No significant relationships.

The authors have not supplied their declaration of competing interest.

Attitudes toward people with mental disorders in Arab countries have undergone huge transformations throughout history. Stigmatization of the mentally ill has been a long tradition in our communities. The public’s views have evolved since then, however, little is known about the current situation regarding mental illness stigma in our context.

Explore attitudes towards mental illness and mental health knowledge in Arab countries.

We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries.The Community Attitudes toward the Mentally Ill scale,the Mental Health Knowledge Schedule scale and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form were administered to participants from the general public.

The study sample was predominantly female (77%), married (41%), educated (89% with tertiary education), living in urban areas (85%), with a mean age of 29.6 ± 10.8 years.

Based on the CAMI, MAKS, and ATSPPH-SF total scores, 75th, 50th, and 25th percentile were considered as cut-off points for the high, medium, and low scores. We found that 26.5% exhibited stigmatizing attitudes towards people with mental illnesses, 31.7% had poor knowledge, and 28.0% hold negative attitudes toward help-seeking. Regarding attitudes toward mental illness, the highest mean score was on the social restrictiveness subscale (35.1 ± 5.6), reflecting the lowest amounts of stigma in this dimension; while the lowest mean score was on the Authoritarianism subscale (32.0 ± 4.6).

We found a significant difference between countries regarding attitudes (F=194.8, p<.001) and knowledge (F=88.7, p<.001).

Although much scientific progress has been made in the fields of diagnosing and treating mental illness, at a societal level the stigmatization of mental illness is still an important societal problem. The general population is largely ignorant about mental disorders, and fear of the mentally ill remains prevalent.

None Declared

Current guidelines for managing antipsychotic-induced hyperprolactinemia recommend the use of aripiprazole, either as a substitute or in combination with the primary antipsychotic. However, there have been reported cases of exacerbated psychotic symptoms when introducing aripiprazole after chronic treatment with another antipsychotic.

We present a case of a patient with unspecified schizophrenia spectrum disorder receiving amisulpride, who developed worsened psychotic symptoms following the introduction of aripiprazole to treat hyperprolactinemia. We also review this phenomenon and its clinical management in the literature.

Clinical case report and brief literature review.

Ms. G, a 54-year-old woman diagnosed with unspecified schizophrenia spectrum disorder, was on amisulpiride 400mg/day and had remained asymptomatic for months. During a follow-up, she complained of mastalgia and had a prolactin level of 71.7 ng/mL. Following clinical guidelines, aripiprazole was added at 10mg/day. Within a month, anxiety and sleep disturbances escalated, followed by the reappearance of psychotic symptoms. Aripiprazole was discontinued, amisulpride reinstated, achieving stability. Subsequently, hyperprolactinemia was managed using metformin.

Antipsychotic-induced hyperprolactinemia is common, especially with first-generation antipsychotics, causing various symptoms in both genders. Long-term consequences may include weight gain, reduced bone density, and potentially increased breast cancer risk, among others.

Aripiprazole is an atypical antipsychotic with a partial agonist effect on dopamine D2 and D3 receptors. This means that aripiprazole will act as a functional D2-antagonist under hyperdopaminergic conditions, but a functional D2-agonist under hypodopaminergic conditions. This property of aripiprazole may contribute to counteract ‘prolactin-raising’ agents, acting as a D2 agonist, potentially reducing prolactin rise.

Chronic use of presynaptic D2/D3 antagonist (amisulpiride) might create a hypodopaminergic environment and hypersensitivity to dopamine agonists, possibly explaining worsened symptoms with aripiprazole introduction.

To prevent adverse outcomes when adding or switching to aripiprazole, gradual reduction of the previous antipsychotic (amisulpride) and high-dose aripiprazole initiation (30-40 mg/day) can help.

Antipsychotic-induced hyperprolactinemia is a serious issue that deserves our attention. While aripiprazole is recommended by several guidelines to treat it, introducing it to patients on chronic antipsychotic treatment may lead to a worsening of psychotic symptoms. Caution is recommended when combining aripiprazole with potent D2 receptor blockers. To mitigate this effect, gradual dose reduction of the previous antipsychotic and high-dose aripiprazole initiation are crucial.

None Declared

Self-stigma plays a powerful role in attitudes toward mental illness and seeking psychological services. Assessing stigma from the perspective of people with mood disorders is important as they were ranked as major causes of disability.

To determine the extent and the impact of stigma experience in Saudi patients with mood disorder and compare them between depression and bipolar disorder patients. To test if stigma is a universal experience and has similar psychosocial impact across cultures.

It's a part of multicenter international study comparing its results to the universal experiences inthe perspectives of individuals with mood disorder.

We randomly interviewed 94 individuals with mood disorder at King Khalid University Hospital using valid reliable tool, Inventory of Stigmatizing Experiences (ISE), which has two components: Stigma Experiences Scale (SES) and Stigma Impact Scale (SIS).

ISE was validated in a population of Saudi patients with mood disorder. There were no significant differences in stigma between patients with bipolar or depressive disorder on SES or SIS. However, over 50% of all respondents tried to hide their mental illness from the others, and to avoid situations that might lead them to be stigmatized. In comparison with the Canadian population, Saudi participants scored lower on both SES and SIS, which may be due to cultural differences.

Stigma associated with mood disorder is serious and pervasive. It's important first to understand how patients perceive stigma in order to conduct successful anti-stigma programs. The ISE is a highly reliable instrument among cultures.

The authors have not supplied their declaration of competing interest.

Internet addiction (IA) is reported to cause significant negative psychosocial consequences. The gender specificity of psychological characteristics that are potentially significant for the formation of IA remains understudied.

To identify gender-related differences in the psychological characteristics of people with IA.

100 subjects aged 16-34 years who scored 65 points or more on the Chinese Internet Addiction Scale (CIAS) were identified and divided into 2 groups by gender: group 1 (54 men) and group 2 (46 women). The individual psychological characteristics were assessed with: the Liebowitz Social Anxiety Scale (LSAS); the Bass-Perry Aggression Questionnaire (BPAQ); the Emotional Regulation Questionnaire (ERQ); the Adverse Childhood Experiences International Questionnaire (ACE-IQ); a short version of the Five-factor Personality Questionnaire (TIPI-RU) and the Cloninger Temperament and Character Inventory (TCI-125).

Women were significantly more likely to experience fear of situations of interpersonal contact and action in public places (p=0.027). They experienced significantly more sexual violence in childhood (p=0.032) and were more likely to have personality traits such as “reward dependence” (p=0.002), “persistence” (p = 0.046), and “self-transcendence” (p=0.002). Men demonstrated physical aggression (p=0.009), suppressed emotions (p=0.019) significantly more often than women and characterized themselves as emotionally stable (p=0.048).

The gender differences identified in the cohort of individuals with IA can potentially be considered specific for this contingent, although such gender relationships can be observed in other forms of addiction and in the general population. The specificity of gender differences may reflect individual psychological markers of increased vulnerability to developing IA.

The study was financially supported by Russian Foundation for Basic Research within the framework of scientific project No 18-29-22079.

This post-authorization safety survey evaluated the long-term safety, tolerability, and efficacy of risperidone long-acting injectable (RLAI) in routine clinical practice.

In this 6-month, multicenter, European, naturalistic survey, patients were included if, during routine clinical practice, long-term antipsychotic therapy with RLAI was deemed necessary by the treating physician. Efficacy measures (at baseline and after 1, 3, 6 months) included Clinical Global Impression-Severity (CGI-S) and Global Assessment of Functioning (GAF). Safety was evaluated by recording treatment-emergent adverse events (TEAEs) at every visit.

RLAI was initiated in 5,134 predominantly male (58.6%) patients (aged 14-94 years) with a diagnosis of paranoid schizophrenia (69.8%). RLAI initial doses were 25 mg every-two-weeks in 37.0%, or 50 mg in 44.4% of patients. at endpoint, RLAI dosages were 50 mg in 49.3% of patients, 25 mg in 27.0%, and 37.5 mg in 22.1%. Six-month treatment with RLAI was completed by 4,314 patients (84.0%). RLAI was discontinued due to loss to follow-up (n=346;6.7%), insufficient response (n=116;2.3%), and AEs (n=106;2.1%). CGI-S significantly improved from baseline to endpoint (p< 0.001). Patient functioning in the GAF scale also significantly improved from baseline to endpoint (45.4±16.0 versus 62.4±17.7, respectively, p< 0.001). TEAEs were recorded by 20% of patients. AEs occurring in ≥5% of patients were akathisia, extrapyramidal disorders, depression, psychotic disorder, anxiety, and weight gain. Serious AEs were reported by 384 (8%) patients.

This large prospective survey confirms the good safety, tolerability, and efficacy of RLAI as reported in previous controlled clinical trials when used in routine clinical practice.

Anorexia nervosa and bulimia nervosa are often accompanied by aggressive manifestations that undergo typical dynamics at different stages of the disease. The presence of aggressive phenomena in eating disorders can cause severe maladaptation of patients, cause difficulties in diagnosis, establishing compliance, and prevent the normalization of family relations.

To study the varieties of aggressive manifestations and their changes in the treatment of anorexia nervosa and bulimia.

Psychopathological, anamnestic, psychological.

The most pronounced aggressive symptoms in typical anorexia nervosa are verbal and physical aggression against relatives and close people; feeding younger siblings, parents; threats and suppression of the opinion of relatives in relation to patients. The above aggressive statements and actions occur at the stage of correction and in the initial period of the stage of exhaustion. With deep exhaustion (pronounced cachexia) and in the process of food rehabilitation, aggressive behavior is significantly reduced. In the future, there is criticism of their own aggressive symptoms. In bulimia nervosa, only verbal aggression toward loved ones is noted, especially when they interfere with purifying behavior and massive compulsive overeating. The degree of aggression in bulimia nervosa is significantly less.

Aggressive manifestations in eating disorders depend on the stage of the disease, the degree of exhaustion and undergo reverse development in the course of therapy. Aggressive phenomena in eating disorders have a significant impact on the clinic, dynamics, outcomes of diseases and the effectiveness of treatment tactics.

No significant relationships.

Circadian rhythm pathways are highlighted in a number of etiological models of bipolar disorder (BD). More than 25% of bipolar patients may present seasonal pattern (SP). However, there is very limited scientific data on the prevalence of SP, its clinical manifestations and any gender influence.

Caucasian individuals who met DSM-IV criteria for BD I or II were recruited from three university-affiliated psychiatric departments in France (Paris, Bordeaux, Nancy). SP was defined according to DSM-IV criteria. Clinical and socio- demographic variables were obtained from structured interviews with the patients and their relatives.

Four hundred and fifty-two bipolar patients (n=452) in euthymic state were included in the study, 102 of them (23%) were considered as having SP according to DSM-IV criteria. Multivariate analysis showed a significant association of BD patients with SP for bipolar II subtype (OR=1.99, p=0.013), rapid cycling (OR=2.04, p=0.02), eating disorder (OR=2.93, p=0.003) and the total number of depressive episodes (OR=1.12, p=0.002). 71% of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR=2.89, p=0.02) and total number of depressive episodes (OR=1.21, p=0.002) in males but with rapid cycling (OR=3.02, p=0.003) and eating disorders (OR=2.60, p=0.02) in females.

The high prevalence of SP in BD, its associated clinical characteristics and the observed differences between genders, suggest that SP represents a potentially important specifier of BD.

We compared the efficacy of 6 week therapeutic program in pharmacoresistant patients suffering with panic disorder and comorbid personality disorder (19 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (43 patients). Patients were treated with CBT and psychopharmacs. They were regularly assessed every week on the CGI, BAI, BDI. Before and after treatment were used also Sheehan anxiety scale, Dissociative experience scale, Quality of Life.

A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder. The treatment effect between groups did not differ in rating scales, but there are more remitted patients in group without personality disorder.

Supported by: Project IGA MZ ČR NS 10301-3/2009

Psychedelic drugs were used extensively in psychotherapy in the 1950s to lower psychological defences and facilitate emotional insight. Thousands of research participants were administered hallucinogens in the context of basic clinical research or therapeutic clinical research, resulting in hundreds of publications. Results across studies were ultimately inconclusive due to such variations in methods and a lack of modern controls and experimental rigour. The growing controversy and sensationalism resulted in increasing restrictions on access to hallucinogens throughout the 1960s (ultimately resulting in the placement of the most popular hallucinogens into Schedule I of the 1970 Controlled Substances Act in the United States).

Renewed human administration research began in the 1990s. Recent clinical studies have administered hallucinogens to evaluate their safety and efficacy in the treatment of psychiatric disorders: specifically, anxiety related to advanced-stage cancer (Grob, 2005), obsessive-compulsive disorder (Moreno, et al., 2006), heroin dependence (Krupitsky, et al., 2007), personal meaning and spiritual significance (Griffiths, et al., 2008), and a meta-analysis of randomized controlled trials of LSD for alcoholism (Krebs,et al., 2012).

Psychedelic-assisted psychotherapy utilizes the acute psychological effects of psychedelic drugs to enhance the normal mechanisms of psychotherapy. The effects of psychedelic psychotherapy are often very pronounced within several days or weeks after a treatment session, but then these effects quickly decline. This phenomenon was termed a “psychedelic afterglow”.

Fhurther research, blinded, randomized, placebo-controlled, methodology should explore the efficacy of hallucinogens.

The purpose of this study was to determine the effect of education on anxiety and depression in patients with myocardial infarction in selected hospitals of Urmia hospitals in 2009.

This study was a quasi-experimental study that comprised 124 patients selected randomly and divided into two groups. The experimental group was educated by a face to face training and educational booklet. Control group did not receive any intervention. The level of anxiety and depression was evaluated by using HADS questionnaire at 3 intervals. After 48 hours of admission, discharge day and 2 months after discharge.

The findings suggest that MI patients worried about their social role, interpersonal relations and personal health, which can exacerbate symptoms and complicate their future care. There was no significant difference between control and experimental groups before the intervention, But after the intervention, anxiety and depression in the experimental group was significantly less than control group (P < 0.05).

Considering the beneficial effect of intervention on reducing anxiety and depression in such patients, the patient's education should be one of the health care goals. Most researches may also be required toconfirm the results in other groups of patients.

The influential role of family in the outcome of chronic mental illness is well documented; however there has been relatively little research on the intrafamilial relationships of people experiencing their first episode of psychosis (FEP).

To investigate possible differences in family environment between FEP and chronic patients with schizophrenia and bipolar disorder.

To compare family measures between relatives of FEP and chronic psychotic patients.

Family functioning (FACES-IV), expressed emotion (FQ), family burden (FBS) and psychological well being (GHQ- 28) were assessed in relatives of 30 FEP and 30 chronic patients.

Multivariable linear regression models adjusted for confounders revealed that relatives of chronic patients scored significantly lower in balanced cohesion (β coefficient -4.27, 95% CI: -08.03, -1.71) and balanced flexibility (β coefficient -4.01, 95% CI: -6.91, -1.10), as well as communication (β coefficient -6.61, 95% CI: -11.70, -1.50) and satisfaction scales (β coefficient -7.32, 95% CI: -13.23, -1.41). Relatives caring for a chronic patient had significantly higher scores in critical comments (β coefficient 7.81, 95% CI: 3.95, 11.68) and emotional overinvolvement (β coefficient 3.70, 95% CI: 0.24, 7.16). They, also, reported higher objective (β coefficient 12.23, 95% CI: 3.76, 20.71) and subjective (β coefficient 2.79, 95% CI: 0.45, 5.14) burden, as well as poorer psychological well being (β coefficient 12.23, 95% CI: 3.76, 20.71).

These findings suggest that chronicity adversely affects patients’ family. Early intervention strategies are needed to reduce family burden which in turn may adversely affect the course of the patient’s illness.

In psychiatric emergencies, there is a high premium on rapid assessment, acuity categorization and objectivity in decisions regarding the disposition of patients. The Crisis Triage Rating Scale (CTRS), a 3-item clinician-rated instrument, has demonstrated validity in determining the disposal of patients in psychiatric emergency settings. However, its utility has not been evaluated in Nigeria.

This study aimed to assess the validity of the CTRS in predicting the disposal (need for hospitalisation or out-patient treatment) of patients presenting to a psychiatric emergency unit in Nigeria.

The CTRS was administered to consecutively presenting patients (N=247) at the Emergency Unit of the Federal Neuro-Psychiatric Hospital, Yaba, Lagos. Following a comprehensive psychiatric evaluation, clinicians blinded to the CTRS scores made appropriate decisions regarding the disposal of the patients. The ability of the CTRS to predict the need for hospitalisation at different threshold scores, compared with clinical judgement as criterion, was determined statistically.

The optimal threshold on the CTRS for detecting the need for hospitalisation is a cut-off score of 9 as it has the best trade-off with a sensitivity of 0.94 and specificity of 0.89. At this threshold, the overall misclassification rate is 0.09, while the area under the Receiver operating characteristics curve is 0.95. The positive predictive validity for the assessment of disposal at the optimum threshold is 0.91.

The CTRS is a useful tool in determining the disposition of patients presenting to psychiatric emergency service in Nigeria

Researches indicate that traumatized people besides development of mental and physical disorders can experience positive changes.

Investigate relationships between war trauma, social support, psychological distress and posttraumatic growth.

Determine the predictors of posttraumatic growth in war displaced persons in Bosnia and Herzegovina.

The test sample was composed of 71 refugees, who were due to war-related events been forced to leave the original residence, and their new residence is on the territory of Bosnia and Herzegovina. Subjects were recruited by snowballing method, and the starting point of inclusion in the study were acquaintances of the medical staff at the Clinical Hospital Mostar. The study used General Demographic Questionnaire, the Harvard Trauma Questionnaire-version for BiH (HTQ), Brief Symptom Inventory (BSI), Social Support Appraisals Scale (SS-A) and Posttraumatic Growth Inventory.

In the first predictive model (R2=0.053; F=4.889; P=0.030) that included BSI, HTQ and SS-A questionnaires, a linear regression analysis showed that a stronger social support leads to greater posttraumatic growth (standardized β coefficient=0.257; P=0.030), same as greater sensitivity in interpersonal relationships (standardized β coefficient=0.698; P=0.014), while growth in the number of positive psychological symptoms have a negative impact on posttraumatic growth (standardized β coefficient=-1.008; P=0.042). In the second predictive model (R2=0.043; F=1.226; P=0.299), of all demographic factors only the economic status was a significant predictor, where persons with stable economic status had greater posttraumatic growth (standardized β coefficient=0.337; P=0.040).

Social support is significant positive predictor of posttraumatic growth, which is also supported by sensitivity in interpersonal relationships.