Although male and female patients with major depression (MDD) differ in psychopathology and other illness characteristics, a potentially confounding effect of gender has not been systematically controlled or investigated in most of the previous neuroimaging studies.

We investigated activation patterns during processing of ambiguous stimuli in MDD by functional MRI.

We aimed at examining potential activation differences between male and female patients.

A matching task was employed in which two stimuli with varying degrees of perceptual uncertainty had to be compared with respect to their sameness. Eighteen patients meeting DSM-IV criteria of MDD and eighteen healthy control subjects participated in this study.

Whereas on the level of behavioral performance no significant group differences could be detected we found distinct disorder- and gender-related differences in the brain activation. Patients activated significantly stronger in superior parietal, prefrontal and cingulate regions. Gender specific analyses revealed that the hyperactivity in the patient group was mainly attributable to hyperactivity in the male patients who activated significantly stronger than the female patients in an extensive fronto-temporo-limbic network, which partly overlapped with the network we found when comparing patients and healthy controls.

Our results indicate that male patients seem to be reliant on a significantly stronger metabolism in task-relevant regions to maintain an equal level of performance.

The present results provide evidence for gender-related differences in the functional organization of the brain in patients with MDD. Gender differences should be taken into consideration when investigating the neural correlates of MDD.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Second-generation antidepressants dominate the medical management of major depressive disorder (MDD). Two published CERs provide conflicting evidence about the comparative efficacy and safety of second-generation antidepressants for the treatment of MDD.

To compare the benefits and harms of bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine for the treatment of MDD in adults.

We updated a CER published in 2007 by the Agency for Healthcare Research and Quality searching MEDLINE, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two persons independently reviewed the literature, abstracted data, and rated the risk of bias. If data were sufficient, we conducted meta-analyses of head-to-head trials of the relative benefit of response to treatment. In addition, we conducted mixed treatment comparisons to derive indirect estimates of the comparative efficacy among all second-generation antidepressants.

Overall, no substantial differences in efficacy could be detected among second-generation antidepressants. Statistically significant differences in response rates between some compared drugs are small and likely not clinically relevant. Differences exist in the incidence of specific adverse events and the onset of action. Venlafaxine leads to higher rates of nausea and vomiting, sertraline to higher rates of diarrhea, and mirtazapine to higher rates of weight gain than comparator drugs. Bupropion caused lower rates of sexual dysfunction than other antidepressants.

Our findings indicate that the existing evidence does not warrant the choice of one second-generation antidepressant over another based on greater efficacy and effectiveness.

Treatment resistant schizophrenia and other treatment resistant psychotic disorders are believed to be over-represented in forensic patient clusters. The true rates of treatment resistant psychoses in secure forensic hospitals remain unexplored.

This study aimed to ascertain the prevalence of treatment resistant psychoses within a complete national forensic mental health service. In addition, the study sought to examine the relationships between treatment resistance for psychotic symptoms and treatment resistance in other domains, such as offending behaviour.

This is a cross-sectional study of a complete cohort of patients admitted to the National Forensic Mental Health Service in Ireland during the period 01/11/2021 to 31/01/2022. All inpatients at the time of the study were included. Demographic details, data appertaining to diagnosis, medication, measures of risk (HCR-20), recovery (DUNDRUM toolkit), functioning (GAF), and symptoms (PANSS) were collated. Data were gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).

The sample consisted of 170 patients. Majority (n=162) 95.3% were male. The majority (n=116), 68.2%, were admitted from prisons, while a smaller number (n=35), 20.6%, were admitted from other psychiatric facilities. The insanity defense (n=94) 55.3% was the most common legal status, followed by unfit to plead (n=16) 9.4%. The commonest diagnosis was schizophrenia (n=97) 57.1%, followed by schizoaffective disorder (n=27) 15.9% and autism spectrum disorder (n=5) 2.9%. The mean age at admission was 35.52 years and the median age was 34.37 ± 9.43 SD.

Of the total sample, 25.9% of patients were on more than 1000 mg per day chlorpromazine equivalent (CPZE) doses. Those whose psychotic symptoms required treatment with CPZE doses over 1000 mg per day scored poorly on DUNDRUM-3 programme completion, DUNDRUM-4 recovery scale, HCR-20 historical, HCR-20 clinical, HCR-20 risk, HCR-20 dynamic, and had poorer overall functioning (all P<0.001) than those who required lower antipsychotic doses. On binary logistic regression, correcting for age and gender, the only variable that remained significant was GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P=0.014). In forward entry model regression, only the DUNDRUM-4 recovery scale (odds ratio = 1.13, 95% CI 1.07-1.19, P<0.001) and GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P<0.001) were significant. This model had a robust forward and backward likelihood ratio.

Rates of treatment resistant psychoses in forensic hospital groups are indeed elevated. Overall functioning on GAF and recovery across a wide range of components in the DUNDRUM-4 scale are the best predictors of treatment resistant psychosis.

None Declared

feeling of hopelessness (Beck depressive triad) may be a manifestation of depression, as well as predictor of suicidal behavior.

investigation of factors of hopelessness and loneliness in teenagers.

Beck Hopelessness Inventory (A. Beck), The UCLA loneliness scale D.W. Russell (version 3). Participants were 1499 schoolchildren (840 female and 659 male) aged from 14 to 18 years (medium age 15.7 years). 763 teens were surveyed before leaving for summer camp, 738 during the school year. 279 of 739 adolescents live in rural areas, 460 in Moscow.

A comparative analysis by gender, the time of the study and place of residence was conducted. Mean rates for Beck hopelessness and loneliness scale Russell were higher in the group of students than in the group of summer camp children (4.9, 4.0, P <.001 and 26.2, 23.07 P <.001). Girls were tend to “believe in their future” less than boys and feel more lonely and misunderstood. Teenagers living in rural areas were more likely to believe that they have “no hope for now and there is no reason to believe that they will in the future” (P <.025).

onset of feelings of hopelessness and loneliness during the school year, especially in undergraduates, due to the tightening of requirements for the graduation exams, increased pre-examination stress. Therefore we suggest the development of the system for preventing manifestations of hopelessness and loneliness, taking into account children’s age, gender and socio-demographic data.

To determine the association of anxiety related to Index of religious moral beliefs (IRMB) and quality of life (QoL) of war veterans in Bosnia and Herzegovina.

The sample consists of 59 male war veterans’ inpatients with clinically presented anxiety disorder and 45 controls that were observed as healthy regarding results of previous psychological testing. We applied the Bosnia-Herzegovina versions of Hopkins Symptom Checklist (HSCL-25), Harvard Trauma Questionnaire (HTQ), Manchester Short Assessment of Quality of Life (MANSA) and Religious moral beliefs questionnaire (RMBQ).

Anxious war veterans were older (mean ± standard deviation = 42.5 ± 7.2) years than not anxious (37.6 ± 3.6) (F = 61.605, P < 0.001, ANOVA). The trauma experiences' mean score of war veterans was (mean ± standard deviation) 33.5 ± 12.5 with significant statistical differences between anxious (38.3 ± 12.9) and not anxious war veterans (27.3 ± 8.7) (F = 24.734, P < 0.001, ANOVA). Among anxious war veterans IRMB was significantly lower 39.9 ± 4.8 than among not anxious war veterans (42.6 ± 3.9) (F = 7.788, P = 0.006, ANOVA). QoL was significantly lower amongst anxious 38.8 ± 11.1 than among not anxious war veterans (65.4 ± 8.4) (F = 180.333, P < 0.001, ANOVA).

IRMB negatively associated with trauma experiencesaverage number, with severity of anxiety and positively correlated with level of QoL (Pearson's “r” = − 252, P = 0.015; Pearson's “r” = − 223, P = 0.031; Pearson's “r” = 337, P = 0.001, respectively).

Anxiety disorder of war veterans significantly decreased their quality of life. The religious moral beliefs may help protection of the mental health stability of war veterans' who are suffering because of anxiety disorder after surviving multiple war traumas and may help in prevention of decreasing of their QoL.

Impulsivity is a core feature of bipolar disorder (BD). The best definition of impulsivity is the predisposition to have rapid and unplanned reactions to internal and external stimuli without regard to the negative consequences of these actions to the impulsive individual or others. Thus, the aim of our study is to investigate the relationship between impulsivity, panic disorder (PD) comorbidity and panic spectrum symptoms in patients with BD.

247 eutimic patients were assessed with SCID-P, MOOD-SR, PAS-SR. Impulsivity dimension was defined on the basis BIS Scale score (version 11).

A backward stepwise logistic regression in bipolar patients with PAS explained score statistically much higher for impulsivity (pas +6.09 vs pas - 3.88 p < 001) and the difference is statistically significant stratifing for BD. A stepwise linear regression, corrected by age and gender, displayed significantly statistical correlation with impulsivity score and PAS-SR by cut-off 35 (OR = 1.210).

In our sample BD eutimic patients explained score statistically much higher for impulsivity. This data confirm the presence of the trait impulsivity in BD eutimic patients. BD patients with a comorbid anxiety disorder seem to display significant higher levels of impulsivity when compared to patients without an anxiety disorder. Impulsivity was linked with atypical panic like symptoms more with PD diagnosis. Results suggest the presence of specific bipolar disorder endophenotipe. Further neurobiologies studies are needed to elucidate the implications and reasons of this association.

to examine short and middle-term effectiveness of a group cognitive-behavioral intervention (CBT) in pathological gambling (PG) and to analyze predictors of therapy outcome.

Two hundred and ninety PG patients consecutively admitted to our Unit participated in the current study. All participants were diagnosed according to DSM-IV-criteria. Manualized outpatient group CBT [16 weekly sessions] was given. Specific assessment before and after the therapy and at 1, 3 and 6 months follow-up was conducted. Logistic regression analyses and survival analysis were applied.

outpatient group CBT was effective with abstinence rates by the end of therapy of 76.1%, and 81.5% at 6 months follow-up. The dropout rate during treatment decreased significantly after the fifth treatment session. Psychopathological distress (p = 0.040) and obsessive-compulsive symptoms were identified as factors predicting relapses and drop-outs respectively.

our findings suggest that group CBT is effective for treating PG individuals. Several psychopathological and personality traits were identified as outcome predictors.

Long-acting depot antipsychotic medication is associated with extrapyramidal side effects (EPS). This may reduce adherence to medication, and precipitate relapse (1). Clearly, EPS is a major drawback and early detection is essential. However, in an earlier review of patients’ medical notes, we identified only one patient with an examination that recorded the presence of EPS. Despite the fact that a number of rating scales are available. We proposed that the application of these rating scales, would allow us to improve the assessment of EPS.

All patients prescribed a depot antipsychotic or long-acting risperidone injection, were identified. the Barnes Akathisia Scale (2) was chosen to rate akathisia, a modified Simpson-Angus scale (3) was chosen to rate parkinsonism and the Abnormal Involuntary Movement Scale (4) was chosen to rate tardive dyskinesia.

A total of 43 patients were evaluated. 23 (53%) patients showed drug induced EPS. the total number of positive cases of akathisia was 12 (28%), and 10 (23%) patients were found to have tardive dyskinesia. 13 (30%) patients were found to have drug induced parkinsonism.

Our screening programme has identified high rates of previously undiscovered drug induced EPS.

PUBMED data base was searched for articles using the key words “supervision in CBT”.

The task of supervision is to increase the value of the therapeutic process in the client's best interest. Supervision is educational process in the truest sense of the word, including an opportunity to select one's own supervisor. This is a very important procedural aspect since the therapist identifies with his/her supervisor, either consciously or unconsciously. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. There is important parallel reflecting the therapist-client relationship. This is because any changes in the supervisory process are analogically transferred onto the therapist-client relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's basic skills involve good theoretical knowledge, professional behaviour towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be in any stage of his/her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt.

By IGA MZ CR NT 11047-4/2010.