Being able to vote empowers people with mental illness to have a political voice and promotes social inclusion. Evidence shows that patients with mental illness are less likely to vote compared to the general population.

This study explores the knowledge and uptake of the voting rights of adult patients in a psychiatric hospital in the 2015 UK general election.

To understand patients’ eligibility and intentions to vote during the 2015 UK general election. To establish what assistance patients may require in order to vote.

A staff-assisted survey was undertaken in all mental health wards in the Gordon Hospital, Westminster prior to the general election in May 2015.

A total of 51 surveys were returned. Seventy-five percent thought they were eligible to vote, and 47% had already registered. Of those that had not yet registered, 37% wanted staff support to do so. Fifty-seven percent of the respondents intended to vote and of those 9 out of 10 intended to vote in person. Twenty-six percent of those intending to vote identified needing assistance in this process.

The majority of inpatients were aware of their eligibility to vote. Over half of the respondents planned to vote, which is lower than the UK average. As 1 in 4 patients intending to vote requested support, this suggests potential barriers impacting on their ability to exercise their right.

Multidisciplinary teams can provide valuable assistance to patients in the voting process in many ways, including information provision, organisation of leave and providing staff escort.

The authors have not supplied their declaration of competing interest.

Social behaviour of drug addicted patients is a key factor in understanding and controlling addiction problem. This study is conducted to investigate the social characteristics of 211 drug addicted males referred to addiction treatment centres in Yasouj, Iran.

More than 80% of participants were smokers among which 40% smoked their first cigarette at about age 14 or younger. Among the respondents 42.8% and 24% had have smoker friends or relatives respectively. 48.7% reported having at least one failed class during their compulsory education. Among the respondents 52.9% had at least one criminal record.

Results suggested smoking as an early and highly common behaviour during drug addiction during adulthood. Moreover, a significant number of the participants had smoker friends or relatives which could act as encouraging and facilitating factor to become addicted. Educational failure was common among addicted males. The above factors may be considered as predicting factor for later drug addiction.

Catatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.

To describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.

A 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.

Intranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse events

Esketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.

None Declared

Objective symptoms of akathisia in the absence of subjective symptoms is known as pseudoakathisia, more often diagnosed in older patients with long-term antipsychotic treatment.

To describe a case of pseudoakathisia in a patient with clotiapine abuse.

Pseudoakathisia management.

X is a 47-year-old male with chronic insomnia treated with clotiapine 40 mg/day for four years. He admits abusive neuroleptic consumption in the past eight months (160 mg/day), without any psychiatric control for years. In recent months he has experienced different organic complications, requiring multiple hospitalizations. During psychiatric examinations due to confusional states, repeated lower limbs movements were objectified. X reported he presented these movements for at least six months, without complaints of inner restlessness feeling. Neurological examination showed normal DAT-SCAN result. Clinical progression was evaluated using BARS scale (Barnes Akathisia Rating Scale).

Following the results of tests and statements of drug history, X was diagnosed with clotiapine-induced pseudoakathisia. Neuroleptic treatment was suspended, and clonazepam 6 mg/day and propranolol in ascending doses up to 80 mg/day were initiated. In subsequent evaluations, progressive decrease in movement intensity was observed. However, complete remission after four months from clotiapine suspension was not achieved.

Pseudoakathisia is a concept not well defined at this moment and different hypotheses about its nature are considered. It has been suggested that it is a form of delayed dyskinesia, or a clinical progression from akathisia, with acquired subjective discomfort tolerance. The most widely used treatment includes benzodiazepines, beta-blockers and anticholinergics, although their effectiveness is limited.

The authors have not supplied their declaration of competing interest.

More same-sex couples become parents by having children in previous heterosexual relationships, through donor insemination, adoption, fostering or surrogacy. Does the parents’ sex impact on the offspring's psychological development?

Literature review on Pub-Med.

Research shows that the warmth and closeness between parents and children –including adolescents- is what counts for the offspring's psychological development and not their parents’ sex. Children's cognitive abilities, sexual orientation and gender identity seem also unrelated to their parents’ sex. Positive outcomes have been observed both for gay and lesbian-parented families. Even though the children of gay and lesbian couples may be exposed to discriminatory sentiments against their parents, their influence on the children's long-term psychosocial adjustment appears debatable. They may even be more tolerant towards marginalized groups but they also describe concerns about becoming friendless and tend to conceal their parents’ sexual orientation. Furthermore, the children seem to be negatively influenced when their parents are not allowed to marry. Marriage could increase stability within a couple and also assist in lessening the stigma and social discrimination faced by many same-sex parents. Future research should address the weaknesses of the existing studies (small samples of white, well-educated and affluent gay and lesbians).

Based on the available data, what counts for the children's normal psychological development seem to be the quality of parenting rather than their parents’ sex. Parenting stress appears to be more predictive of children's psychological problems. The social prejudice and legal discrimination against same-sex parented families seem to lack scientific validation.

Revealing of clinical features of anxiety in victims of disaster for definition of the treatment and forecast.

Clinical, psychological testing, statistical. Clinical features of anxiety are investigated at 471 victims of disaster -- were staying in hostages (women -- of 68,4%, men -- of 31,6%) in the age of 18-60 years. Diagnostics of ASR was carried out according to diagnostic criteria МКБ-10.

Clinical variants of anxiety are allocated within the framework of ASR with: vegetative symptoms - 34,2%; asthenia - 52 (11,0%); emotional instability - 9,5%; somatoform symptoms - 8,7%; phobia - 11,3%; depressive symptoms - 17,0%; apathy - 3,1%); the others - 8,1%. On behavioural features with: hyperknezia - 60,9%; hypoknezia - 22,7%; mixed condition -- 16,3%. On current: undulant - 59,9%; constant - 30,8%; attack - 9,3%. After 1 year of dynamics of a mental condition has revealed formation of PTSD at 40,1% of injured, adjustment disorder at 24,2% anxiety disorder - at 18,7%, at 17,0% - recovery.

The least favorable forecast was marked at hostages with prevalence of somatoform symptoms (р≤0,001), emotional instability (р≤0,001) and apathy (р≤0,05). Favorable forecast -- at persons with vegetative (р≤0,05) and depressive symptoms (р≤0,05).

To audit benzodiazepine prescribing in a Community Mental Health team, with a view to identifying areas for improvement.

All the 245 patient's case notes were audited, from October 2004 to October 2005, of those in the Outpatients Clinic's case load, in North Shields. A semi structured pro-forma was designed. On the basis of the guidelines from Committee on Safety of Medicines (CSM) (1988), DOH Document (1999), DOH Ireland report of benzodiazepine commission (2002), www.benzo.org.uk, Newcastle, North Tyneside and Northumbria NHS Trust Guidelines for hypnotic/anxiolytic use and Lanarkshire PCT guidelines, the standards were finalised. The audit tool looked at demographics, indications of benzodiazepine prescription, co-morbid medical conditions, substance misuse, psychotherapeutic intervention and follow up of patients prescribed benzodiazepines.

245 notes were audited. 24% of all patients were on benzodiazepines. Out of those, 56% were women. A third of these patients were between 41-50 year olds, while another third were older than 50years. Co-morbid substance and alcohol dependence was uncommon. The most common diagnoses in these patients were mood disorder (31%), schizophrenia (20%), and personality disorders (12%). Nearly two-third of patients suffered from co-morbid medical conditions. 25% patients had had psychological therapies. None of them were given advice about sleep hygiene and driving.

Older women with mood disorders are more likely to be prescribed benzodiazepines longer than recommended. Advice about driving, sleep hygiene, information about side effects and risks was not offered to most patients. Recommendations have been made, with a view to re-auditing and improving services.

Internet use has affected the pattern of working style at the workplace. Recent years have seen an increased use of online activities (especially pornography/gaming) at the workplace. It has been shown to affect productivity at the workplace. There is a dearth of literature from the Indian context in this area.

This study was conducted to explore the pattern of pornography use and gaming at the workplace and its dysfunctions.

The present study was a cross-sectional prospective study.

The objective of the study was to assess the pattern of pornography use at the workplace. Five hundred employees having experience of internet use for more than a year of various government/private sector organizations in Bengaluru were assessed using background data sheet, DSM-5 criteria, internet addiction test and pornography addiction screening instrument. Users who were unwilling to participate were excluded from the study.

Seven to 9% reported preference for Internet to work, meals, personal hygiene, sleep, and interaction with family members and effects on productivity. Three to 4% have excessive use of pornography and game.

The present study has implications for evolving psychoeducational modules for the promotion of healthy use of technology.

The author has not supplied his declaration of competing interest.

The purpose of this study was to estimate the general population life-time and point prevalence of visual height intolerance and acrophobia, to define their clinical characteristics and to determine their anxious and depressive comorbidities.

A case-control study was conducted within a German population-based cross-sectional telephone survey. A representative sample of 2,012 individuals aged 14 and above were selected. Defined neurological conditions (migraine, Menière's disease, motion sickness), symptom pattern, age of first manifestation, precipitating height stimuli, course of illness, psychosocial impairment, and comorbidity patterns (anxiety conditions, depressive disorders according to DSM-IV-TR) for vHI and acrophobia were assessed.

The life-time prevalence of vHI was 28.5% (women: 32.4%, men: 24.5%). Initial attacks occurred predominantly (36%) in the second decade. A rapid generalization to other height stimuli and a chronic course of illness with at least moderate impairment were observed. 22.5% of individuals with vHI experienced the intensity of panic attacks. The life-time prevalence of acrophobia was 6.4% (women: 8.6%, men: 4.1%), point prevalence was 2.0% (women: 2.8%; men: 1.1%). VHI and even more acrophobia were associated with high rates of comorbid anxious and depressive conditions. Migraine was both a significant predictor of later acrophobia and a significant consequence of previous acrophobia.

VHI affects nearly a third of the general population; in more than 20% of these persons vHI occasionally develops into panic attacks and in 6.4% it escalates to acrophobia. Symptoms and degree of social impairment form a continuum of mild to seriously distressing conditions in susceptible subjects.

The GAF is a worldwide known rating scale for severity of illness in psychiatry and very much used in research papers. GAF covers the spectrum from positive mental health to severe psychopathology on a 100-points scale (1–100). From systematic literature reviews (Aas 2010; 2011), we know there are problems with GAF, including reliability and validity problems. How good GAF is, is an important question. Systematic literature searches have not identified qualitative studies of clinicians experience with GAF.

To collect information which can play a role in work to improve GAF.

An interview guide (with 28 questions) for qualitative interviews of clinicians was developed, with focus on issues considered important for an improved GAF (Aas 2010; 2011). Purposive sampling is used and sample size decided by saturation. Respondents varies in, for example: profession (psychiatrists, psychologists), experience with diagnostic categories, years of experience from psychiatry, and organization they work for.

The qualitative interviews have resulted in a considerable amount of information.

Collected information confirms that clinicians have unique experiences of importance for further work towards an improved GAF.

A growing body of research has indicated that difficulties in emotion regulation (ER) are associated to eating disorders as well as to weight changes. However, it has not been clearly investigated the intergenerational transmission of ER and its role on the onset of early feeding and weight problems of the child.

The goals of the present study are: 1) to examine the relationship between maternal ER during pregnancy and the feeding practices at 8 months of the baby; 2) and to assess the predictive role of ER on the onset of overweight at 3 years of age.

The sample is made up by 65 dyads distributed to 2 different groups based on their BMI. During pregnancy they were administered DERS. 8 months after the delivery they were videotaped during the meal time with baby through the Feeding Observational Scale (Ammaniti et al., 2002). Weight outcome of the baby was reported by the mother at 3 years of age.

Findings has shown that overweight mothers emerged as more emotional dysregulated during pregnancy. Their feeding interaction with the baby was also featured by greater difficulties compared to the control group. ER during pregnancy was able to predict the affective state of the dyad and the interactional conflict during the mealtime at 8 months. The affective state of the dyad at 8 months predicted the weight gain of the baby at 3.

The maternal and the dyadic emotional functioning play a key role in shaping the risk for childhood obesity.

For young people, just as in the general population, COVID-19 caused many changes in their lives. The literature review has shown an increased risk for mental illness symptoms as a consequence of the pandemic.

With this study, we aimed to evaluate the impact of COVID-19 pandemic in university students’ anxiety and depression symptoms.

This study is part of a larger longitudinal research on university students’ mental health with the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) data with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.

341 university students (257 females and 84 males) were included in this study, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived well-being loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. In the PHQ-9, the proportion of students with scores equal or above 15 ranged between 22.6% and 25.5% in 2019, however, in June 2020, the proportion was significantly higher (37.0%). The proportion of GAD-7 scores above the cut-off 10 ranged between 46.0% and 47.8% in 2019, and, in 2020, 64.5% of the students scored 10 or above. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.

COVID-19 had a negative impact on depressive and anxiety symptoms in university students, in line with the literature and confirming the vulnerability of young people in such uncertain times.

ECT can be a safe treatment choice in cases of PVD.

The authors have not supplied their declaration of competing interest.

The Modified Mini- Mental State Examination (3MS) is a brief cognitive testbattery designed to detect cognitive impairment.

To adapt the 3MS in German and to assess the effectiveness of the 3MS in identifying Alzheimer's disease (AD) in comparison with the conventional Mini- Mental State Examination (MMSE) in a German population.

A clinical group composed of 31 patients with early AD and 5 patients with moderate dementia of AD etiology was compared with 46 cognitively normal participants matched for gender and age. The 3MS scores were adjusted for educational attainment.

The 3MS and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic work- up. Statistical analysis was performed using the Receiver Operating Characteristics (ROC)

ROC curves demonstrated the superiority of the 3MS over the MMSE in identifying AD. The optimal cut- off score for the 3MS for detecting dementia was 88, which had a sensitivity of 98% and a specificity of 94%.

The German version of the 3MS is a short and practical but accurate test battery for the identification of AD.

To compare Magnetic Resonance Imaging (MRI) findings in Alzheimer's dementia (AD) in the general population with Down's syndrome dementia.

Background review: AD is characterised by cognitive dysfunction interfering with activities of daily living. Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia. People with Down's syndrome have an increased risk of developing AD. AD pathology initially appears in the entorhinal cortex, followed by the hippocampus and later in the temporal lobes. These areas are critical for memory functioning.

Volumetric analysis was performed on MRI brain scans using Measure software. Manual tracing was undertaken for the hippocampus, temporal lobes and lateral ventricles as well as the total brain volume of the cerebral hemispheres and cerebellum. Brain volumes were normalised as a percentage of traced intracranial volumes. Freesurfer software was used to obtain entorhinal cortical thickness measures. Statistical analysis was undertaken using SPSS15.

Subjects with AD (n=46), MCI (n=28) and controls (n=39) were compared with Down's syndrome demented subjects (DS+, n=20), non-demented subjects with Down's syndrome (DS-, n=45) and age-matched controls (n=43). Hippocampi, entorhinal cortex and temporal lobes were significantly reduced in AD and DS+ compared to controls. Lateral ventricles were significantly increased in AD and DS+ compared to controls. MCI and DS- produced findings between those of dementia and controls.

Critical memory regions atrophy in dementia corresponding to decreased cognitive functioning. DS+ morphology is comparable to AD in the general population but the atrophy is less pronounced.

Quality of life (QoL) research has increased during last decates. Psychiatric patients spend many days for their treatment so QoL is something that should be measured for these patients too.

To examine the relationship between dispositional optimism and Quality of life (QOL) among patients suffering from schizophrenia, schizoaffective disorder, bipolar disorder, depression, and other psychiatric conditions from a psychiatric department and to find out the existing correlations with other measures of personality characteristics.

To reveal the underlining correlation between QoL and dispositional optimism.

69 inpatients in a psychiatric ward in Athens-Greece took part in the study.31 (44.9%) of them were males and 38 (55.1%) females. The questionnaires that were used are the Short Form health questionnaire (SF12), the life orientation test-revised (GrLOT-R), the subjective well being scale (SWBC) and the Satisfaction with life Scale(SWLS).

Both Physical (M = 39,9 SD = ±7,2) and Mental (M = 29,4 SD = ±7,8) composite scores are lower than in the greek general population (M = 50 SD = ±6,8). Optimism (M = 14,8 SD = ±4.9) correlates significantly with both mental (p = ,571**) and physical (p = ,438**) health, well being (p = ,427**) and with the days of hospitalization (p = .,261**). Global happiness correlates significantly only with mental health (p = ,493**) and well being (p = ,573**).

Quality of life in mental patients seems to have a mediator and that is Optimism. Optimistic patients seems to have better health related quality of life and well being and stays more days in hospital for treatment needs.