Qualitative research has been met with growing interest in recent years. Several trends in medical and psychiatric practice, including patient orientation, the recovery movement and the search for evidence-based psychotherapeutic interventions, have propelled scientific inquiry into subjective perspectives on experiencing mental health problems, their consequences, and psychiatric services. While initially largely criticised as lacking scientific rigour, the value of qualitative research has increasingly been recognised, following a certain disenchantment with genetic research, the acknowledgement of methodological limitations in measuring subjective constructs such as needs, quality of life or stigma with standardised tools, and the definition of clear quality criteria for qualitative studies.

Multiple databases (Ovid Medline, PsycINFO, PsychLit, Cochrane Reviews) were scanned for relevant publications in the period from 1990 to 2007.

A proliferation of qualitative literature could be noted, especially from 2000 onward. Published research focuses on patients’ and caregivers’ experiences of mental health problems (subjective illness models, stigma, help-seeking motivations) and of using mental health services (expectations, empowerment, service evaluation). Among mental health professionals, experiences of service provision (service development, job motivation, stress & burnout) were studied.

Qualitative methods are becoming an integral part of the methodological canon of psychiatric research. This presentation gives an overview of publication trends regarding topics covered, journals featuring qualitative papers, and methodological quality criteria. It further focuses on fields of application for qualitative vs. quantitative methods and discusses specific requirements on scientific writing in publishing qualitative data.

Anorexia nervosa (AN) is characterized eating behaviors and body image disturbances. Given poor treatment outcomes are available for AN, treatment innovations are urgently needed. Recently, non-invasive neuromodulation tools have suggested having potential for reducing AN symptomatology targeting brain alterations.

The objective was to verify whether an excitatory transcranial direct current stimulation (tDCS) over the left prefrontal cortex may aid in altering/resetting inter-hemispheric balance in AN patients, re-establishing control over eating behaviors.

Research is aimed to evaluate the potential of tDCS treatment in determining a more rapid improvement compared to classical treatments in adolescents with AN.

Twenty-two adolescents with AN, underwent the treatment as usual (AU) plus the tDCS treatment (TDCS + AU: n = 8, age M 13.7 ± 1.9 years) or a family therapy (FT + AU: n = 14, age M 15.1 ± 1.75 years), for six weeks. Psychopathological scales (EDI-III, EAT 26, BUT, MASC, CDI) and anthropometric indicator of nutritional status (BMI) were assessed before and after treatment.

BMI improved only in the TDCS + AU group (P < 0.01). Mean BMI percentage of improvement was 14.43% + 10.8 in the TDCS + AU and 4.83% ± 5.4 in the FT + AU. Both groups improved in the total scores of the EDI, EAT-26, MASC and CDI scales (all P < 0.01).

tDCS treatment improved BMI values more than classical treatment and determined comparable to the classical treatment improvement in the psychopathological scales. This results may be an important starting point to further explore the beneficial effect of brain based treatments for AN.

The authors have not supplied their declaration of competing interest.

Text analysis can significantly enrich ideas about the functioning of the psyche in mental illness.

The purpose of this study was to identify the linguistic features of texts written by people with schizophrenia spectrum disorders and to study the relationship between them and the personality traits and indicators of the standard of living of patients.

Twenty-nine patients with schizophrenia spectrum disorders (F20, F21, F23, F25 according to ICD-10) and 37 without mental disorders participated. All participants wrote a text on a given topic and filled in psychodiagnostic methods: a short version of the Big Five method (TIPI-RU), Q-Les-Q, and MOS SF-36. The text was analyzed using the phpMorphy morphological analysis library.

A comparative analysis showed that in the speech of patients, there are fewer adjectives and more verbs than in the speech of healthy subjects (p<0.05) and that the volume of speech production in patients is significantly reduced (<0.001). The results of correlations of such data with the volume of words were contradictory. A statistically significant inverse relationship was found between the verbality index and the factors of extraversion and openness to experience in the clinical group. As for the indicators of quality of life, expectedly positive correlations between the use of adjectives and negative correlations of the use of verbs with the quality of life were revealed.

Studying the linguistic features of the speech of patients with mental disorders is essential. These indicators can be helpful in the diagnosis and treatment of the disease.

None Declared

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.

The people who maintain close relationships with relatives suffering from addiction to psychoactive substances may become more sensitive to develop a physical, mental and emotional state, similar to an emotional addiction.

The aim of this study is to give a cross-cultural perspective to codependence and reveal the profile of female relatives of addicted persons in Greece and Bulgaria.

Thirty-nine Greek mothers of addicted persons from Greece (Mage = 43.97, SDage = 18.34, all high school graduates), a similar group of forty Greek female participants (32 mothers of non-addicted persons, Mage = 40.97, SDage = 17.22, all high school graduates), and thirty Bulgarian women (all mothers of addicted persons, Mage = 53.55, SDage = 5.58, all high school graduates) were examined with the STAI-state questionnaire, the ZUNG Self Rating Depression Scale and the Questionnaire of Establishment of Codependency.

Results indicated that there are statistically significant differences between the Greek and the Bulgarian female relatives of addicted persons on the scores ofZUNG (MGreek = 51.64, SDGreek = 2.07, MBulgarian = 73.63, SDBulgarian = 4.04) and STAI (MGreek = 53.89, SDGreek = 2.68, MBulgarian = 74.16, SDBulgarian = 4.84), but not for the Questionnaire of Establishment of Codependency. Statistically significant differences in all three questionnaires were found for the groups of Greek mothers of dependent and non-dependent persons (P < .005).

This research suggests that although there is more anxiety and depression reported by the Bulgarian mothers of addicted persons, no cross-cultural difference was found for codependence in mothers of addicted persons.

The authors have not supplied their declaration of competing interest.

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.

Brain-derived neurotrophic factor (BDNF) plays an important role in depression and sleep disorders. It influences the inflammatory process and may affect the interactions between psychological state and gastrointestinal symptoms.

The study aimed to compare BDNF concentrations in the group of Crohn’s disease (CD), ulcerative colitis (UC) patients, and healthy control (HC), as well as to correlate it with the severity of depression and insomnia.

The study included 94 inflammatory bowel disease patients (IBD, 57 CD, and 37 UC) and 26 HC. Each participant completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Beck Depression Inventory (BDI). BDNF protein concertation measurements were performed using ELISA. Funding: National Science Centre, Poland-2018/31/N/NZ5/03715.

CD patients had a higher serum level of BDNF (22.5 ng/mL, IQR:17.5-28.5) than UC patients (19.1 ng/mL, IQR:12.3-24.6; p=0.045). CD group had higher BDNF concentrations than HC (17.5 ng/mL, IQR:13.2-23.8; p=0.010), but no such differences were found between UC and HC groups (p=0.544). A positive correlation was found between AIS and BDNF among IBD (r=0.22, p=0.035). Additionally, patients, who obtained high BDI scores (>7 points) had lower BDNF concentrations than others (p=0.004). The patients with long sleep latency (>10 min) achieved a higher BDNF level than others (p=0.038). However. BDNF level did not correlate with PSQI results.

BDNF serum level is increased in CD, but not in UC patients. Overall, the severity of insomnia symptoms correlates positively with BDNF levels. Future research should focus on the further explanation of those observations.

In Correctional Institutions of Kosovo (CIK), the rate of suicide and attempted suicide is low (in the last six years have been six suicide).

Disturbing is the fact that during the period October 2007 to January 2009 at the Lipjan Detention Center (LDC) have been nine suicide and three attempted suicide, while in all other correctional institutions has not happened any suicide and only one attempted suicide. This level is to high when we consider the fact that the capacity of LDC is approximately 200 prisoners, while in all other correctional institutions have about 1500 prisoners.

The objective is to find reasons for such a high level of suicide and attempted suicide in LDC.

The aim is to return the low level of suicidal behavior in LDC.

Mapping:

1. 1. Survey documentation

2. 2. Interviews

3. 3. Focus groups

1. 1. Lack of detection of cases at risk for suicide during admission.

2. 2. Inadequate administrative and health management.

3. 3. Insufficient communication between staff and prisoners

Better management in early detection of cases Creation of a multidisciplinary team for management of cases referred as risky for suicide

Recent research has shown that adiponectin levels in patients with schizophrenia vary similar to the general population. Moreover, antipsychotic medication may influence adiponectin levels, independent of metabolic parameters. We hypothesise different antipsychotics might vary in their effect on adiponectin levels independent of BMI and metabolic syndrome (MetS) status.

113 patients, with similar baseline demographic and metabolic characteristics, received either risperidone (n=54) or olanzapine (n=59). They were followed prospectively for 12 weeks. Adiponectin levels as well as general metabolic parameters were measured at baseline, 6 weeks and 12 weeks.

We observed a significant treatment by time interaction, showing an adiponectin increase in the risperidone treated patients and an adiponectin decrease in olanzapine treated patients. This effect was independent of BMI and the presence/absence of the metabolic syndrome. There was a significant association between fall in adiponectin and increase in waist circumference in the Olanzapine treated group (Figure 1).There was no change in HOMA-IR as a measure of insulin resistance in either group.

We observed a differential effect of antipsychotic treatment (risperidone vs olanzapine) on adiponectin levels over time, independent of BMI (and MetS) suggesting an effect of olanzapine on adipose tissues, similar to what has been observed in animals models. The effects on adiponectin levels may partly explain the increased rates of obesity with Olanzapine.

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.

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.

Several cases of transient acute depression or manic symptoms are reported in the literature after bilateral subthalamic nucleus (STN) deep brain stimulation in patients with Parkinson's disease. Different hypothesis involve premorbid personality disorders, thymic past history or subthalamic nucleus.

We elaborate a one year prospective study to evaluate mood disorders frequency and physiological mechanisms of 20 Parkinsonian patients treated by bilateral STN stimulation. Evaluation consists of pre and post-operative psychiatric interview and scales assessing depression and mania.

At the present time, 18 patients have been operated, 17 have finished the program. Meaning age of patients: 63,1 years ± 7,3, with 5 women. No significant differences between men and women age, and duration of Parkinson disease (11,9 ± 4,4), were found (n=18).

One month before surgery, MADRS, Bech and Beck means (n=18) are respectively: 7,2 ± 4,2; 1,3 ± 1,6; 6,4 ± 3,5. At 3 months after surgery means (n=18) are: 3,9 ± 3,8; 1,1 ± 1,6; 3,1± 2,6. At 6months after surgery means (n=17) are: 6,7 ± 4,8 ;0,65 ± 1,1 ; 3,80 ± 2,6.

One patient, 70 years old, has presented a hypomanic-like episode post-operatively ; one other patient, 68 years old, presented a major anxio-depressive episode one month post-operatively (DSM-IV criteria). One patient, 53 years old, presented a moderated anxio-depressive episode, 6 months after surgery.

Data are still on analysed, but these cases draw our attention to the effects of STN stimulation on mood and behavioural disorders.

Assess prevalence and clinical relevance of 'with mixed features” using a more liberal (2 opposite pole symptoms) compared to the more conservative DSM-5 (3 opposite pole symptoms) threshold in depressed bipolar disorder (BD) patients.

BD outpatients were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Prevalence and clinical correlates of baseline depressive episodes 'with mixed features” were compared using a more liberal threshold and the more conservative DSM-5 threshold.

Among 503 BD patients, 151 (30.8%) had baseline syndromal major depressive episodes, among whom 'with mixed features” occurred in 22.5% (34/151) using a more liberal threshold, but in only 9.9% (15/151) using the more conservative DSM-5 threshold. Hence, the rate of 'with mixed features” for depressive episodes using the more liberal compared to the conservative threshold was more than twice (2.3 times) as high (Chi-square=8.8, p=0.004). Moreover, the more liberal threshold yielded more important statistically significant clinical correlates of 'with mixed features” compared to pure depressive episodes, which were not significant using the more conservative DSM-5 threshold. Specifically, using the more liberal threshold, mixed compared to pure depression was associated with more anxiety disorder comorbidity and alcohol use disorder comorbidity, and less antidepressant use.

Further studies are warranted to assess our preliminary observation that a more liberal 'with mixed features” threshold for bipolar depression may be more inclusive and have more clinical relevance.

Individuals with serious mental illness (SMI) are at considerably higher risk for morbidity and mortality than those in the general population. In these diagnoses – a refinement of intervention is required, the user perspective overall is still underrepresented.

In mental health Services there is an international trend toward recovery-orientated interventions, like Peer-support (PS) in formal mental health services. There is a raising but still insufficient evidence for it's benefits

In Germany this is the first try to implement and research peer support services area-wide in psychiatric facilities to provide a low-threshold service that aims individual recovery. This project forms a part of 'psychenet ', a project supported by the Federal Ministry of Education and Research of Germany during 2011 – 2014 and investigates the effect of peer support on psychosocial factors, functioning and hospital admissions.

In a controlled multi-centre-trial involving 10 hospital facilities in Hamburg − 216 in- and outpatients suffering from affective disorders, psychoses or personality disorders get randomized to either receive additional Peer-Support at most half a year aligned to individual requirements or treatment as usual. A mixed method repeated measurement analysis is conducted.

Subjects refill questionnaires and get rated by clinicians at three points of measurement: Entry of the half year of intervention, after the intervention and in a six month follow up. Psychosocial Outcomes, global functioning, and in and outpatient days were assessed. There is a significant positive Effect for the PS of the primary outcome. Results will be presented