and with MCI (n = 23, 44% female, 75.2 years) from a population sample were included. MCI diagnosis was established based on a detailed neuropsychological assessment. Inflammatory (IL1b, IL4, IL6, IL8, IL10, TNF-a) and OS (total anti-oxidants, NO, neopterin) markers were assessed in plasma samples. Associations between biomarkers, MMSE, and MCI status were tested with multiple linear and logistic regression analyses.

Univariate analyses showed that log IL4 (estimate: −0.175, SE: 0.085, P = 0.041) and NO (estimate: 0.015, SE: 0.006, P = 0.017) were the only markers associated with MMSE scores. MCI status was predicted by log IL4 (estimate: 0.822, SE: 0.357, P = 0.021) and total anti-oxidants (estimate: −0.007, SE: 0.003, P = 0.014). Controlling for pro-inflammatory conditions (T2D, BMI, depression, hypertension) removed the associations with inflammation but not with OS.

These results indicate that increased systemic inflammation and increased OS were associated with lower MMSE scores and higher odds of having MCI. This confirms that systemic pro-inflammatory processes are associated with impaired cognition and should be specifically considered in treatment and risk-reduction interventions.

The authors have not supplied their declaration of competing interest.

Mental illness is known to come along with a large mortality gap compared to thegeneral population and it is a risk for COVID-19 related morbidity andmortality. Achieving high vaccination rates in people with mental illness is therefore important. Reports are conflicting on whether vaccination rates comparable to those of the general population can be achieved and which variables represent risk factors for nonvaccination in people with mental illness.

The COVID Ψ Vac study collected routine data on vaccination status, diagnostic groups, sociodemographics, and setting characteristics from in- and day-clinic patients of 10 psychiatric hospitals in Germany in August 2021. Logistic regression modeling was used to determine risk factors for nonvaccination.

Complete vaccination rates were 59% (n = 776) for the hospitalized patients with mental illness versus 64% for the regionally and age-matched general population. Partial vaccination rates were 68% (n = 893) for the hospitalised patients with mental illness versus 67% for the respective general population and six percentage (n = 74) of this hospitalized population were vaccinated during the hospital stay. Rates showed a large variation between hospital sites. An ICD-10 group F1, F2, or F4 main diagnosis, younger age, and coercive accommodation were further risk factors for nonvaccination in the model.

Vaccination rates were lower in hospitalized people with mental illness than in the general population. By targeting at-risk groups with low-threshold vaccination programs in all health institutions they get in contact with, vaccination rates comparable to those in the general population can be achieved.

The aim of the study was to compare a clinical course and treatment results of depression occurring as the first depressive episode, the second depressive episode or the third or further depressive episode. The study was 1-year, prospective, naturalistic observation made by Polish psychiatrists.

One-hundred and seventy-nine patients with the first depressive episode (group I), 170 patients with the second episode (group II) and 183 patients with the third or further episode of depression (group III) were compared. The main analysed variable was remission, defined as the score of ≤7 points on 17-item Hamilton depression rating scale (HDRS), after 6 and 12 months of observation.

The groups of patients studied did not initially differ as to age, proportion of gender and intensity of depression. The percentages of remission after 6 months of observation in groups I.III were: 49%, 41% and 32%, and after 12 months 69%, 60% and 50%, respectively.

The results obtained indicate that the course of subsequent depressive episodes is less favourable compared to the first depressive episode. The percentages of remission obtained in individual groups studied may have implications regarding duration of pharmacological treatment of depressive episode.

This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents’ psychiatric problems.

In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were assessed using self-reports (Youth Self-Report; YSR), parent reports (Child Behavior Checklist; CBCL), and teacher reports (Teacher's Report Form; TRF) of child behavioral and emotional problems. Paternal, maternal, and pre-adolescent religiosity were assessed by self-report. MANCOVAs were performed for internalizing and externalizing problems as dependent variables, with maternal religiosity, paternal religiosity, pre-adolescent religiosity, parental religious harmony, and gender as independent variables, and socioeconomic status and divorce as covariates.

Internalizing problems. Pre-adolescents of actively religious mothers had more internalizing symptoms than pre-adolescents of nonreligious mothers. Harmony and gender did not significantly affect the association between maternal religiosity and internalizing problems. Externalizing problems. No associations between religiosity of pre-adolescents, religiosity of mothers, religiosity of fathers and/or harmony of parents and externalizing problem behavior have been found.

Overall, associations between mental health and religiosity were modest to absent. Results are discussed in the context of a clinic-referred cohort, the quest phase of internalizing religious beliefs and role modeling of parents.

Higher incidence of mental illnesses and less access to care is previously reported concerning migrants but few studies focus on the needs and care of migrant groups in psychiatry. The aim of this study was to compare differences in needs and care between migrant and nonmigrant groups of severely and persistently mentally ill (SMI) after the 1995 Swedish mental health care reform.

In a Swedish area, inventories were made in 2001 and 2006 of persons considered as SMI. These persons were interviewed and their needs were assessed. In a cross-sectional study in 2006, needs and care were compared between migrants and nonmigrants. In a longitudinal study, migrants and nonmigrants interviewed in both 2001 and 2006 were compared concerning the development of needs and care.

The needs of the migrant group were less taken care of. In 2006, there were more unmet needs in this group concerning accommodation, physical health, psychological distress, basic education and economy.

The improvement of groups considered as SMI concerning functional disability and efforts of care found in the actual area did not seem to include the migrant group, at least not to the same degree.