Kosovo war had a devastating effect in the country as evident in the increasing prevalence of depression and post-traumatic stress disorders in the population.

To investigate levels of Quality of Life and the presence of PTSD and Depression thirteen years after war at the most war-affected region of Kosovo-Drenica.

The study aimed to measure the levels of Quality of Life and explore correlations with the presence of PTSD and Depression.

The purposeful sample of general population of Drenica region have filled out PTSD questionnaires (adapted from DSM-IV), Beck Depression Inventory and The Quality of Life Scale. In the sample of 249 respondents (17-70yr, Mage=36, 6) 2/3 of them were males; 88% lived in rural regions; 18, 65% ex-soldiers; 66. All data was analyzed by SPSS 21.0 and Microsoft Excel 2007.

Results showed that 27% of the sample declared experiencing war trauma. We found PTSD in 17, 9% cases; depression at clinical level in 10, 7%. 38, 1% of the sample has perception of low level of Quality of Life. PTSD was significantly positively related with depression (r=.562; p<.01) and significantly negatively related with the level of Quality of Life (r=-.39; p<.01). Presence of PTSD predicted low level of Quality of Life while controlling for depression (r=-.26; p<.01)

The prevalence of PTSD in the specific region is still high and is obviously related to poor quality of life and depression. More effective programs are needed both to identify and treat PTSD and depression.

To study (a) if children with Language delay (LD) or Typical Language (TL) at 2½ y of age had persistent or transient language difficulties at 6 y of age and, (b) whether or not children with LD at 2½ y of age had language or neuropsychiatric impairments at school age.

At the 2½-y language screening 25 children with LD and children with TL were recruited. At 6-y 22 children from the LD group and 77 children from the TL group were examined. The 7-8-y follow–up concerned 21 of the 22 children with LD who participated at age 6 y. The 6-y examination included several tests of language and linguistic awareness. The 7-8-y follow-up consisted of a multidisciplinary examination of language, intellectual functions and neuropsychiatric disorders.

The 6-y examination showed a highly significant difference between the children with and without LD. At age 7-8 years 62% of the LD children had a neuropsychiatric diagnosis (ADHD or ASD). Half of them also had marked problems with narrative skill according to the Bus Story test and the NEPSY Narrative Memory Subtest independently of co-occurrence of neuropsychiatric disorder.

All children with LD at age 2½ y appeared to be at later risk of ADHD or ASD. Remaining language problems at age 6 y predicted the presence of neuropsychiatric disorders at age 7-8 years. The observed difficulties in the LD children indicate that these children are at high risk of developing problems concerning reading and writing.

The 2006-2007 Iraqi Mental Health survey (IMHS) reported surprisingly low prevalence of alcohol and drug abuse in the Iraqi population. Anecdotal suggested that abuse of alcohol and drugs has increased. To investigate this possibility, we conducted a survey of drug and drug abuse at youth centers in Baghdad.

A total of 2678 persons was included in this survey with male to female ratio of 3.8:1. They were randomly selected from youth centers located in different sectors in Baghdad. Composite International Diagnostic Interview was used to generate diagnosis. The interviewers were trained youth center staff. Data collection was carried out on Dec. 2009.

A total of 17% met criteria for alcohol abuse and 7.02% met criteria for drug abuse. In those below 18 years of age, 2.1% reported alcohol abuse and 1.1% reported drug abuse. The peak age for alcohol and drug abuse was at 24-35 years. No female reported alcohol and substance abuse. Age of onset of alcohol was 21.7 ± 3.6 years and for drug abuse was 22 ± 5.8 years. Alcohol abuse was significantly associated with high crowding index, but drug abuse was not associated with crowding index. Low educational level was associated significantly with both alcohol and drug abuse.

High rates of alcohol and drug abuse and a tendency in early age of onset in alcohol and drugs were observed. High household density and low educational level are important factors in alcohol and drug abuse.

Risperidone-ISM is a new long-acting intramuscular formulation intended to achieve sustained plasma concentrations over 4 weeks without oral supplementation. The clinical efficacy to risperidone has been associated with 65–80% occupancy of dopamine D2 receptor (D2RO) and a mean Cmax between 7.5 ng/mL and 80 ng/mL.

Use a population PK/PD model to predict the PK and the D2RO for Risperidone-ISM in schizophrenic patients and to characterize the relationship among doses, in order to guide dose selection for a future Phase-III trial.

A population PK/PD analysis for Risperidone-ISM using Monolix software was conducted based on 6641 plasma samples from two Phase-I studies (17 healthy subjects and 31 schizophrenic subjects, respectively) and 1 Phase-II study (60 schizophrenic subjects). Simulations were subsequently undertaken predicting the steady state PK and D2RO after multiple Risperidone-ISM doses administered every 28 days for 12 weeks.

Doses of 75 and 100 mg, administered either in gluteal or deltoid muscle, were predicted to result in median Cmax and Ctrough that stayed between 7.5 ng/mL and 80 ng/mL. At steady state 75 mg and 100 mg dose (gluteal) achieved a D2RO average [min–max] of 70.8% [61.4–80.4] and 74.3% [66.2–82.1], respectively; a 75-mg and 100-mg dose (deltoid) achieved a D2RO average [min–max] of 69.3% [56.5–80.3] and 73.0% [61.8–82.1], respectively. The model estimated that the 65% D2RO occurs within first 8 h after treatment.

Simulations were carried out supporting doses of 75 mg and 100 mg Risperidone-ISM to show the greatest efficacy and safety potential to be assessed in the future Phase-III trial.

The authors have not supplied their declaration of competing interest.

Under contemporary social circumstances, there is a tendency to increasing of amount of persons disposed to addictive behavior (AB) as a mean to remove psychoemotional tension and to solve their significant problems. This tendency raises in patients with neurotic disorders (ND) that influences on clinical manifestations of the pathology and impedes diagnosis and timely care for this category of patients.

To investigate AB in the structure of neurotic disorders (F44.7, F40.8, F48.0).

Assessment of personal addictive status with AUDIT-like tests to detect disorders related to substance and non-substance abuse; 109 patients with ND (main group) and 52 persons without ND (control group) were examined.

It was revealed that patients with ND had significantly higher risk of AB formation (59.73% compared with 21.15% in healthy persons; P < 0.0001). According to the group comparison, in patients with ND levels of AB expression on parameters of “Job” (12.06 points), “Food” (11.98 points), “Internet” (11.10 points), “TV” (8.82 points), “Shopping” (6.59 points) were significantly higher than in healthy persons (9.73; 9.23; 9.00; 7.38; 4.25 points, respectively; P < 0.05). However, levels of keenness on computer were significantly higher in healthy persons (3.48 points) than in patients with ND (2.34 points; P < 0.05). AB connected with substance abuse was not registered in the groups.

The results suggest that the patients use AB in forms of food, Internet, job, TV, shopping dependencies as a subconscious mechanism substituting unsatisfied needs and decreasing motivation-emotional tension under conditions of a frustration conflict.

The authors have not supplied their declaration of competing interest.

Chronic non-malignant pain (CNMP) is defined as pain lasting a minimum of three months. In general, chronic pain affects 20% adult worldwide population. Moreover, pain is more common in patients with depression, anxiety, and substance-use disorders and with low socioeconomic status. We aimed to better understand the influence of pain on substance use and treatment use patterns of individuals who experienced clinically recognized pain and have substance use disorder.

Patients with pain disturbances were identified in Electronic Health Records (EHR) through ICD-9 code 338*, medical written diagnoses, or diagnoses of fibromyalgia. A patient was considered to have a substance use disorder if he received treatment for illicit drug or alcohol abuse or dependence. We combined 2010–2012 (EHR) data from primary care and specialty mental health setting in a Boston healthcare system (n = 131,966 person-years) and a specialty mental health care setting in Madrid, Spain (n = 43,309 person-years).

We identified that 35.3% of individuals with clinically recognized pain also report substance use disorder, compared to only 10.6% of individuals without clinically recognized pain (P < 0.01). Those with co-morbid pain and substance use disorder were significantly more likely than their specialty care counterparts without co-morbid pain and substance disorders to be seen in the emergency room (56.5% vs. 36.6%, respectively, P < 0.01).

The findings suggest that CNMP is associated with an increase risk of substance abuse disorder.

The authors have not supplied their declaration of competing interest.

Proper attitudes by medical students can impact on the quality of health care delivered to their patients. Negative attitude toward person with mental illness may form a barrier for patients to receive appropriate care.

The aim of this study is to determine the attitudes of medical students toward mentally ill and to investigate impact of medical education on attitude among medical students.

The study comprised 200 clinical &135 basic science medical students at the medical school of Shiraz university who agreed to participate. Community Attitudes towards the Mentally Ill questionnaire were used to assess attitude toward mental illness The tool focuses on measuring levels of authoritarianism, benevolence, social restrictiveness and community mental health ideology.

There was little difference in attitudes about mental illness Between basic science- and clinical medical student except for restrictiveness (p value< 0.05).This difference also was noted between male and female student with higher restrictiveness in female students . 70% of our student have familiarity with someone who have mental illness . Pearson correlation test show significant correlation between familiarity with mental illness and community ideology sub dimension p value< 0.009.

Our sample overly have positive attitude about mental illness ,but there is no significant positive correlation between years of studying in medical university and attitude about mental illness . Medical school need to develop new curricula to convey scientific information to students and implementing and evaluating suitable programs leading to appropriate attitude development.

Cannabis use can both increase and reduce anxiety in humans. The neurophysiological substrates of these effects are unknown.

Fifteen healthy English-native right-handed men were studied on three separate occasions using an event-related fMRI paradigm while viewing faces that implicitly elicited different levels of anxiety. Each scanning session was preceded by the ingestion of either 10mg of D-9-THC, 600mg of CBD, or a placebo, in a double-blind, randomised, placebo controlled design. Electrodermal activity (Skin Conductance Response, SCR) and objective and subjective ratings of anxiety were recorded durign the scanning.

D-9THC increased anxiety, as well as levels of intoxication, sedation and psychotic symptoms, whereas there was a trend for a reduction in anxiety following administration of CBD. The number of SCR fluctuations during the processing of intensely fearful faces increased following administration of D-9THC but decreased following administration of CBD. CBD attenuated the BOLD signal in the amygdala and the anterior and posterior cingulate cortex while subjects were processing intensely fearful faces, and its suppression of the amygdalar and posterior cingulate responses was correlated with the concurrent reduction in SCR fluctuations. D-9-THC mainly modulated activation in frontal and parietal areas.

D-9-THC and CBD had clearly distinct effects on the neural, eclectrodermal and symptomatic response to fearful faces. The effects of CBD on activation in limbic and paralimbic regions may contribute to its ability to reduce autonomic arousal and subjective anxiety, whereas the anxiogenic effects of D-9-THC may be related to effects in other brain regions.

Hypochondrias is a psychiatric disorder that is recognized with a strong belief and concerns about having a serious illness. Objectives of this study were determination of the frequency of these symptoms in medical sciences fields’ students in their relation with age, gender & educational major and degree.

This study was performed on 500 randomly selected students in Mashhad University of Medical Sciences. Those with a known previous medical or mental disorder or defectiveness were excluded. Assessment was done with the hypochondrias questionnaire that includes 36 items. Data was analyzed with appropriate statistical descriptive and analytic tests such as chi-square, independent t and ANOVA.

In the present study the prevalence of hypochondrias in medical students were %36.8 at the borderline level and 16% as the disorder level. Out of 70 cases with hypochondriac disorder 57 had mild and 13 had moderate symptoms. This disorder was significantly more prevalent in girls than boys (P=0.000) and it was not related to marital status (P=0.318), However, all the students with moderate disorder were single.

The present study showed the higher prevalence of hypochondrias in Iranian medical sciences fields’ students compared to those in other countries. In contrast to other studies, the disorder was more prevalent in women in this research. Hypochondriac symptoms in medical sciences fields’ students especially in ones with inaccurate medical information are frequent, in this study also there was a higher prevalence of symptoms in people with bachelor degree than those with other educational levels.

Today there is a large number of antidepressant drugs. However, the effect of treatment is often suboptimal. Unlike other antidepressants agomelatine has a novel neurochemical mechanism. It is an MT1 and MT2 melatonergic receptor agonist and a selective antagonist of the 5-HT2C receptors. In this open-label 8-week study we aimed to investigate the efficacy of agomelatine on depressive symptoms in patients with major depression. Secondary endpoints were the effect of agomelatine on anhedonia.

Thirty major depressive patients received a flexible dose (25–50 mg; per os, daily) of agomelatine. Depressive (Hamilton Depression Scale) and anxious (Hamilton Anxiety Scale) symptoms, anhedonia (Snaith Hamilton Rating Scale), and sleep quality (Leeds Sleep Evaluation Questionnaire) were assessed.

Twenty-four patients (80%) completed 8 weeks of treatment. Significant improvements were seen at all visits on the HAM-D (p< .05), HAM-A(p< .01), SHAPS (p< .05), LSEQ (p< .05). Nine subjects (30%) were responders and 5 (17%) remitters at week 1; 18 (60%) were remitters by the end of the trial. There was no serious adverse event. No aminotrasferase elevations were noted.

In line with previous studies, in which agomelatine was associated with early clinical improvement this study also provides evidence of an early response and the findings of improvements in depression scores. Beside this is the first study where agomelatine was effective in the treatment of anhedonia. Additional trials are needed to delineate the place of agomelatine in the contemporary pharmacotherapy for depressive disorders.

High levels of impulsive behavior represent a core symptom of different psychiatric conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), Borderline Personality Disorder (BPD), impulse control and conduct disorders, bulimia nervosa, substance use disorders, and other maladaptive behaviors. Impulsivity is a multidimensional construct, having at least three factors.

Our aim was to describe the impulsivity profile in adult ADHD and BPD patients in comparison with a healthy control group, taking into consideration the different impulsivity factors.

aADHD (n=80) and BPD Patients (n=60) were recruited, based on the DSM-5 criteria. Control subjects (n=80) were screened using Derogatis Symptom Checklist (SCL-90). Comorbidities were assessed by structured clinical interviews. Participants were further investigated with online questionnaires including the Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), and neuropsychological tests, like Rogers’ decision-making test.

Based ont the BIS-11 and DERS results, significantly higher levels of impulsivity (motor, attentional, non-planning) and difficulties in emotion regulation were present both in the aADHD and BPD groups, compared to the control group. Impulsivity factors were more characteristic to aADHD, emotion dysregulation was more specific to BPD. In the Rogers test, aADHD group was significantly slower in decision-making, while in BPD decision quality and risk-taking were affected.

Impulsivity profiles of the two disorders are different, which leads to the assumption of potentially altered pathway of developing impulsive behavior. As a neuropsychiatric condition, impulsivity in aADHD is related to neurobiological dysinhibition, in BPD impulsive behavior is attached to emotionally involving situations, and emotional dysregulation rooted in childhood adverse events.

No significant relationships.

Psychiatry in the UK has longstanding recruitment problems (1). Evidence suggests the positive effects of clinical attachments on attitudes towards psychiatry are often transient (2). We therefore created the Psychiatry Early Experience Programme (PEEP) where year 1 medical students are paired with psychiatry trainees and shadow them at work. Students will ideally remain in PEEP throughout medical school, providing consistent exposure to psychiatry and a broad experience of its subspecialties.

1. 1. To present PEEP

2. 2. To assess:

   1. a. Students’ baseline attitudes to psychiatry

   2. b. PEEPs’ impact on students’ attitudes to psychiatry

Design

A prospective survey based cohort study of King’s College London medical students.

PEEP started in 2013. In this cohort all students that signed up were accepted.

Students’ attitudes towards psychiatry were assessed on recruitment using the ATP-30 questionnaire (3), and will be re-assessed annually.

127 students were recruited. Attitudes were positive overall. 73% listed psychiatry in their top three specialities. 95.3% agreed or strongly agreed that ‘psychiatric illness deserves at least as much attention as physical illness.’ 84.3% disagreed or strongly disagreed that ‘at times it is hard to think of psychiatrists as equal to other doctors.’

Baseline attitudes to psychiatry were positive. By March 2015 we aim to collect and analyse data on students’ attitudes after one year in PEEP. Through on-ongoing analysis of this and future cohorts, we aim to assess the impact of PEEP on improving attitudes to psychiatry and whether this will ultimately improve recruitment.

Climate change is a major global public health challenge that will have wide ranging effects on human psychological health and wellbeing through the increased incidence of acute (e.g., storms, floods, wildfires), sub-acute (e.g., heat stress, droughts, lost agricultural yields) and long-term stressors (e.g., changes to landscapes and ecosystems). Children and adolescents are particularly at risk because of their rapidly developing brain, vulnerability to disease and limited capacity to avoid or adapt to climate change-related threats and impacts. They are also more likely to worry about climate change impacts than any other age group.

To produce a new conceptual framework that describes climate change-related threats to youth mental health from a developmental life course perspective.

We critically review and synthesis literature documenting the pathways, processes and mechanisms linking climate change to increased mental health vulnerability.

We show that climate change-related threats can additively and interactively increase psychopathology risk from conception onwards, that these effects are already occurring and that they constitute an important threat to mental health and therefore human capital worldwide. We then argue that birth cohort studies are uniquely positioned to examine climate change-related threats and that incorporating relevant measures into existing and planned birth cohorts is a matter of social justice and crucial long-term investment in mental health research.

Climate change is affecting the healthy psychological development of children and these risks are increasing worldwide. New theoretical and empirical work is urgently needed so that threats can be tracked and mitigated.

Major depressive disorder (MDD) is a leading cause of disability worldwide, and yet delivery of care for this illness is rife with gaps. The COVID-19 pandemic has had far reaching implications for every facet of healthcare, and MDD is no exception. This scoping review aimed to ascertain the impacts of COVID-19 on the delivery of MDD care in Europe, as well as to evaluate any novel MDD care strategies trialled in this period.

We searched the PubMed and PsycINFO databases up to January 2022 with a strategy centred around COVID-19 and MDD. Full texts of eligible studies examining working-age adults and conducted in Europe were evaluated against several criteria. All outcomes were then extracted and a narrative synthesis was constructed to summarise identified themes.

Of 1,744 records identified in our search, 11 articles were eligible for inclusion in the review. In general, these studies reported a decrease in treatment rates, access to care, and perceived access to care during the COVID-19 pandemic. In addition, digital interventions trialled during the pandemic were broadly well-received by users, though their efficacy in improving MDD care was ambiguous.

Despite a limited number of pertinent studies, this scoping review identified a trend of exacerbated treatment gaps in MDD care during the pandemic. Several of our pre-specified gaps, including delays to detection or treatment of depression and rates of follow-up contacts, remained unexplored in the context of COVID-19. This highlights the need for further investigation to obtain a full understanding of the relationship between COVID-19 and MDD care in Europe.

The Flow experience in job result in increasing the internal interest to job and it is so enjoyable that causes people do that job for itself. So, designing the effective methods and programs for treatment has important role in increasing this features, especially in nursing staff in the psychiatric units that confront to high stress.

the present study has been done by the purpose of effectiveness of the Mindfulness-Based Cognitive Therapy of the Flow experience in nursing staff at the Psychiatric Hospital in Tehran Iran.

This study is a semi-experimental with pretest-posttest plan along with control group. 30 nurses in the Psychiatric Hospital with score less than 108 in the questionnaire of the Flow State Scale (FSS) of Jackson and Marsh (1997) were selected randomly and then they were divided in two groups of control and experimental. The period of training was 8 sessions with duration of 2 hours for each session once weekly. One week after completion the sessions of Mindfulness-Based Cognitive Therapy, the above mentioned questionnaire was performed for both two groups.

The results demonstrated that the Mindfulness-Based Cognitive Therapy meaningfully has been effective on the flow experience, Action-awareness merging, the clear goal, Unambiguous feedback, Concentration on task at hand, sense of control and also it has the most effect on the mini-scale of the Loss of self-consciousness (P<0.05).

Mindfulness-Based Cognitive Therapy can be effective in increasing the flow experience of nurses who work in the psychiatric hospitals.

The menopause transition is a vulnerable period that can be associated with changes in mood and cognition. The present study aimed to investigate whether a symptomatic menopausal transition increases the risks of depression, anxiety, and sleep disorders.

This population-based, retrospective cohort study analysed data from five electronic health record databases in South Korea. Women aged 45–64 years with and without symptomatic menopausal transition were matched 1:1 using propensity-score matching. Subgroup analyses were conducted according to age and use of hormone replacement therapy (HRT). A primary analysis of 5-year follow-up data was conducted, and an intention-to-treat analysis was performed to identify different risk windows over 5 or 10 years. The primary outcome was first-time diagnosis of depression, anxiety, and sleep disorder. We used Cox proportional hazard models and a meta-analysis to calculate the summary hazard ratio (HR) estimates across the databases.

Propensity-score matching resulted in a sample of 17,098 women. Summary HRs for depression (2.10; 95% confidence interval [CI] 1.63–2.71), anxiety (1.64; 95% CI 1.01–2.66), and sleep disorders (1.47; 95% CI 1.16–1.88) were higher in the symptomatic menopausal transition group. In the subgroup analysis, the use of HRT was associated with an increased risk of depression (2.21; 95% CI 1.07–4.55) and sleep disorders (2.51; 95% CI 1.25–5.04) when compared with non-use of HRT.

Our findings suggest that women with symptomatic menopausal transition exhibit an increased risk of developing depression, anxiety, and sleep disorders. Therefore, women experiencing a symptomatic menopausal transition should be monitored closely so that interventions can be applied early.