Depression is difficult to diagnose in schizophrenic patients although it represents a frequent motive for suicide. In clinical practice nonspecific sadness is more often observed than major depressive episodes. Our analysis of these states led us to the concept of demoralization.

The objective of our study was to demonstrate the existence of demoralization in psychotic patients as a real entity and to see how it could be correlated with other dimensions.

A total of 55 ambulatory patients diagnosed with a schizophrenic disorder were included and distributed in 2 groups according to the level of demoralization. The correlation with residual psychotics symptoms (PANSS), depression (CDSS), despair (BHS), and quality of life (SQoL) as well as the sociodemographic characteristics and past history of suicide attempts was assessed.

More than 94% of our patients were found demoralized, 16,36% of them severely. The degree of demoralization was correlated with the intensity of positive symptoms (p = 0.016), depression (p < 0.001), despair (p = 0.015), suicidality (p < 0.01) as well as poor quality of life (p = 0.007) and low self-esteem (p < 0.000).

Demoralization appears to be a relevant concept during schizophrenia, bound in schizophrenic and depressive process, and impacting the suicidal risk. It could represent an important stake in the care of schizophrenic patients especially for the prevention of relapse and suicidal risk.

Although there is general consensus that only prolonged and intensive psychotherapy can provide real recovery from Borderline Personality Disorder (BPD), almost nothing is known about the relative effectiveness of different approaches. The present study compared the (cost-)effectiveness of two psychotherapies for BPD aiming at a fundamental change: a modern psychodynamic approach (Transference-Focused Psychotherapy, TFP) and schema-focused cognitive therapy (SFT).

In a multicenter trial 86 patients were randomised to either TFP or SFT and treated for max. 3 years. In Maastricht, patients also participated in fundamental studies on emotion regulation (attentional bias, fMRI, peripheral nervous system responses).

TFP had more (early) drop-outs than SFT. SFT was about twice as effective as TFP in terms of recovery from BPD. This effect could not be explained by differences in drop-outs. SFT was superior to TFP on all other measures. On cost-effectiveness ratios, SFT was superior with respect to recovery, and equivalent when quality-of-life was considered. Functional MRI and other indices indicated that recovery from BPD was associated with normalizing of emotion regulation.

The results indicate that it is possible to successfully and cost-effectively treat these difficult patients by prolonged psychotherapeutic treatment. Assessment of attentional bias and amygdala/hipocampal responses to threat cues indicates that ‘symptomatic’ cure is accompanied by normalizing of these processes, suggesting a deep and fundamental change. Moreover, results of a 1-year follow-up indicate that recovery continues.

Both MMSE and MoCA are two widely used cognitive screening test. Comparison of the two tests has been done in specific populations (Parkinson) but not in general elderly psychiatric populations. In research, equating methodologies has been used to compare results among studies that use different scales, which measure the same construct.

To explore their level of agreement within a particular clinical setting.

(a) To find MoCA and MMSE agreement. (b) To derive a conversion formula between the two scales and test it in a random population of similar setting.

Prospective study of consecutive community dwelling older patients who attend outpatient clinic or day hospital. Both tests were administered from the same researcher the same day in random order.

The total sample (n = 135) was randomly divided in two. One from where the equating rule derived (n = 70) and a second (n = 65) in which the derived conversion was tested. Agreement of the two scales (Pearson's r) was 0.86 (P < 0.001), and Lin's Concordance Correlation Coefficient (CCC) was 0.57 (95% CI 0.45–0.66). In the second sample, we convert the MoCA scores to MMSE scores according to equating rule from the first sample and after we examined the agreement between the converted MMSE scores and the originals. The Pearson's r was 0.89 (n = 65, P < 0.001) and the CCC 0.88 (95% CI 0.82–0.92).

Although the two scales overlap considerably, the agreement is modest. The conversion rule derived showed promising accuracy in this population but need further testing in other populations.

The authors have not supplied their declaration of competing interest.

The sudden and large-scale Russian invasion of Ukraine has caused significant stress not only in Ukrainians but also in citizens of countries which have received the largest numbers of refugees.

The aim of the current study was to identify stress, resilience, and self-efficacy levels, as well as to examine the relationships between these variables, in a sample of women from Ukraine, Poland, Slovakia, and Romania during the third month of Russian aggression on Ukraine.

The study involved measuring a sample of Ukrainian (N = 82), Polish (N = 102), Slovak (N = 79), and Romanian (N = 42) women using the Perception of Stress Questionnaire, the Brief Resilience Scale, and the Generalized Self-Efficacy Scale in May 2022.

The results showed that during the third month of Russian aggression on Ukraine, stress levels and its components (emotional tension, external stress, and intrapsychic stress) were the highest among Ukrainian women and the lowest among Polish women. The sense of self-efficacy was the lowest among Ukrainian women and highest among Polish women, while resilience was the lowest among Ukrainian women and the highest among Slovak women.

Women from Ukraine reported being in the worst mental state compared to the rest of the sample. Moreover, a path analysis of the measured variables points to a multifaceted relationship between stress, resilience, and self-efficacy among women from Ukraine, Poland, Slovakia, and Romania during the third month of the Russian invasion.

None Declared

The aim of this study is to investigate mobbing in the Hospitals of Etoloakarnania, Greece. Additionally, this research aims to find out which coping strategies are used by health care professionals who have suffered mobbing and how their quality of life has been affected.

This research aims to depict mobbing phenomenon’s extent and investigate the coping strategies and quality of life of working staff, victims of mobbing.

The research methodology was based on two questionnaires: LIPT scale and the scale of assessing bullying management strategies, as well as demographic data, which were answered by 130 people. A sufficient sample for the needs of this study to produce comparable results with the existing literature.

Mobbing is observed to a large extent of 83.8% , which, however, seems to be at lower levels in relation to corresponding researches abroad. In addition, the majority of respondents who appear to have been harassed at work are mostly women (78.5%), which seems to be in line with global studies. Τhe consultants and the supervisors take advantage of their position of power and impose or change duties on other staff (45.3%), in order to punish their subordinates, exacerbating the phenomenon of mobbing, also. Finally, the participants recognize the phenomenon and look for the majority of positive ways of action (65%), while they do not resort to non-constructive ways of solving the problem.

Mobbing is a serious phenomenon that affects working staff’s mental health and quality of life. Policies should address effectively this deleterious aggressive behaviour.

No significant relationships.

Delusion and hallucinations occur in a variety of psychiatric disorders. In the last years they have been considered multidimensional phenomena, since emotional, cognitive and action-oriented aspects were recognized. According to the cognitive model of the development of positive symptoms, emotional processes play an important role for the relationship between delusion and hallucinations. Although delusion and hallucinations often coexist, there are few empirical studies, which explore this relationship.

Aim of the study is to elucidate the relationship between delusion and hallucinations taking into consideration their multidimensionality.

Eighty-two patients with delusion and hallucinations with a schizophrenia spectrum disorder were examined. Several instruments to the exploration of delusion and hallucinations were used as the Psychotic Symptoms Rating Scales (PSYRATS), MacArthur-Maudsley Delusions Asessment Scchedule (MMDAS), Dimensions of Delusional Experience (DDE), Positive and Negative Syndrom Scale (PANSS), Brown Assessment of Beliefs Scale (BABS), Clinical Delusion Rating Scale (CDRS) and the Heidelberger Delusion Profile (HDP). The correlations between formal hallucination and delusion criteria, as well as formal hallucination criteria and delusion content were calculated. The causal relationship between delusion and hallucinations was tested through a structural equation modelling.

Correlations between delusion and hallucinations dimensions could be found, at item, subscale and scale levels. Emotional and cognitive delusion dimensions correlated significantly with hallucinations magnitude. The delusion content showed a significant influence on the occurrence and emotional dimension of hallucinations. Delusion secondary to hallucinations could only be partially confirmed.

The results confirm the complex structure of the relationship between delusion and hallucinations.

Cognitive deficit is a consequence of organic lesions of the central nervous system. Activation of neuroplasticity is a way of effective treatment. There is a suppose that the autonomic nervous system (ANS) involves in the regulation of neuroplasticity.

We developed a technology for non-invasive electrical stimulate segmental and suprasegmental parts of ANS [1].

Developed technology is implemented in the “SYMPATHOCOR–01” device. The device produces spatially distributed field of current pulses between two multiple electrodes located on the neck. The targets of impact are cervical ganglia of the sympathetic trunk and vagus nerve.

The restoration of blood supply in artificial ischemia calf muscles and recovery of behavior patterns during acute phase of the adjustment disorder were received as a result of application technology in experiments on rats [2]. An increase global neurometabolic activity on SPECT was shown in clinical studies [2]. Application device for two weeks in children with ADHD led to reduction of inattention and hyperactivity symptoms [2].

We suggest that the demonstrated clinical effects are the results of activate of neuroplasticity by impact on ANS structures. It is necessary to conduct fundamental studies by means of neurovisualization methods (fMRI, PET) for the confirmation action of these mechanisms.

The authors have not supplied their declaration of competing interest.

Classical homocystinuria (cystathionine beta synthase deficiency) is a rare autosomal recessive disease of methionine metabolism that causes accumulation of homocysteine in the blood and cysteine deficiency. It is characterized by intellectual disability, ectopia lentis, skeleton abnormalities resembling Marfan syndrome and thromboembolic episodes. The majority of patients have psychiatric disturbances as depression, behavioral disorders, personality disorders, obsessive-compulsive disorder and, less commonly, bipolar disorder and psychosis.

To briefly review psychiatric disturbances in patients with homocystinuria and present a case report.

Literature research and analysis of patient's clinical data.

A 22-year-old male was diagnosed with classical homocystinuria at age 4 due to intellectual disability and renal alterations. With aging, other problems emerged: epilepsy; postural tremor; dysesthesia; ectopia lentis; orofacial myofunctional disorder; asthma; and patellar instability. He went to a special education program. At age sixteen, he initiated Child Psychiatry consultations due to anxiety and behavioral changes, as difficulty in controlling impulses, establishing relationships and in the perception of the self. Nowadays, the patient is followed in psychiatric consultations, where he has demonstrated high difficulty to empathize. He is being treated with vitamin supplements; betaine; levetiracetam; clobazam; and propranolol, combined with a special diet.

It is not practical to screen every psychiatric patient for Homocystinuria, but this disease should be considered when there is a family history, early and/or acute onset, intellectual disability, atypical symptoms, unusual response to treatment, progressive cognitive change and other organic disturbances present in this disorder.

The authors have not supplied their declaration of competing interest.

While polypharmacy is common in long-term residential psychiatric patients, prescription combinations may, from an evidence-based perspective, be irrational. Potentially, many psychiatric patients are treated on the basis of a poor diagnosis. We therefore evaluated the DITSMI model (i.e., Diagnose, Indicate, and Treat Severe Mental Illness), an intervention that involves diagnosis (or re-diagnosis) and appropriate treatment for severely mentally ill long-term residential psychiatric patients. Our main objective was to determine whether DITSMI affected changes over time regarding diagnoses, pharmacological treatment, psychosocial functioning, and bed utilization.

DITSMI was implemented in a consecutive patient sample of 94 long-term residential psychiatric patients during a longitudinal cohort study without a control group. The cohort was followed for three calendar years. Data were extracted from electronic medical charts. As well as diagnoses, medication use and current mental status, we assessed psychosocial functioning using the Health of the Nations Outcome Scale (HoNOS). Bed utilization was assessed according to length of stay (LOS). Change was analyzed by comparing proportions of these data and testing them with chi-square calculations. We compared the numbers of diagnoses and medication changes, the proportions of HoNOS scores below cut-off, and the proportions of LOS before and after provision of the protocol.

Implementation of the DITSMI model was followed by different diagnoses in 49% of patients, different medication in 67%, some improvement in psychosocial functioning, and a 40% decrease in bed utilization.

Our results suggest that DITSMI can be recommended as an appropriate care for all long-term residential psychiatric patients.

This study aimed to investigate and compare the social skills of students addicted to computer games with normal students. The dependent variable in the present study is the social skills.

The study population included all the students in the second grade of public secondary school in the city of Isfahan at the educational year of 2009–2010. The sample size included 564 students selected using the cluster random sampling methods. Data collection was conducted using Questionnaire of Addiction to Computer Games and Social Skills Questionnaire (The Teenage Inventory of Social Skill or TISS).

There was a significant difference between the social skills of students addicted to computer games and normal students. In addition, the results indicated that normal students had a higher level of social skills in comparison with students addicted to computer games.

Addiction to computer games may affect the quality and quantity of social skills. In other words, the higher the addiction to computer games, the less the social skills. The individuals addicted to computer games have less social skills.

The association between anxiety disorders and verified coronary heart disease (CHD) remains to be clarified.

To report the prognostic association between anxiety disorder subtypes and subsequent major adverse cardiac events (MACE), report anxiety disorder prevalence in CHD, and the efficacy of randomized controlled trials (RCTs).

A comprehensive literature search was conducted for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE and RCTs. From 4,041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence), no RCTs were eligible.

Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n = 2851). There was a non-significant association between GAD and MACE risk (Risk Ratio = 1.20, 95% CI .86 – 1.68, p = .28) however the effect size was highly significant in outpatient samples with adjustment for covariates (adjusted hazard ratio = 1.94, 95% CI 1.45 – 2.60, p <.001). No other anxiety disorder subtype was associated with MACE. Prevalence data showed high comorbidity with depression (49.06%; 95% CI 34.28 – 64.01) and substantial heterogeneity between studies and anxiety disorder subtypes. Panic disorder prevalence was higher in psychiatrist/psychologist raters (9.92% vs. 4.74%) as was GAD (18.45% vs. 13.01%). Panic and GAD estimates were also significantly higher in DSM-III-R versus DSM-IV taxonomies (13.40% vs 3.43%, p <001; 11.12% vs. 6.80%, p <.001 respectively).

The paucity of extant anxiety disorder RCTs, alongside MACE risk for GAD outpatients, should stimulate further anxiety disorder intervention in the CHD population.