To evaluate the effectiveness of extended-release quetiapine fumarate (quetiapine XR) as once-daily monotherapy for bipolar depression.

Patients in this double-blind, placebo-controlled study were acutely depressed adults with bipolar I or II disorder (with or without rapid cycling), and were randomized to 8 weeks of once-daily treatment with quetiapine XR 300 mg (n=133) or placebo (n=137). The primary outcome measure was change from baseline to endpoint (Week 8) in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Secondary outcome measures included response (MADRS total score reduction ≥50%) and remission (MADRS total score ≤12) rates at endpoint, changes from baseline to endpoint in MADRS item scores, and Clinical Global Impressions-Bipolar (CGI-BP) severity of illness and change. Change from baseline was compared between groups with analysis of covariance using last observation carried forward approach.

Quetiapine XR 300 mg/d was significantly more effective than placebo in improving depressive symptoms, from first assessment (Week 1; P< 0.001) to endpoint (P< 0.001). Compared with placebo, quetiapine XR was associated with higher response (P< 0.001) and remission (P< 0.05) rates and greater improvements from baseline to endpoint in MADRS total score (-17.43 vs -11.92; P< 0.001), MADRS item scores for core symptoms of depression, and CGI-BP-related outcomes at Week 8. Most common adverse events with quetiapine XR were dry mouth, somnolence, and sedation.

Quetiapine XR (300 mg) once-daily monotherapy was efficacious (from Weeks 1 through 8) compared with placebo and generally well tolerated in bipolar depression.

Supported by funding from AstraZeneca Pharmaceuticals LP.

We aimed to review the distribution of diagnoses in children and adolescents evaluated by a child psychiatrist, in refugee camps in Diyarbakır, Cizre and Silopi province of Turkey.

Sociodemographic data, psychiatric complaints and distribution of psychiatric diagnoses of 38 children and adolescents living in refugee camps in Diyarbakır, Cizre and Silopi were evaluated. Psychiatric diagnoses were made according to DSM-5 criteria but some diagnoses as conversion disorder were also mentioned even tough they were not included in DSM-5.

The sample consisted of 22 female and 16 male children and adolescents. The mean age was 12.1 ± 4.5 and the range was 2–18 years. The mean duration of residency in the camp was 23.2 ± 3.9 days. The most common symptom was sleep problems. The most frequently seen psychiatric disorder was depressive disorder (36.8%) and at least two comorbidities were detected in 50% of children and adolescents. This diagnosis was followed by conversion disorder (28.9%), adjustment disorder (21.8%), acute stress disorder (18.4%), enuresis nocturna (18.4%), post-traumatic stress disorder (10.5%), separation anxiety disorder (10.5%), somatization disorder (7.8%), selective mutism (2.5%) and night terror (2.5%) respectively.

The study revealed that in refugee children and adolescents, starting from the early days of the migration period, various psychiatric symptoms and disorders might be seen. Therefore, it is essential to integrate psychosocial support units into the aid and support programs for refugees and quite important to observe and treat children in terms of psychiatric disorders, starting from the early days of the migration period.

The authors have not supplied their declaration of competing interest.

To explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.

Twelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.

Patients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.

In this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

The purpose of this study is to develop a self-administered version of the Health of the Nation Outcome Scales for Older Adults (HoNOS65+) in Spanish – the HoNOS65+A – and to study its reliability and validity.

There are two phases in the study: construction of the HoNOS65+A and the study of its psychometric properties. In the second phase, 179 users of 10 services for older people of Madrid were interviewed. They completed the HoNOS65+A, the Spanish version of the HoNOS65+, and other instruments that evaluate similar constructs. Reliability (internal consistency with the other-administered HoNOS65+, intraclass) and validity (concurrent, discriminant, and criterion validity) were analyzed.

High reliability indexes (intraclass correlation coefficients) were found for all the scales (HoNOS65+ and HoNOS65+A), except for items 4 and 6. Moreover, the HoNOS65+A has satisfactory concurrent (except 4, 6, and 9) and discriminant validity (except for items 4 and 10). Considering all these data and some theoretical points the items 4 and 6 have eliminated from the scale. Upon eliminating items 4 and 6, the analysis of the reliability (Cronbach's Alpha) and criterion validity (discriminant function among autonomous and assisted people) presents positive values.

The results indicate that the HoNOS65+A is a useful measure that does not assess a homogeneous area but instead different aspects of health and psychosocial functioning.

This article compares in a systematic way the team's intervention choices of professionals across seven European countries: France, Ireland, Italy, the Netherlands, Portugal and Spain towards problems and needs of patients with schizophrenia and relates this to the diversity of psychiatric systems.

The clinical and social status of 433 patients was assessed by means of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Needs for Care Assessment instrument (NFCAS) which was used to determine teams' intervention choices toward the NFCAS problems.

There is no, or little, consensus across Europe on teams' intervention choices towards either the clinical or the social problems and needs of patients suffering from schizophrenic disorders. These comparisons outlined the cultural differences concerning the interventions that were proposed and should be taken into account when interpreting the number of needs and the need status since the need status relies heavily on the interventions proposed. The differences were not connected with the availability of resources; most of the comparisons show differences between centers as well as differences between groups of relatively similar resource countries.

The aim of this study was to examine the the effectiveness of psycho-education delivered via a printed booklet for Schizophrenia patients and their primary caregivers’ in Jordan. It was hypothesised that treatment as usual and psycho-education delivered by a booklet would improve patients’ and primary caregivers’ knowledge of schizophrenia, improve patients’ positive and negative symptoms and reduce their relapse rates, and improve primary caregivers’ burden of care and quality of life better than treatment as usual alone.

A single blind parallel randomized controlled trial was conducted between September 2012 and September 2013 at four mental outpatient clinics in Amman, Jordan. 121 patients with their primary caregivers were allocated randomly to an experimental (Psycho-educational intervention plus TAU in outpatient clinic) group (n = 58) or control (TAU alone) group (n = 63).

Outcomes, measured prior randomization (pre-test), immediately post-intervention and at three months after intervention were patients and primary caregivers’ knowledge of schizophrenia, patients’ positive and negative symptoms and relapse rates, primary caregivers burden of care and quality of life.

Participants receiving psycho-education and treatment as usual had better knowledge of schizophrenia at both post-tests, reduced positive and negative symptoms at post-test 1 and further reduction at post-test 2 compared with participants in control group. Patients hospitalisation and caregivers outcomes had reduced burden of care and better quality of life (P<0.001, all outcomes).

Psycho-education delivered via printed booklets improves outcomes patients and their primary caregivers in Jordan better than treatment as usual. Our hypothesis is supported.

The problem of job satisfaction connected with work efficiency and psychological well-being of professionals is especially actual in stress conditions due to COVID-19 pandemic. The stress has a negative effect on job satisfaction (Singh et al., 2019). The one of the most important criteria for successful activities is a job satisfaction (Burić & Moè, 2020). The highest level of job satisfaction can be achieved by the high adaptive potential of professionals, who have a diverse arsenal of self-regulation resources and apply them adequately to working conditions (Kuznetsova et al., 2019).

The study was held in 45 professionals from different fields, who work remotely during the self-isolation due to COVID-19 pandemic and aimed to estimate the correlation between job satisfaction and self-regulation resources of professionals under work stress.

The assessment methods included: 1) test “Job Satisfaction” by V.A. Rozanova 2) S. Hobfoll’s “SACS” 3) Ch. Spilberger’s “Trait Anxiety”.

The results revealed an average level of anxiety with a tendency to growth. Avoidance, asocial and aggressive behaviour are frequently used. The direct correlation between the level of job satisfaction and such a resource of self-regulation as a search for social contact was revealed (r=0.291; p=0.049). The general level of anxiety is directly related to avoidance (r=0. 374; p=0.011), manipulative (r=0.343; p=0.021) and aggressive actions (r=0.343; p=0.021), and negatively correlates with assertive actions (r=-0.703; p=0).

The results of the study can be used to develop programs to improve the psychological well-being and performance of employees working under stress due to COVID-19 pandemic.

Psychiatric disorders are often characterised by cognitive impairment. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed for routine screening of psychiatric patients and is available in several languages.

Using the German version (SCIP-G), 3 studies were conducted: 1. feasibility, reliability, and validity of the SCIP-G were investigated [Sachs et al. Schizophr. Res. Cogn. 2021: 25, 100197], 2. a confirmatory factor analysis was performed [Sachs et al. Schizophr. Res. Cogn. 2022: 29, 100259], and 3. patients with psychotic, bipolar affective, and depressive disorders were assessed before and after standard inpatient treatment including cognitive remediation.

Study 1 included patients with schizophrenia or schizoaffective psychosis and thirty healthy controls matched for sex, age, and education. Data were collected at the Medical University of Vienna, Department of Psychiatry and Psychotherapy. In studies 2 and 3, patients from the Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria, were studied. In study 3, all patients received modern pharmacotherapy plus cognitive remediation using the COGPACK® software package version 6.06; based on the ICD-10 criteria for research, 54 patients received an F2 diagnosis (schizophrenia, schizotypal, and delusional disorders), 39 patients met criteria for bipolar disorder (F30 and F31), and 50 for depression (F32 and F33).

In Study 1, significant differences in cognitive performance were found between patients and healthy controls on both versions of the SCIP. The SCIP effectively discriminated between patients and the control group. In Study 2, a two-factor solution in which the Verbal Learning Test-Immediate Recall subtests, Delayed Recall Test of the VLT, and Working Memory Test loaded on the first factor and the Verbal Fluency Test and Psychomotor Speed Test subtests loaded on the second factor yielded good model fit (χ² = 6.7, df = 3, p = .08, χ²/df = 2.2). In Study 3, SCIP total score showed significant improvement after treatment in all three diagnostic groups (p < .001), with no statistically significant interaction between SCIP total score and diagnostic groups (p = .860).

Our data indicate that the SCIP-G is a valid and reliable instrument for assessing cognitive impairment. Good model fit can be achieved with a two-factor solution for the SCIP. Our study is the first to perform a confirmatory factor analysis with the German SCIP version and to test its dimensional structure with a hypothesis-testing approach. Inpatient treatment consisting of pharmacotherapy and cognitive remediation improved cognitive deficits. This improvement in cognitive performance was observed to a similar extent in patients with psychotic disorders, bipolar disorder, and depression.

None Declared

The authors have not supplied their declaration of competing interest.

Previously, a number of observational studies have found no association between contact with services and improved outcomes in children with psychopathology, despite the existence of effective interventions. The British Child and Adolescent Mental Health Survey (BCAMHS) 2004 is a study of 5,325 children aged 5-16, with data on parent-reported mental health-related public sector service contacts and psychopathology over three years, allowing exploration of the association in a large community-based dataset.

• Describe the trajectories of children in contact and not in contact with services over three years from 2004-2007

• Explore the association between mental health-related service contact over the study period and outcomes in terms of parent-rated psychopathology

This study is a secondary analysis of children's trajectories by service contact status (no contact, contact 2004 only, contact 2007 only, contact 2004 & 2007). The main measure of psychopathology over time was the well-validated Strengths and Difficulties Questionnaire. Multivariable linear regression was used to examine the association between contact and outcomes in children with a psychiatric disorder at baseline in 2004.

Children in contact with services demonstrated the highest levels of psychopathology over time, and the 2007-only contact group displayed a trajectory of increasing difficulties. Overall, contact with services was not associated with improvement in outcomes, following adjustment for measured confounders.

The effectiveness of contact alone with services was not demonstrated in our findings. Despite methodological limitations, this underlines the need for continuing development and consistent implementation of effective interventions, alongside initiatives evaluating outcomes within services.

Although studies show that those suffering from autism spectrum disorders (ASD) face an increased risk of exposure to trauma (bullying, physical abuse), the co-morbidity between autistic symptoms/traits and post-traumatic stress disorder (PTSD) was almost entirely neglected by researchers. The aim of this preliminary study is to explore the possible associations between these two conditions among typically-developing college students.

Participants were 39 students, recruited from 2 Israeli universities. Twenty-four participants were psychology students, and 15 were business administration students. Participants completed self-report questionnaires tapping sociodemographic background, trauma exposure, PTSD (the PTSD Checklist-5, PCL-5), and autistic traits (the Autism Spectrum Quotient, AQ).

Our preliminary findings revealed a positive association between symptoms of PTSD and autistic traits. More specifically, among those in the 3rd and 4th highest quartiles of AQ scores, 87.5% met the cut-off score for a probable PTSD diagnosis (χ2 (3) = 8.25, P < 0.05). In addition, t-tests comparing the PTSD and non-PTSD groups showed significant differences in 3 out of 5 AQ sub-scales: social skill (t(37) = –2.12; P < 0.05), attention switching (t(37) = −2.09; P < 0.05) and communication (t(37) = −2.80; P < 0.01). Thus, higher AQ scores were reported by those in the PTSD group.

ASD may serve as a significant risk factor for post-traumatic symptomatology. The associations between these two conditions may be mediated by a variety of potential shared vulnerabilities, including increased rumination, dysregulated emotion and impaired social cognition. Further research is needed in order to explore these mechanisms, as well as to assess co-morbidity in clinical samples of both ASD and PTSD.

The authors have not supplied their declaration of competing interest.

There is an evidence indicating that women experiencing intimate partner violence (IPV) quite common suffer from anxiety and depression, but predictors and protective factors are not well known in this group of patients.

The aim of the study was to try to find factor that are connected with higher rates of anxiety and depressive symptoms in the group of female patients experiencing IPV.

The study was conducted in six randomly selected centers of primary health care (PHCs) in Lublin province. One hundred and two female patients experiencing IPV were administered a structured questionnaire and the Hospital Anxiety and Depression Scale (HADS). The sequential models were created with using backward stepwise multiple regression to investigate potential risk and protective factors connected with higher rates of anxiety and depression symptom in the group.

In a study group, 68% in Anxiety Subscale(A) and 56% in Depression Subscale of HADS (D) had positive scores. Living in the country (P = 0.003) was connected with higher scores in HADS-A (P = 0.003) but not in HADS-D. Experiencing physical violence was connected with higher score in HADS-D (P = 0.005), but not in HADS-A. Chronic physical illness (A P = 0.013; D P = 0.015), being unemployed (A P = 0.024; B P = 0.008), and experiencing economic violence (A P < 0.001; D P = 0.001) were connected with higher stores in both Subscales of HADS. Taking financial support (A P = 0.002, D P = 0.003) was the protective factor for both kinds of symptoms.

Socio-economic factors have stronger influence on anxiety and depressive symptoms in women experiencing IPV than demographic factors.

The authors have not supplied their declaration of competing interest.

Rare diseases are chronically debilitating, possibly impairing the quality of life both of the patient and of his parents.

To examine the quality of life and the coping strategies of the parents of children affected with rare diseases comparing 30 mothers and 25 fathers of children affected by rare diseases with 30 mothers and 26 fathers of non-rare chronic diseases. Anxiety, depression, coping strategies, satisfaction about their life are assessed.

All the subjects are interviewed and undergo an evaluation with the self-report tools Satisfaction With Life Scale, Profile of Mood States, COPE, Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. The data are analyzed using the statistical package SPSS.

Our results show that subjects having children with rare diseases experience more anxiety, but not a more severe depression, worse psychological well-being and have more difficulties to face the daily living. Comparing the mothers and the fathers of children with rare diseases, the first group show higher scores in HRSA.

So the feature of uncertainty of a rare disease in terms of aetiology, course and treatment can be associated with a more severe impact on the parents’ psychological end emotional well-being.

The purpose of this study is to examine the factors which influence schizophrenia patients’ levels of insight and functional remission.

In this study, 70 outpatients between the ages of 18–65 who applied to the Karadeniz Technical University Psychiatry Clinic and were diagnosed with schizophrenia according to DSM-IV were evaluated. Patients who have disease which affects the central nervous system, whose CGI disease severity score is above four, who were taken as inpatients to the hospital in the last two months were excluded from the study. The patients were evaluated by using socio-demographic data collection form, clinical interview structured for DSM (SCID-I), the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), the Functional Remission of General Schizophrenia Scale (FROGS), Schedule for Assessing the Three Components of Insight (SAI-E) and cognitive test battery.

Patients SAI-E levels were found to be correlated with the PANSS, Stroop Test (ST), Controlled Word Association Test (FAS) and Trail Making Test (TMT) A-B scores. In the regression analysis, FAS scores were the predictor of SAI-E total scores .The FROGS functional levels of patients were found to be related with occupational status, gender, age of onset illness, comorbid psychiatric illness, PANSS, CDS, SAI-E, FAS, TMT, ST and Wisconsin Card Sorting Test scores. In the regression analysis, occupational status, comorbid obsessive compulsive disorder, PANNS negative and general psychopathology and FAS scores were the predictors of patients’ functional status.

The effect of cognitive functioning and insight on the patients’ level of functionality is prominent.