Meditation is frequently applied in Western as well as non-Western countries for different purposes; we know little about adverse events. The symptomatology of a meditation-related psychosis appears to show similarities with that we call “bouffée delirante”.

A female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating (Bikram-yoga). We made a literature search for psychotic states related to meditation.

There are some case reports of psychosis disorder induced by meditation. Some cultural syndromes like Qi-gong appear on DSM-IV as psychotic reaction. In this case, the syndrome is not culture bound.

Meditation can act as a stressor in vulnerable patients who may develop a transient psychosis with polymorphic symptomatology (confusion, pananxiety, mood swings and mood dystonic psychotic symptoms) with a short duration.

The authors have not supplied their declaration of competing interest.

Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.

A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.

Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.

Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.

Emerging evidence suggests that sedentary behaviour, specifically time spent taking part in screen-based activities, such as watching television, may be associated with mental health outcomes in young people [1]. However, recent reviews have found limited and conflicting evidence for both anxiety and depression [2].

The purpose of the study was to explore associations between screen time at age 16 years and anxiety and depression at 18.

Subjects (n = 1958) were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort study. We assessed associations between screen time (measured via questionnaire at 16 years) and anxiety and depression (measured in a clinic at 18 years using the Revised Clinical Interview Schedule) using ordinal logistic regression, before and after adjustment for covariates (including sex, maternal education, family social class, parental conflict, bullying and maternal depression).

After adjusting for potential confounders, we found no evidence for an association between screen time and anxiety (OR = 1.02; 95% CI 0.95–1.09). There was weak evidence that greater screen time was associated with a small increased risk of depression (OR = 1.05, 95% CI 0.98–1.13).

Our results suggest that young people who spend more time on screen-based activities may have a small increased risk of developing depression but not anxiety. Reducing youth screen time may lower the prevalence of depression. The study was limited by screen time being self-reported, a small sample size due to attrition and non-response, and the possibility of residual confounding. Reverse causation cannot be ruled out.

The authors have not supplied their declaration of competing interest.

Anorexia Nervosa (AN) is an eating disorder characterized by low body weight, fear of gaining weight and distorted perception of body. Patients have rigidity, repetition of thoughts, alterations in decision-making skills and poor ability to provide new solutions. Avoidant/Restrictive Food Intake Disorder (ARFID) is a new eating disorder characterized by the absence of distress about body shape or fear of weight gain. Studies on neurocognitive aspects are few and no effective treatments are known.

The aim of our study was to further investigate the executive functions’ domains in AN and ARFID children and adolescents, to provide possible distinct neurocognitive traits in these patients.

AN or ARFID patients (15 + 15; range 6-18 years), were assessed by neuropsychological tools, such as: Wechsler Intelligence Scale to measure I.Q. profile, NEPSY-II to explore attention and executive functions, Tower of London test to detect planning and problem solving abilities, the Bells Test to evaluate visual selective and focused attention, the Wisconsing Card Sorting Test (WCST) for assessment of flexibility and directing behaviors by achieving a goal and the Rey-Osterrieth complex figure test (ROCF) to assess visual-spatial abilities.

Patients with ARFID presented impairments in several executive functions domains, with difficulties in the impulse inhibition, in the sustained attention and in visual-spatial skills. Finally, in their anamnesis a higher comorbidity with neurodevelopmental disorders such as specific learning disorder has been underlined.

The identification of specific deficit in neuropsychological profile of ARFID patients could be a rehabilitation target, together with standardized treatment.

Cyberbullying has become more prevalent with the increased use of social media among younger population. It is more harmful than traditional bullying as it can happen at any time, has a much wider audience, and can invade personal space. YouTube, Instagram and Snapchat are the most popular online platforms among teens. The victims of cyberbullying can present with social anxiety (41%), depression (37%), suicidal thoughts (26%) among many others (self-harm, substance use, etc). In the past year, these numbers have significantly risen due to switch to virtual learning due to the pandemic, hence the risk of exposure to cyberbullying has risen.

To study the impact of cyberbullying on Adolescent Mental health

A review of articles (2016-2021), was done using PubMed and Google scholar focusing on impact of cyberbullying in children and young adults.

John et al group showed that both victims [OR- 2.10 (95% CI 1.73-2.55)] and perpetrators [ OR 1.21 (95% CI 1.02-1.44)] have increased risk of exhibiting suicidal behaviors. Kwan I et al group showed a negative association between cyberbullying and mental health. One study suggested that during the pandemic there has been increased online perpetrators due to increased amount of fear and anger which has projected in the form online aggression.

There is an increase in prevalence of cyberbullying with young population spending more time on internet and social media. Psychoeducation of parents and mental health experts is needed to recognize early warning signs in order to take steps for early intervention.

No significant relationships.

Genetic approaches are increasingly advantageous in characterizing treatment-resistant schizophrenia (TRS). We aimed to identify TRS-associated functional brain proteins, providing a potential pathway for improving psychiatric classification and developing better-tailored therapeutic targets.

TRS-related proteome-wide association studies (PWAS) were conducted on genome-wide association studies (GWAS) from CLOZUK and the Psychiatric Genomics Consortium (PGC), which provided TRS individuals (n = 10,501) and non-TRS individuals (n = 20,325), respectively. The reference datasets for the human brain proteome were obtained from ROS/MAP and Banner, with 8,356 and 11,518 proteins collected, respectively. We then performed colocalization analysis and functional enrichment analysis to further explore the biological functions of the proteins identified by PWAS.

In PWAS, two statistically significant proteins were identified using the ROS/MAP and then replicated using the Banner reference dataset, including CPT2 (PPWAS-ROS/MAP = 4.15 × 10−2 and PPWAS-Banner = 3.38 × 10−3) and APOL2 (PPWAS-ROS/MAP = 4.49 × 10−3 and PPWAS-Banner = 8.26 × 10−3). Colocalization analysis identified three variants that were causally related to protein expression in the human brain, including CCDC91 (PP4 = 0.981), PRDX1 (PP4 = 0.894), and WARS2 (PP4 = 0.757). We extended PWAS results from gene-based analysis to pathway-based analysis, identifying 14 gene ontology (GO) terms and the only candidate pathway for TRS, metabolic pathways (all P < 0.05).

Our results identified two protein biomarkers, and cautiously support that the pathological mechanism of TRS is linked to lipid oxidation and inflammation, where mitochondria-related functions may play a role.

To describe reasons for not seeking professional help at the age of 17-18 years, when a need for mental help is present.

In a person identifiable survey among 3278 Finnish adolescents 15-16 years old at baseline, reasons for not seeking professional help were studied among respondents of a two-year follow-up, who had reported a need for help for a mental health problem but had not sought professional help(n=128). The respondents were instructed to choose from the following list all alternatives describing their situation: thought that the symptoms will eventually alleviate anyway, unsure about who to turn to, felt too exhausted to get help, anxious of somebody finding out, negative experiences of dealing with health professionals, distrusted the effectiveness of professional help, turned to parents for help, parents estimated that there was no need for professional help, turned to friends for help,. friends estimated that there was no need for professional help.

The three most common reasons for not searching for professional help were, the notion that the symptoms would alleviate without help (71%), exhaustion (43%) and turning to friends for help (26%). Uncertainty about to whom to turn and exhaustion were more common among those with depression compared to those with no depression (33% vs 14%, p=0.025 and 55% vs 35%, p= 0.042).

Mental health literacy of late adolescents must be enhanced in order to make them take mental health problems seriously enough to get professional help.

Several reviews have reported the incidence of schizophrenia in patients with eating disorders (ED) to be between 3–10% and the incidence of transient psychotic episodes to be 10–15%. On the other hand, anorexia nervosa appears to affect 1 to 4% of schizophrenia patients. Reports of psychosis and ED occurring in the same patient have led to various views as to the nature of the relationship between the two.

Analysis of the literature illustrated by different clinical cases in which appears to be a relationship between ED and psychosis.

Critical reflection about the hypothesis that could underlie the comorbidity of psychotic illness and ED.

Non-systematic review of a literature search using the keywords: eating disorders; psychosis; comorbidity.

There is no consistent sequence in the co-occurrence of the two conditions – ED sometimes precede and sometimes follows the onset of psychosis. ED patients can develop psychotic symptoms, most frequently transient in the course of the disorder, while others are subsequently diagnosed with a chronic psychotic disorder. On the other hand, patients with a primary psychotic illness can develop an eating disorder. The connection between the two, however, remains speculative, considering the hypothesis that ED and psychosis can be entirely separate disorders that can, by chance, occur in the same person.

The area of comorbidity and overlapping symptoms in psychiatry requires more deep research. Despite evidence from case series, the comorbidity between ED and psychosis is poorly understood, and firm conclusions cannot be drawn from this analysis.

The authors have not supplied their declaration of competing interest.

Feelings of unrealistic body parts are related to deficits in human information processing and can occur as a part of schizophrenic disorders or phantom sensations after amputation (Koide, 2008; Goller, in press). Experimentally induced sensoric illusions like rubber hand illusion (RHI) (Botvinik & Cohen, 1998) may help to understand basic information processing and could give new ideas for treatment or the rehabilitation process.

Factors that are related to modulate sensoric illusions during movement may help to develop new intervention strategies in the rehabilitation of illusory symptoms.

The goal of this study was to review the factors affecting persistence of the RHI effect during movement.

We selected 13 keywords and searched in the following www.dimdi.de data bases (CCTR93, CDAR94, CDSR93, DAHTA, DAHTA, EA08, ED93, EM00, EM47, HG05, KP05, KR03, ME00, ME60, PI67, PY81, TV01, TVPP). A total of 160 articles were found. Duplicates were removed and the remaining list was filtered with the objective to explore the influence of active or passive movement during experimentally induced RHI. Then we identified six articles which experimentally examined persistence of RHI during active or passive movements.

Results indicate that RHI are maintained during active or passive movements due to visual and temporal congruency. During active movements the RHI is more stable or global than in passive movements or during tactile stimulation.

Factores like visual and temporal congruency are related to maintain RHI and are discussed in the rehabilitation of phantom sensations or symptomes of schizophrenic disorders.

Existential anxiety (EA) has been described as the anxiety about the meaning of life, death and the necessity to make choices (Tillich, 1953).Although recent research found EA to be associated with trauma and general psychological symptoms in community samples (Weems et al. 2004), to date, no study has investigated its relationship with trauma exposure and posttraumatic stress disorder (PTSD) symptoms in psychiatric outpatients.

To examine the association between EA and self-reported trauma history and PTSD symptoms in psychiatric outpatients.

Seventy-two stable psychiatric outpatients (mean(SD) age=46.1(14), 55% females) were assessed with the Existential Anxiety Questionnaire (EAQ; score ranging 0-39), the Trauma History Questionnaire which reports on criminal experiences, natural disasters, death exposure and questioning about physical and sexual experiences, and the PTSD Checklist (PCL; score ranging 17-85).

Mean(SD) EAQ and PCL scores were 20.0(7.8) and 40.0(15), respectively. A majority of participants (93%) reported at least one lifetime trauma exposure. Results revealed a positive correlation between existential anxiety and lifetime trauma exposure (r=.28, p< .05).Furthermore, in patients with lifetime trauma exposure, increased EA was associated with increased PCL total score (r=.57, p< .001) as well as with all PTSD symptom clusters: re-experiencing (r=0.45, p < 0.001), hyperarousal (r=.51, p< .001) and avoidance (r=.53, p < .01).

Our findings suggest that EA might be an interesting construct to examine further in the assessment and treatment of PTSD and paves the way for empirical investigations of existential therapies.

Data that assess the co-morbidity between post-traumatic stress symptoms and autism spectrum are scarce. Nevertheless, some authors suggested that subjects with autism spectrum disorder (ASD), due to their difficulty in understanding the codes of communication, empathy, expression, are lower resilience to traumas.

The aim of this study was to explore in a sample of parents of children with epilepsy, the presence of correlations between the symptoms of post-traumatic stress and adult autism subthreshold spectrum.

Seventy-seven parents completed the Trauma and Loss Spectrum Self-Report (TALS-SR), specifically modified for one's son epileptic disease, and 72 parents completed the AdAS Spectrum (Adult Autism subthreshold Spectrum).

Eight subjects (11.1%) presented a total score ≥45 at the AdAS Spectrum, corresponding to the satisfaction of a symptomatic ASD criteria and indicative of the Adult Autism Spectrum subthreshold. More specifically, a total score ≥45 was found in 7 (15.9%) of mothers and 1 (3.6%) of the fathers, with no statistically significant differences between the two groups (P = 0.139).

Noteworthy correlations between TALS and AdAS, emerged only in the subgroup of the fathers. In particular, a relevant number of moderate to good correlations emerged between the Domain II (reactions to the events of loss) of the TALS-SR and the AdAS Domain III (non verbal communication), Domain VI (restricted interests and ruminations) and total score.

Results indicate that this peculiar psychopathological model could lead to increased vulnerability to effects of the trauma, in particular in male.

The authors have not supplied their declaration of competing interest.

To evaluate the comparative efficacy of 3 antidepressants, each representative of a distinct psychopharmacologic class, in the treatment of depressive disorders associated to Parkinson disease with dementia (PDD).

A group of 23 patients, mean age 72.1, diagnosed with PDD for at least 2 years, who were admitted in our department for a major depressive episode (DSM IV TR), received antidepressant treatment with escitalopram (mean dose 15 mg daily, n=7), duloxetine (mean dose 45 mg daily, n=8) or trazodone (mean dose 150 mg daily, n=8). All patients received treatment for PDD with rivastigmine or donepezil continuously, for at least 12 months. The distribution of patients on the antidepressant treatment was randomized, in a single-blind manner. Patients were evaluated monthly, for 6 months, using Montgomery Asberg Depression Rating Scale, Hamilton Rating Scale for Depression- 17 items, Clinical Global Impression-Improvement and Mini Mental Status Examination.

Patients treated with duloxetine had the most significant improvement in the depressive symptoms, as the endpoint MADRS (-18.6+/-2.3, p< 0.01), HAMD (-13.2+/-1.1, p< 0.01) and CGI-I (- 3.2+/-0.5, p< 0.01) scores reflected. The differences between escitalopram and trazodone didn’t reach a significant level but, overall, both improved the depressive symptoms compared to baseline (p< 0.05). The difference between duloxetine and the other two antidepressants became significant after 8 weeks (p< 0.01). The severity of dementia symptoms didn’t vary significantly between the three groups at endpoint.

Duloxetine had proven itself more efficient than escitalopram and trazodone in the improvement of the depressive symptoms in PDD.

In the present study we aimed to explore the possible relationships between plasma oxytocin levels and romantic attachment in a group of healthy subjects.

Forty-five healthy subjects with no family or personal history of any major psychiatric disorder were enrolled in the study. Thirty-three subjects had a current romantic relationship with a mean duration of 80.5 months (ranging from a minimum of one month to a maximum of 25 years); the remaining 12 had no current relationship. The romantic attachment was assessed using the Italian version of the “Experiences in Close Relationships” (ECR).

Plasma oxytocin levels were unrelated with age, gender, marital status, or length of the relationship and ranged between 0.13 and 4.59 pg/ml (mean+SD: 1.53+1.18). A significant and positive correlation was observed between the anxiety scale of the ECR and oxytocin levels (r= 0.30, p= 0.04). On the other hand, the correlation between the avoidance scale and oxytocin levels was not significant (r= 0.12, p=0.42). The distribution of attachment styles was twenty-six (57.8%) subjects showed a secure attachment, 12 (26.7%) a preoccupied, 5 (11.1%) a fearful/avoidant and 2 (4.4%) a dismissing style. Although no statistical correlation was observed between these styles and oxytocin levels, the preoccupied style of attachment was related to higher peptide concentrations.

It could be speculated that the observed link between anxiety and oxytocin represents the biological basis of those processes resulting in positive emotions related to romantic attachment and, possibly, to all social bondings.

Studies of PTSD among Malaysians are virtually unavailable. Three years after the 2004 tsunami, PTSD symptoms among Malays directly exposed to this disaster were examined.

To examine the potential predictive factors of PTSD symptoms.

To determine PTSD prevalence, severity, and number of lifetime traumas. To examine if sociodemographic characteristics can be significant predictive factors of PTSD severity.

Cross-sectional survey was conducted interviewing 250 Malays from the most severely affected villages. Measurements include socio-demographic characteristics and number of lifetime traumas. The Posttraumatic Stress Diagnostic Scale (PDS)(Foa, 1996)was also included to measure DSM-IV PTSD symptoms.

In total, 18.8% (47) of participants met DSM-IV PTSD criteria, with 14.8% having mild symptoms, 36.1% having moderate symptoms, 42.5% having moderate to severe symptoms, and 6.3% having severe symptoms. The highest reported symptom among all participants was criterion A: intense fear, helplessness and horror. Analysis of lifetime prevalence shows 4.4% never having traumatic experience, 48% having one exposure, 28.4% having two exposures, 12.8% having between 3–4 exposures, and 6.4% having more than 5 exposures to traumatic events in their lifetime. Ordinal logistic regression analysis was additionally conducted to determine the relationship between PTSD level of severity and its socio-demographic predictors.

The prevalence of PTSD remained high with many participants still exhibiting severe symptoms. Findings in this study highlight that an immediate community intervention program is urgently needed.