Adolescent suicide and suicide attempts (SA) present a complex and multifactorial problem that deserves special attention. Identifying particularities of suicidal behavior in this age group is essential in order to identify suffering adolescents.

To determine the characteristics of adolescent suicide attempts compared to those of adults.

It was a retrospective study carried out on a clinical population who consult in the psychiatry department at the Gabes regional hospital during the period from January 1st, 2020 to September 30, 2020. Sociodemographic and clinical data of the patients as well as their family dynamics, their education, their personal and family history, characteristics of the SA and psychiatric symptoms preceding the act were assessed. We compared two subgroups: patients aged 10 to 19, and those aged 20 and over.

278 suicide patients were included. 101 of them were adolescents (10 -19 years), of which 89 (88.11%) were female. Mean age of suicidal adolescents was 16.5 years. They were mostly living with their families (92.07%). Intentional drug ingestion was more common in adolescents (81.1%) than in adults (40%). Adolescent suicide attempts were correlated with a conflictual family environment (p=0.04), exposure to mistreatment (p=0.001), the absence of underlying mental disorders (p<10-3), the presence of academic difficulties (p<10-3) and the presence of a precipitating factor such as family conflict (p<10-3) or school failure (p= 0.004).

A good knowledge of the particularities of suicidal behavior in adolescents is preliminary to support an effective preventive measure targeting both family and school environment

The authors have not supplied their declaration of competing interest.

Involuntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.

The purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.

Three hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.

Two hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).

The best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.

The authors have not supplied their declaration of competing interest.

The extent to which social media contributes to body image dissatisfaction and lower self-esteem is currently under debate

This research seeks to study the relationship between the use of Instagram (one of the main platforms used by young people nowadays) and the degree of dissatisfaction with body image and the level of self-esteem among their younger users

A sample of 585 Spanish adults between 18 and 40 years old was used, to whom the Body Shape Questionnaire (BSQ), the Rosenberg Self-esteem Scale and the Social Comparison of Appearance Scale (PACS) were applied.

A positive correlation was observed between the frequency of use of the social network and dissatisfaction with body image and low self-esteem. In addition, it was found that content observation time significantly predicts body dissatisfaction and low self-esteem. On the other hand, the type of content both published and observed, showed no effect on any of these variables, although it has been found that the relationship between the use of the platform and the study variables seems to be mediated by the tendency of their users to compare their appearance with others.

These results invite us to reflect on the use of social networks and their impact on constructs as relevant to the person as self-esteem and body image and on how different policies should be taken into account to prevent a negative impact on the mental health of their users

No significant relationships.

Suicide is a major public health problem, especially in young people. It is one of the most significant causes of mortality and potential years of life lost. Medical students are a vulnerable group presenting mental health problems.

To study the prevalence of common mental illnesses among medical students from the university of Valladolid in order to assess the need for intervention programs.

Cross-sectional study in which, 584 students participated during the academic year 2015–2016 by completing an online self-administered questionnaire. Mental health outcomes were measured by different batteries of depression, anxiety and suicide (BDI, GAD-7 and MINI). Information about possible related risk factors was also obtained. Statistical Chi2 and Student t-tests were applied to estimate associations between socio-demographic, socioeconomic data and clinical results.

We found a prevalence of 15.8% for depression, 11.6% for ideation suicide and 38.5% for anxiety, with gender differences in the latter case. Prevalence rates were higher than those described in general population. Compared to other international studies, prevalence estimates were also higher among our sample.

This study shows for the first time data of these three psychiatric disorders among medical students in Spain. It suggests the urge to implementing preventive activities to alleviate maladaptive behaviors, academic stress, improve the quality of life and adaptation of students to college life. Larger, prospective, multicentre studies are needed to draw conclusions about the causes and consequences of students’ stress, since evidence shows that mental health problems are perpetuated throughout professional performance.

The authors have not supplied their declaration of competing interest.

In Denmark, about 14% of patients with depression develops treatment resistant depression (TRD) in the following year after the first hospital contact. Possible explanations for TRD include lack of adequate clinical effect of pharmacological treatment and reluctance to treatment due to unacceptable side effects. Cold water swimming (CWS), also known as winter swimming, describes swimming outdoors - mainly during the winter season in cold to ice-cold water on a regular basis. Many winter swimmers believe that exposure to cold water is beneficial for their health. However, evidence of health effects have been anecdotal or based on results from small sample-size studies. The availably studies report that winter swimming abolishes general tiredness, boosts self-esteem and improves mood and/or general well-being.

To test if it is possible for patients with depression to participate in two weekly sessions of CWS and to measure the effects of CWS on general well-being and depression among the participating patients.

All psychiatric in- and outpatients from the department of psychiatry at Little Belt Hospital, Vejle with a diagnose of depression are eligible for inclusion. CWS-sessions will include a dip in an inlet - and if desired a short swim for a few minutes – depending on individual preferences. The CWS sessions will take place at the local inlet at a recreational area with sauna and changing facilities available.

The study starts in October 2021 and we expect to have results by April 2022.

Conclusion: Awaiting.

No significant relationships.

Observations from different fields of research coincide in indicating that a defective gamma-aminobutyric acid (GABA) interneuron system may be among the primary factors accounting for the varied clinical expression of schizophrenia. GABA interneuron deficiency is locally expressed in the form of neural activity desynchronization. We mapped the functional anatomy of local synchrony in the cerebral cortex in schizophrenia using functional connectivity MRI.

Data from 86 patients with schizophrenia and 137 control subjects were obtained from publicly available repositories. Resting-state functional connectivity maps based on Iso-Distant Average Correlation measures across three distances were estimated detailing the local functional structure of the cerebral cortex.

Patients with schizophrenia showed weaker local functional connectivity (i.e., lower MRI signal synchrony) in (i) prefrontal lobe areas, (ii) somatosensory, auditory, visual, and motor cortices, (iii) paralimbic system at the anterior insula and anterior cingulate cortex, and (iv) hippocampus. The distribution of the defect in cortical area synchrony largely coincided with the synchronization effect of the GABA agonist alprazolam previously observed using identical functional connectivity measures. There was also a notable resemblance between the anatomy of our findings and cortical areas showing higher density of parvalbumin (prefrontal lobe and sensory cortices) and somatostatin (anterior insula and anterior cingulate cortex) GABA interneurons in humans.

Our results thus provide detail of the functional anatomy of synchrony changes in the cerebral cortex in schizophrenia and suggest which elements of the interneuron system are affected. Such information could ultimately be relevant in the search for specific treatments.

There are disparities in mental health services (MHS) utilization within and between populations and several factors are studied as its potential correlates. Identifying those correlates would help health policy makers to adjust service provision with characteristics of their community.

To evaluate demographic, socioeconomic and system correlates of MHS utilization among married women from Tehran, Iran.

A household survey of 615 married women residents of 22 municipal districts of Tehran selected via a cluster sampling method. All subjects were asked about health services utilization during last one and 12 months as well as need and access for MHS, demographic and socioeconomic factors. Independent correlates of MHS use were determined with logistic regression analysis.

Total 615 women, mean±SE age and duration of marital life of 42.6±0.9 and 22±0.8 years, respectively were selected, rate of MHS utilization during last one and 12 months were 5.2% and 10.1% respectively. 23.6% of women reported having mental illness and 19.3% and 17.9% had need for MHS and access to outpatient health services, respectively. Logistic regression models showed that need for MHS (OR:5.25, 95%CI:2.7–10.1), access to outpatient services (OR:2.17, 95%CI:1.04–4.52), smoking (OR:3.4, 95%CI:1.16–10.2) and crowding index (OR:0.69, 95%CI:0.48–0.99).

Rate of MHS utilization in women are low considering the near to estimated rate of perceived illness. Bridging the gap between perceived illness and need for services, then providing better access to services in areas with higher crowding index and higher rates of smoking in residents should considered in any mental health promotion programs.

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).

To determine the comorbidity of mental disorders in patients on MMT.

The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.

The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.

Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.

With most mental health disorders emerging in the later teenage years, university students are arguably an at-risk population with increased mental health support needs. This population is characterised by important, life-changing transitions (moving away from home, friends and family) and new potential stressors (including increased academic pressures and relational challenges). Research to examine determinants of mental health help-seeking behaviours in university students is needed to ensure emotional health needs are being met at this critical time.

To examine levels of psychological distress and mental health help-seeking behaviours in a sample of UK university students. By identifying factors associated with help seeking, we can better understand the mental health needs of this population and inform support provision.

This study draws on data from the social and emotional well-being in university students (SoWise) study, an online survey which aimed to examine risk and resilience for social and emotional well-being in young people attending a UK university.

Whole sample analysis (n = 461) showed help seeking was significantly associated with psychological distress, current life stressors and anxious attachment and not associated with perceived mental health stigma. Sub-group analysis (n = 171) suggests being female and older significantly predicted help seeking in students with mild/moderate psychological distress.

Younger males with mild/moderate psychological distress are less likely to seek mental health support and represent an “invisible” at risk group. Results also suggest that global anti-stigma campaigns in universities may not prove effective in encouraging help seeking.

The authors have not supplied their declaration of competing interest.

The current investigation assessed a) the performance of the FOCUS ADHD mobile health application (App) in increasing pharmacological treatment adherence and improving patients’ knowledge of attention-deficit/hyperactivity disorder (ADHD) and b) the impact of implementing a financial incentive for using the App (i.e., a discount on medication).

In a randomized, blind, parallel-group clinical trial, 73 adults diagnosed with ADHD were allocated into three groups for 3 months: a) Pharmacological treatment as usual (TAU); b) TAU and the App (App Group); and c) TAU and the App + a commercial discount on the purchase of medication prescribed for ADHD treatment (App + Discount Group).

There was no significant difference in mean treatment adherence between groups, assessed as a medication possession ratio (MPR). However, the App + Discount Group exhibited greater medication intake registrations compared with the App Group during the initial phase of the trial. The financial discount also produced a 100% App adoption rate. App use did not increase ADHD knowledge, though knowledge scores were high at baseline. The usability and quality of the App were rated favorably.

The FOCUS ADHD App achieved a high adoption rate and positive evaluations by users. Use of the App did not increase adherence to treatment as measured by MPR, but, for App users, the addition of a financial incentive to use the App produced an increase in treatment adherence in terms of medication intake registrations. The present results offer encouraging data for combining incentives with mobile digital health solutions to positively impact treatment adherence in ADHD.

There has been a rapid influx of 30,000 Syrian refugees in Canada, many are women of childbearing age, and most have young children. The literature reports that refugee women are almost 5 times more likely to develop postpartum depression than Canadian-born women. However, little is known about the experiences that the Syrian refugee women have encountered pre- and post-resettlement and their perceptions of mental health issues in general, and of maternal depression in particular. Thus, there is an urgent need to understand the refugee women's experiences of having a baby in Canada from a mental health perspective.

Participants include Syrian refugee women who migrated to Saskatoon Canada in 2015–16 and who were either pregnant or up to one year postpartum. Qualitative data was collected via a focus group with thematic analysis, while depression with Edinburgh Postnatal Depression Scale (EPDS) and PTSD screening and sociodemographic descriptive data were collected from a structured questionnaire to provide context for the qualitative analysis.

Twelve women participated in the focus group, despite smiling often, 58% of them screened as probable depression (EPDS > 10), 25% screened positive for depression (> 12 on EPDS), and 17% screened positive for PTSD. None of the women indicated intimate partner violence or suicidal thoughts. All participants indicated social support, mostly partner, and 25% had a history of depression. Thematic analysis will be shared.

Perinatal Depression is a serious problem for refugee women that deserve more in-depth study to ensure optimal outcomes and to develop services and programs.

The authors have not supplied their declaration of competing interest.

Internet gaming is acknowledged as a common leisure activity among adolescents yet only a little known about the pscyhodevelopmental roots. Emotion recognition and metacognition which are proved to be determinants in behavioral disorders may be considered salient factors in also internet gaming disorder (IGD).

The research to date has focused on psychological comorbidities rather than risk factors (e.g. dysfunctional metacognitive beliefs, emotion recognition deficits), whereas, improved early intervention would be more likely if risk factors were well defined, especially before the onset of the illness. The objective of this study was to investigate these areas by analyzing associations between metacognitive beliefs, emotion recognition, and IGD among late adolescents with tendency for pathological gaming behavior.

806 high school students were recruited and instructed to take Internet Gaming Disorder Scale (IGDT), Meta-Cognitions Questionnaire for Children and Adolescents (MCQ-C) and Reading the Mind in the Eyes Test - Children’s Version (RMET).

Mean comparisons corresponding to IGD risk potential showed that positive meta-worry and superstitious, punishment, and responsibility beliefs of MCQ-C were significantly higher in the risky group, whereas; RMET neutral subtest was significantly higher in the non-risky group. Additionally, a positive correlation was found in all subtests of MCQ-C, RMET positive emotions and IGD. Regression analysis revealed that RMET positive subtest and positive meta-worry of MCQ-C predict IGD risk.

The findings of the study partially corroborated the early results found among early adolescents; however, they also indicated the requirement of distinct therapeutic approach for cognitive interventions of IGD in late adolescence period.

No significant relationships.

There is a huge need to search for new treatment options for depression but as well as its comorbidities. Particularly, depression and metabolic abnormalities often coexist, while a pathophysiological overlap, including microbiota changes, may play a role. Thus, the trials of microbiota interventions (e.g., probiotics) may establish a safe and easy-to-use treatment option as an adjunctive therapy in patients only partially responsive to pharmacological treatment.

The paper presents preliminary results of an RCT on the effect of probiotic supplementation on depression, anxiety and stress level, anthropometric, metabolic, and inflammatory parameters in adult patients with depressive disorders.

The trial was a two-arm, parallel-group, prospective, randomized, double-blind, controlled design that included 43 participants and lasted 60 days. The probiotic preparation contained Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 in the amount of 3 × 109 colony forming units (CFU). We assessed depression level with Montgomery-Asberg Depression Rating Scale (MADRS), depressiveness, anxiety and stress level with 21-item version of Depression, Anxiety and Stress Scale (DASS-21), quality of life, blood pressure, body mass index and waist circumference, complete blood count, serum levels of C-reactive protein, high-density lipoprotein cholesterol, triglycerides, fasting glucose, selected secondary markers of inflammation and metabolic risk, as well as noninvasive biomarkers of liver fibrosis (APRI and FIB-4).

There were no differences in sociodemographic traits and psychometric questionnaires scores, as well as in anthropometric and basic laboratory findings between placebo and probiotic group at the start of the intervention period. Interestingly, there was a statistically significant improvement in MADRS score in both, placebo (p=0,010) and probiotic group (p=0,037) after intervention (see figure). The same finding was observed in total DASS-21 score as well as anxiety subscale of DASS-21. However, there were no differences in anthropometric, inflammation or metabolic laboratory parameters at the end of the study regardless of intervention.

Image:

Whilst probiotics may benefit some individuals who do not fully respond to antidepressant medications, our study did not show the superiority of probiotics over placebo in managing depressive and anxiety symptoms. However, the target clinical sample, as well as the intervention period and dosage of preparation for this intervention is not fully recognized. Moreover, larger clinical sample may be needed to detect differences between placebo and probiotics.

None Declared

The aim of this study was to assess the course of quality of life and emotional status outcomes during the six months after elective CABG.

In a prospective study, we followed up for 6 months 138 of the original 147 CABG patients. A series of psychometric self - rating scales were administered.

The ratings obtained from the BDI reflected significant decreases in levels of depression from preoperative to 6 - month follow - up assessments (before surgery = 6.5 ± 4.9; at 6 - month follow - up = 4.6 ± 4.7; p < 0.001). The PTSS - 10 ratings from the whole sample reflected significant decreases in levels of PTSD symptoms from preoperative to 6 - month follow - up evaluations (before surgery = 18.2 ± 6.7; at 6 - month follow - up = 17.3 ± 8.0; p < 0.01). The measurements of health - related quality of life indicated significantly higher SF - 36 values on all of the eight health - related domains from preoperative to 6 - month follow - up. However, at 6 - month follow - up, patients with clinical depression and posstraumatic stress symptoms had significantly lower SF - 36 values on a variety of SF-36 domains.

Elective CABG is associated with significant improvements in HRQOL relative to the preoperative period, but impairments in HRQOL were found in a subgroup of post - CABG patients with evidence of PTSD, or depression at 6 - month follow - up.

The motivation of the patient may affect response to treatment and prognosis.

The objective of this study was to compare the various types of application of patients in terms of their motivation and sociodemographic variables.

To demonstrate that patients who apply for treatment themselves have greater motivation and less depression and anxiety.

Patients who applied or were referred for treatment of addiction to the Elazig Hospital for Mental Disorders were included in this study. Patients diagnosed according to DSM-IV criteria, giving written informed consent and who did not have severe comorbid psychopathology were enrolled. Beck Depression and Anxiety Scales, and Motivation for Treatment Scale (MfT) were used in evaluation. p was set at 0.05.

Forty five male patients with a mean age of 37.9 (S.D. 11.2) were enrolled in the study. The mean scores for Beck Depression and Anxiety Scales and the Motivation for Treatment Scale were 27.7 (S.D. 12.8), 25.2 (S.D. 15.2) and 67.4 (S.D. 11.4); respectively. When the socio-demographic and clinical variables of the patients who applied voluntarily and those who were referred for treatment involuntarily were compared by Mann-Whitney U test, only the total score on the Motivation for Treatment Scale as well as those of its subscales for seeking help and being ready for treatment differed betwen groups (p: 0.01, 0.05 and 0.01; respectively).

Types of application for treatment may affect levels of motivation in patients for treatment. Techniques for motivational interview may especially be important for patients applying involuntarily.

Non-psychotic axis I diagnoses are highly prevalent in at-risk mental state (ARMS) and first episode psychosis (FEP) patients, the most common being affective and anxiety disorders. Few studies have examined differences between ARMS and FEP patients or gender effects regarding such diagnoses.

To examine current and lifetime comorbidities in ARMS and FEP patients. Furthermore, to examine gender differences, and differences between patients with (ARMS-T) and without later transition to psychosis (ARMS-NT).

This study was part of the Früherkennung von Psychosen (FePsy) study. Current and lifetime axis I comorbidities were assessed using the Structured Clinical Interview for DSM-IV (SCID-I).

One hundred and thirty-two ARMS and 98 FEP patients were included. Current comorbidities were present in 53.1% of FEP and 64.4% of ARMS patients, the most common being affective, anxiety and substance use disorders. Current affective disorders were significantly more common in ARMS than FEP. Lifetime comorbidities were diagnosed in 58.2% of FEP and 69.7% of ARMS patients, with significantly more affective and anxiety disorders in ARMS than FEP. Male FEP patients had more current and lifetime substance use disorders (across all substances) compared to female FEP. No differences emerged between ARMS-T and ARMS-NT.

As expected ARMS patients have many comorbidities, while clearly diagnosed FEP have less comorbidities. There were few gender differences in axis I comorbidities. Moreover, no differences between ARMS-T and NT emerged, suggesting that axis I comorbidities do not improve prediction of transition. Nevertheless, the high comorbidity prevalence is relevant for global functioning and clinical treatment.

The authors have not supplied their declaration of competing interest.