Romantic relationship quality (RRQ) and break-ups (RRB) among young adults have been associated with the onset of a first major depressive episode or suicide attempts. However, the size of these associations varies across studies and the relative weight of RRB versus RRQ needs to be understood.

To investigate (1) the size of the association between adolescent RRQ/RRB and psychopathology (i.e., depression, suicide ideation, deliberate self-harm, and suicide attempt); and (2) the role of potential moderators (e.g., gender, age, and nationality).

A meta-analysis of 20 manuscripts reporting on 21 studies (n = 19623) was conducted, focusing specifically on adolescents and young adults. Studies focused on physically abusive relationships were excluded.

A model combining relationship quality and break-up yielded a highly significant association between relationship measures and depression/self-harm but the strength of this relationship was modest (r = .229). The strength of the association between depression/self-harm and RRQ (r = .279) was statistically different from RRB (r = .145) (P = .006). Location (US vs. Non-US) had no effect. Age was not significant, B = -0.005, 95% CI [-0.026, 0.016], P = .647. Gender was a weak moderator (B = .160, 95% CI [-0.021, 0.340], P = .083).

The association between psychopathology and RRQ/RRB was statistically significant but relatively small. RRQ was a stronger predictor of depression compared to RRB. This association was slightly stronger for women than for men. Implications for practice and future research will be discussed.

The authors have not supplied their declaration of competing interest.

Quetiapine, a short-acting atypical anti-psychotic drug for the treatment of bipolar I disorder and schizophrenia, is increasingly used off-label for the treatment of sleep disturbances or insomnia. However, data supporting this off-label prescription of quetiapine are limited.

To report and discuss the effects of “off-label” use of quetiapine for the treatment of sleep disturbances.

An English-language literature search was conducted using Pubmed, EMBASE and Cochrane library (December 1980–December 2015) using the search terms quetiapine, insomnia, sleep disorders, sleep disturbances, and sleeplessness.

During the last decade, there is an enormous increase in prescribing quetiapine. This anti-psychotic drug is among the best selling drugs worldwide. For the approved indications, the usual therapeutic dose range is 400–800 mg/day. However, off-label use of quetiapine was most evident for the 25 mg/day to 100 mg/day. In some countries, off-label uses are promoted to non-psychiatrists for the treatment of insomnia, dementia, agitation, and aggression. Inappropriate anti-psychotic use may lead to serious health problems, including metabolic effects, increased sudden cardiac death, and age-related side effects with increased risk for orthostatic hypotension, fractures, pneumonia, cognitive impairment, and stroke.

There is growing concern regarding the potential harm from off-label prescription of anti-psychotics, particularly quetiapine. There is little evidence supporting the enormous off-label uses of quetiapine. In addition, prescribing quetiapine for indications that are not evidence based has ethical, financial, and safety implications, especially in the older population.

The authors have not supplied their declaration of competing interest.

There is an ongoing debate about the impact on mental health associated with Covid-19 pandemics. Some studies have shown an increase in depressive and anxious symptomatology in general population. It has been noted that young people might be among the highest risk populations due to various enviorenmental and developmental influences.

To estimate the impact of Covid-19 related restrictions on mental health measures among Latvian adolescents and young adults (14-24).

We conduct a survey on social media, recruiting 500 participants among the 14-24 age gropup. The survey consists of three parts: 1) sociodemographics; 2) quantitative mental health self-evaluation form; 3) open ended questionaire about the needs and expectations. For statistical analysis we use Excel software and use a regression analysis.

483 participants participated in our survey. The average age was 17.2, 62% was female, 36% male, 2% identified as trans. 52.3% reported decline in their mental functioning and wellbeing in one or several mental health domains (depression, anxiety, addictive behaviours) out of which 13.4% reported significant impairment in a major life area. The support and needs defined by respondents can be divided in three clusters: socialising outside immediate family, psychosocial services, recreational needs.

Confirming to findings in other EU countries, majority of adolescents and young people in Latvia have experienced clinically significant mental health decline during the Covid-19 pandemic. These results can help policy makers in establishing appropriate, needs oriented support in tackling this problem.

An eighty-one-year-old lady presented with mood changes within days of the commencement of prednisolone eye drops, which was prescribed following a cataract operation. She had a history of chronic schizophrenia, with one previous episode of hypomania in the early1990s. She was admitted to our institution on this occasion, with symptoms including elated mood, disinhibition, insomnia, pressured speech, flight of ideas and grandiose ideation. This was a distinctly different presentation from her previous relapses and the duration of this episode was prolonged. Her symptoms persisted despite an aggressive titration of psychotropic medications. After a review of her medication, the possible causal relationship between the prednisolone eye drops and manic episode was made. As the steroid eye drops were necessary following her eye operation, we allowed the completion of its course. Within days of its discontinuation, we saw a dramatIc improvement in her mental state and she was discharged. She currently remains in remission two months from the cessation of prednisolone.

The postulation that the prednisolone eye drops triggered this manic episode can be substantiated by the clear observation that her symptoms completely resolved after the steroid course was completed. This appeared to be the one single factor which coincided with the emergence, maintenance and termination of her symptoms. Steroid-induced psychiatric symptoms are a well documented phenomenon, but are typically seen with higher doses and systemic administration of corticosteroids. This case report is of a rare presentation, and to our knowledge there are no similar cases described.

Every year in the month of September, National Suicide Prevention Week is celebrated. The goal of suicide prevention week is to inform the public about suicide prevention, primarily the warning signs of suicide. However, the impact of this month on the general population is unknown. The Google trends show how frequent web searches have been performed for a particular search-term, which provide an approximation of the people’s interest.

To evaluate public interest in suicide prevention by analyzing the google trends of “Suicide Prevention” search-term.

We estimated the interest in such topics by running the google trends data of the last decade by using the filter [Search Term:“Suicide Prevention”, Locations: “United States” and Time Ranges “ 2010 to 2020”].

During this specific interval, people have searched “Suicide Prevention” most frequently during the month of September (month of National Suicide Prevention week). Conversely, in the other months, interest in “suicide prevention” fluctuated between little to none. The only other time people have shown interest in Suicide prevention, other than the month of September, was with suicide news in the media, such as the death of a celebrity by suicide, or suicide-related TV shows. [Figure]

Although it is not definitive, it gives some idea that National Suicide Prevention week has a considerable impact on population interest. Since we did not observe sufficient public interest in other months, there should be frequent and systematic efforts to spread suicide prevention awareness among the general population.

The COVID-19 pandemic affected today more than 76,000,000 worldwide, and more than half of humanity has been placed in quarantine. This pandemic affects mental health problems and influences the onset of symptoms.

The aim of this review is to analyze the impact of the COVID-19 pandemic on psychotic disorders and its interaction with the various risk factors.

We undertook a review of the impact of COVID-19 pandemic on psychosis. We carried out a systematic review of electronic databases using the keywords “COVID-19”, “pandemics”, “psychotic disorders”, and “delusions”. Relevant literature was limited to articles conducted around the world and published between January and December 2020.

We identified ten papers addressing incident cases of psychosis relapse linked to coronavirus pandemic. In multiple cases, psychotic symptoms were characterized by delusional thoughts about being infected by the coronavirus. The limited access to regular medications and psychosocial interventions was the main factor to psychotic relapse. This review included one cross-sectional clinical study comparing the impact of this pandemic on patients suffering from severe mental illness compared with healthy controls and they found that patients with mental disorders reacted to the pandemic and the lockdown restrictions with higher anxiety levels than the general public. Our study also revealed that elderly people suffering from psychosis and other chronic illness were the most vulnerable to relapse.

Psychotic disorders can relapse during stressful events like COVID-19 pandemic. Therefore, specific attention to these vulnerable subjects is crucial to prevent relapses in times of worldwide pandemic.

No significant relationships.

The revision of DSM-5 and the mental disorders chapter of ICD-11 are informed by concepts of mental disorders, which share some features, and some differences.

To review the similarities and differences in concepts of ICD-11 and DSM-5

By describing the classification of psychotic disorders, we exemplify the different conceptual approaches of both classification systems.

Review of the classification of psychotic disorders in DSM-5 and ICD-11 and the underlying concepts of mental disorders.

Both systems take an anosological approach and base the classification of mental disorders on psychopathology, which takes centerstage in the clinical evaluation for classification purposes. A major difference is the role of functional impairments, which are mandatory in DSM-5, but not ICD-11. Time course criteria were harmonized and dimensional assessments were introduced in both systems. Differences in duration criteria lead to different approaches regarding brief psychotic disorders. Attenuated psychotic symptoms did not receive full diagnostic status.

Neither DSM-5 nor ICD-11 have introduced neurobiological or genetic factors into the classification of psychotic disorders. Both systems take steps towards dimensional symptom assessments, with different practical operationalizations. Some differences prevail regarding time course criteria and the handling of brief psychotic disorders, which may indicate different concepts of chronicity underlying these decisions. An important aspect was the non-inclusion of attenuated psychotic symptoms syndrome among the mental disorders, indicating that the border towards normality is still uncharted terrain in both classification systems and open for discussions about concepts of subclinical or otherwise dimensional ratings of subdiagnostic symptoms in the general population.

Over the past years multi-source-feedback (MSF) is increasingly used in healthcare systems worldwide in assessing multiple components of professional performance. Despite the current widespread available research on MSF in industry, comparatively little research exists focusing on health services. Most of the effort to date, however, has focused on developing the instruments. Insufficient attention has gone into investigating its impact on physician's performance. This study is focused on psychiatrists and change in their performance following MSF.

43 Consultant psychiatrists who have participated in two MSFs were identified. Change in MSF ratings were used as a possible indicator of feedback impact on the performance. The study compared ratings over two administrations to identify: (1) changes in self, colleagues and patients’ ratings, (2) correlation between self and others’ ratings over time, (3) impacts of feedback on self-assessments.

Significant change in colleagues’ ratings over time noted, however the self and patients’ ratings did not revealed meaningful change. Self ratings were remained uncorrelated with others ratings even after receiving the feedback. However colleagues and patients’ ratings remained correlated. Self ratings at Time 1 were predictive factor of self ratings at Time 2.

Though we identified significant change in colleagues’ ratings over time, but self and patients’ ratings did not change. The remained question is to what extent colleagues and patients’ ratings could reflect an individual's work performance. A great deal of additional research looking at MSF and impact on performance is required prior to make any guidance for beneficial feedback system.

Self Disorders (SDs) are regarded as the subjective phenotype of Schizophrenia vulnerability. The EASE (Examination of Anomalous Self-Experiences) scale is the most detailed and widely used instrument to investigate SDs, but it requires long administration times and specific training. The IPASE (Inventory of Psychotic-like Anomalous Self-Experiences) scale might be a self-administered instrument of widespread use for an easier SDs investigation.

The present study was aimed at validating the Italian version of IPASE, testing its internal consistency and usability for a first level SDs survey. A secondary objective was to confirm the correlations between IPASE, EASE, main symptom dimensions, subjective bodily experiences, symptoms of schizophrenic autism as well as levels of global functioning.

Fifty patients with Schizophrenia were administered the IPASE scale in its Italian version, the Examination of Anomalous Self-Experiences scale (EASE), the Positive And Negative Symptoms Scale (PANSS), the Social and Occupational Functioning Assessment Scale (SOFAS) to assess global functioning, the Autism Rating Scale (ARS) and the Abnormal Bodily Phenomena questionnaire (ABPq). The internal consistency of IPASE in its Italian version was investigated and the correlations between IPASE, EASE, ABP, ARS, PANSS and SOFAS were explored.

The internal consistency of the Italian version of IPASE was high (α 0.97). The IPASE and EASE total scores were positively correlated with each other, as were many of the conceptually related subdomains of both scales. The IPASE score was negatively correlated with global functioning (SOFAS) and positively correlated with total PANSS scores and with PANSS negative domain. Moreover, the IPASE total score was positively correlated with autism dimension (ARS), while anomalies in subjective experience of the lived body were coherently correlated with higher scores in IPASE “somatization” subdomain.

The IPASE may be an easy instrument with high internal consistency for an initial investigation of SDs. IPASE domains appear to be correlated with the SDs investigated through EASE and with the main symptomatologic dimensions of Schizophrenia, in particular with negative symptoms. IPASE might also be a useful instrument for a first level investigation of subjective experiences concerning intersubjectivity and bodily dimensions.

SDs are confirmed to be a core feature of the schizophrenia psychopathology, with a adverse impact on global functioning.

None Declared

The incidence of depression is associated with decreased social, occupational, and educational performance.

The aim of this study was assessing the prevalence of depression and its related effective factors among students at health faculty at Isfahan University of Medical Sciences in 2019.

In this cross-sectional study 177 students were included randomly. The Beak test included 21 questions were applied to collect data. Data were analyzed by SPSS software (version 22) and were presented as descriptive statistics and analyses included One-way analysis of variance, t-test and correlation Pearson.

The mean and standard deviation of the age of students was 22.15±3.88 years. More than 80% of students experienced some levels of depression. Of the participants 19.8% indicated no sign of distress, 26% mild distress, 37.3% average distress and 16.9% high depression. There was no statistical association of distress between female and male students (P=0.198). However, significant associations were Sedative drugs, parents level and occupation, Study Field, Future Career and Financial situation with depression (P<0.05).

Overall, the prevalence of depression was higher among students compared with general population. Providing programs for improving student’s mental health is suggested.

Psychological disorder such as anxiety and depression have been related to increased mortality in both healthy individuals and medical patients. This study has been done for evaluation of prevalence of anxiety and depression and comparison with a control group (A&E's patients 1.

We checked three hundred patients of internal medicine and A&E (as a control group) department. They have chosen by a Purposive accessible sampling method. The psychopathological profile was assessed using the SCL-90 questionnaire by Iranian version. Data have been computed and analyzed by SPSS V.17 and we used Student t test for parametric variables and Mann-Whitney for the analysis of nonparametric variables and Linear regression was used to identify the impact of independent variables. The results have been considered significant when the two tailed p-value was less than 0.05.

In internal ward 69.3% and A&E department 42% of patient have had depression (OR= 3.5; 95% CI, 1.9 to 6.5). Anxiety were observed in 50.7% of internal medicine patients and 12% of A&E's patients (OR= 1.94; 95% CI, 5.1 to 23.7).

Prevalence of the depression and anxiety in internal ward patients was significantly higher in compare to A&E's patients. Therefore, it's necessary to consider these patients in order to diagnosing for the early treatment.

Modern scientific researches about interaction between TBI and PTSD are characterized by few amounts and contradiction of conclusions.

Twenty-eight persons with TBI were examined by means of questionnaires and structured clinical interviews. 17 patients were suffering from PTSD. We compared clinical features in patients with isolated TBI and group with both disorders.

Four groups of symptoms were analyzed–sleep, emotions, cognition and personality features. Disorders of sleep were presented with violation of REM cycle, nightmares, hyperexcitation, increase watchfulness during the sleep. Emotional disorders were expressed as lability without external irritations; an excessive emotional reaction is on small events, agitation, irritability, inadequacy of emotional reactions and apathy (loss of desire to think, to feel, and/or to operate). Cognitive disorders included deceleration of psychomotor reactions, difficulties of searching of words in communication, problems of switching of attention, rigidity, difficulties in planning, decision of multistage tasks, violation of operative memory, executive dysfunction. Features of personality disorders were loss of initiation and self-control, decline of spontaneity, surplus attention is to the details, inadequacy of self-appraisal, feeling of inferiority, an increase necessity is for control and lordship over other, aggression (socially inadequate behavior, episodes of anger).

Psychopathological features presented in patients with comorbidity of PTSD and TBI are not specific and can be within the framework of other psychogenic, exogenous, organic, posttraumatic or neurological disorders and diseases. PTSD can combine with other psychical and somatic disorders that caused chronological and pathogenetical comorbidity in patients with both states.

The authors have not supplied their declaration of competing interest.

Psychological resilience is defined as an individual's ability to adapt to stress and adversity. People with psychotic illness often experience high levels of distress and difficulties adapting.

To assess the relationship between the resilience of people with psychotic illnesses and their quality of life.

Outpatients from multiple settings attending Sligo-Leitrim Mental Health Services, aged 18+ years old with a diagnosis of either schizophrenia, bipolar affective disorder or schizoaffective disorder were approached by their treating teams and invited to participate. Other inclusion criteria were having a family member. Drug induced psychoses or no family member were exclusion criteria. The scales used were the Resilience Appraisal Scale and the schizophrenia Quality of Life Scale. This study is part of a larger study looking at family factors and psychosis.

The study sample was 58 enrolled but only 49 participants completed the 2 assessments, of these 33 were males (67.3%). Data was analysed using SPSS 21. Pearson's correlation coefficient for resilience and quality of life was 0.503, P < 0.001. This shows that higher resilience is associated with better quality of life amongst people with psychotic illnesses. These results could have useful clinical implications. If we can intervene to therapeutically increase resilience, we can eventually improve the quality of life of people with psychoses.

The authors have not supplied their declaration of competing interest.

This study investigates the effects of accelerated high-frequency repetitive transcranial magnetic stimulation (aHF-rTMS), applied to the left dorsolateral prefrontal cortex (DLPFC), on locus coeruleus (LC) functional connectivity in the treatment of refractory medication-resistant major depression (MRD).

We studied 12 antidepressant-free refractory MRD patients, focusing on how aHF-rTMS affects the LC, a central component of the brain’s noradrenergic system and key to mood regulation and stress response.

A stronger decrease in LC functional connectivity following aHF-rTMS treatment resulted in better clinical improvement. We observed such LC functional connectivity decreases with several brain regions, including the superior frontal gyrus, precentral gyrus, middle occipital gyrus, and cerebellum. Moreover, our exploratory analyses hint at a possible role for E-field modeling in forecasting clinical outcomes. Additional analyses suggest potential genetic and dopaminergic factors influencing changes in LC functional connectivity in relation to clinical response.

The findings of this study underscore the pivotal role of the LC in orchestrating higher cognitive functions through its extensive connections with the prefrontal cortices, facilitating decision-making, influencing attention, and addressing depressive rumination. Additionally, the observed enhancement in LC-(posterior) cerebellar connectivity not only highlights the cerebellum’s role in moderating clinical outcomes through noradrenergic system modulation but also suggests its potential as a predictive marker for aHF-rTMS efficacy. These results reveal new insights into the neural mechanisms of refractory depression and suggest therapeutic targets for enhancing noradrenergic activity, thereby addressing both cognitive and psychomotor symptoms associated with the disorder.

Only a limited number of studies have examined the association of conversion disorder (CD) with depression and anxiety in adolescents. Furthermore, no data regarding the association of CD with anxiety sensitivity and perceived social support are available. This study aimed to assess the relationships among psychological characteristics and conversion symptoms in adolescents.

We assessed 50 outpatients, aged 8–18 years, who had been diagnosed with CD and members of a control group using the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI), and Multidimensional Scale of Perceived Social Support (MSPSS). Symptoms of CD were assessed using the Somatoform Dissociation Questionnaire (SDQ) and Children's Somatization Inventory (CSI).

Compared with controls, adolescents with CD scored higher on the CDI, SCARED, CASI total, CASI physical and cognitive subscales, and MSPSS total and MSPSS family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the SDQ scores and that CDI and CASI total scores predicted the CSI scores of subjects.

This study suggest that adolescents with CD had poor psychosocial well-being, and depression and global AS and AS cognitive concerns may play a role in the development of conversion symptoms.

One of the only few options available for rehabilitation of orphans in eastern societies is orphanage rearing. A lot many factors, however, go into determining the level of cognitive, behavioral and emotional development of children in these institutions.

A study was conducted on four major orphanages located in Srinagar city, to assess the existing differences in available facilities and their impact on the psychological adjustment of these children.

The UCLA loneliness scale was used to assess levels of loneliness, an indicator of psychological distress, among the resident children.

High scores were associated with adverse living conditions, like poor residential setup, rigid timetables, poor recreation facilities, poor nutrition and lack of modern educational facilities.

These facts could prove seminal in planning for better rehabilitation modules for orphans, especially in the wake of their exponential increase in the chronic conflict and disaster affected regions.

This paper examines the historical development of mental health services in the UAE including formation of federal laws associated with mental health and ministerial decrees. It also discusses cultural considerations in mental health practice in a society that is highly pluralistic and populated mainly by foreigners. The sharia aspects of mental health are also addressed.

The aims of the paper are to familiarize readers in above areas and encourage further work in the area of mental health in UAE.

The research is based on literature review.

All federal laws and ministerial decrees are listed and local cultural considerations and sharia laws discussed, as they are unique to his country and region.

Although mental health is traditionally neglected in this country it is developing very fast and it is essential to keep track of and encourage such growth for the benefit of consumers and mental health professionals.

The authors have not supplied their declaration of competing interest.

The COVID-19 pandemic has brought additional worries and challenges to people’s lives, with potential implications for psychological well-being.

To understand which worries and life changes have affected most the Portuguese general population during the COVID-19 pandemic and to analyse which contents are associated with higher levels of repetitive negative thinking/RNT and psychological distress/PD.

In September-December 2020, 413 Portuguese adults (69.2% female; Mean age= 31.02±14.272) were asked one open questions, with reference to the COVID-19 pandemic period: “what was your biggest worry?”; the answers were independently categorized by two researchers. Participants also filled the validated Depression Anxiety and Stress Scale and the Perseverative Thinking Questionnaire.

The most prevalent worries were about: 1) fear of contamination (oneself and others-48.7%; 2) physical and mental health and well-being (self and others)-27.2%; 3) studies and profession-13.3%; 4) uncertainty about the future-7.7%; 5) economic-financial issues-6.5%; 6) miscellaneous-3.3%; 7) no worries-0.7%. Participants who had worries of the theme 4 had the highest RNT and PD mean scores, followed by themes 3 and 5, and then themes 2 and 1. These thematic groups significantly (p<.01) differ between each other (except 3-5) and from the other groups. RNT was a significant predictor of PD (R2=37.0%, β=.609, p<.001).

People who worry about the future uncertainties, occupational activities and finances should be systematically assessed with regard to their levels of anxiety, depression and stress and they can learn to deal with the RNT as a way to reduce their psychological suffering in times of pandemic.

No significant relationships.