The studies of Carroll e Hesse (1987) and the studies of Arntzen e Almas (2002) demonstrate the effectiveness of mand-tact training rather than only tact training on the expansion of the tact repertoire in groups of children with developmental disabilities.

The authors want to show the effectiveness of mand-tact training rather than only tact training on the expansion of the tact repertoire in a child with moderate mental retardation.

In the present work, we conducted an assessment pre-training in which the baseline data of the tact in the child's repertorie was collected, with an assessment choice preference to identify the reinforcers to use in the training. in the training, sessions only-tact training and sessions mand-tact training are alternated, according to the principles and procedures of Applied Behavior Analysis (ABA).

The results obtained show that the mand-tact training is more effective than the only-tact training in the rapid acquisition of tacts.

The mand contingiences represent a facilitation in the acquisition of the tact repertoire.

Depression - the main cause of suicidal behavior among young people.

Optimizing therapeutic approaches to the correction of non-psychotic depression accompanied by suicidal behavior in young adults.

75 patients with psychogenic depression, committed suicide attempt.

Clinical-psychopathological, psychodiagnostical.

The clinical picture of depression in the patients the most frequently observed in depressed mood and affect sadness, asthenic symptoms, as well as various manifestations of anxiety. The vast majority of patients were found various violations of sleep-wake cycle. Feature of depressive disorders was their massive somatization characterized by polymorphic vegetative disorders.

Building on the received data in the work we have developed pathogenetically grounded system of correction of depression involving suicidal behavior, which includes the application of integrated psychotherapeutic programs in conjunction with medical treatment. In conducting drug therapy should be given preference for the latest generation of antidepressants with a proven safety profile, high therapeutic index and low “behavioral toxicity”. Psychotherapeutic correction includes family therapy, cognitive-behavioral therapy, interpersonal psychotherapy, and psychoeducational training.

Developed and implemented in practice the system of psychotherapy and medical and social rehabilitation of patients with depression involving suicidal behavior, which confirmed the effectiveness of data of observation after 12 month.

Conducted follow-up study showed the high efficiency of the proposed system of psychotherapeutic interventions for example 83.8% of patients with repeated suicide attempts were observed, 16.2% had undergone repeated courses of complex therapeutic interventions due to additional stressful circumstances.

Obsessive phenomena, when present, are usually seen in the depressive phase of bipolar disorder.

The peculiar case with aggravation in ruminative and obsessive thinking with simultaneous hypomania may widen our understanding of the phenomenology of antidepressant induced hypomanic symptoms.

We present a case of ruminative hypomania induced by high dose venlafaxine. Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Yale Brown Obsessive Compulsive Scale (YBOCS) were used for symptom ratings.

The patient was 30 years old and she had treatment history of depression for 3 months. She had two consecutive suicide attempts with drugs in the week before she was hospitalized for suicidal risk. She was using venlafaxine 300 mg/day and olanzapin 2,5 mg/day; continuous ruminative thinking about the past and imaginary sexual affairs with former friends were apparent with an unremitting pattern, leading to intense psychomotor agitation and suicide attempts. Irritable mood, and increased energy was observed with continuous ruminations. She was diagnosed with bipolar-II-disorder, with mixed features and anxious distress (YMRS:17, HAM-D:22, YBOCS:34). After discontinuing venlafaxine and starting anti-manic treatment with haloperidol 10 mg/day in the first week, both affective symptoms and ruminations were improved (YMRS:2, HAM-D:4, YBOCS:8). Aripiprazol 20 mg/day and quetiapine 100 mg/day which were given for continuation treatment were also effective for preserving full remission.

When prescribing high dose venlafaxine for treatment resistant depression, it should be remembered that this may induce hypomanic symptoms and prominent ruminative thinking which can be ameliorated with anti-manic treatment.

No significant relationships.

This study was to analyze the sample data collected from divorce marital therapy sessions in the local court system in South Korea as well as diagnose typical symptoms in the divorcing couples.

The survey forms and marital therapy notes were collected from 200 divorce counseling cases in the local court systems, South Korea. The 200 divorce counseling cases were categorized as twelve major themes. Family therapy notes were utilized as an aid in verifying the divorcing couples’ self-reports. The research method was partially adopted from the article, “Working with Korean-American Families: Multicultural Hermeneutics” (Sang Bok Lee, 2003: The American Journal of Family Therapy, 31, 159 – 178). Multicultural hermeneutics was instrumental for explicating multiple layers of multicultural narratives, psychological dynamics, socio-economic systems, and of family systemic relations when dealing with the divorcing couples.

The results were summarized as: economic issues (20%); extra-marital relationship (16%); in-law conflict (12%); substance abuse, addiction & marital violence (12%); international marriage & cross-cultural differences (10%); personality difference (8%); re-marriage issues (6%); sexual conflict (6%); age gap (4%); personality disorder & mental disorder (2%); parenting & children issues (2%); pre-mature marriage (2%). The twelve categories were grouped as mainly

1. (1) family systemic or relationship-related issues,

2. (2) socio-economic issues, and

3. (3) mental health-related issues.

Psychiatrists, family therapists, and mental health professionals who work with the divorcing couples need to be aware of the predominant causes for rapidly increasing divorce rates when conducting therapeutic assessment and implementing intervention for the divorcing couples.

Human factors have been reported as the reason behind the majority of car accidents. However, to date, no studies at least in the Arab world generally and Gulf area specifically, conducted a comprehensive examination of cognitive functioning as potential predictors of car accidents and driving violations.

Examining the role of cognitive functions e.g., verbal working memory, attentional control as predictors of traffic accidents and driving violations.

Examining the predictability of individual's cognition of occurrence of driving violations and accidents.

The study was carried on a sample of hundred and thirty two participants whose age ranged between 24 and 31 years. They were classified into groups of violators and non-violators, accident free and accident involved as well. Cognitive functioning were measured using self-reports and task performance, and a series of ANOVAS as well as stepwise multiple regressions were conducted to test the research hypothesis.

Findings showed significant differences between violators and non-violators and between the accident free and accident involved groups in almost all of the considered factors, except for the decision making factor. Moreover, Pearson product-moment correlations showed that there were significant negative correlations between age, driving violations, and cognitive performance and the accidents.

Human cognition such as executive functioning and mental planning are key factors for predicting driving behavior and traffic accidents. The study results have many implications in diagnosing and preventing or at least reducing driving violations and road accidents.

The author has not supplied his/her declaration of competing interest.

Bulimia Nervosa (BN) is a debilitating eating disorder characterized by binging and purging episodes generally accompanied by excessive concern with body weight and shape as well as body image disturbance. BN and Borderline Personality Disorder (BPD) may co-occur. In fact, studies estimate that one quarter to one third of patients with BN also meet criteria for BPD. However not much is known about the relationship between these two diseases. Nevertheless, the high comorbidity rate might not be surprising as both BN and BPD may share interacting aetiologies and common core symptoms such as impulsivity and emotional instability. So far, only very little is known about the clinical presentation of patients with both BN and BPD and their response to treatment.

Literature review on BN and comorbid BPD. An illustrative clinical case is presented.

Case report and non-systematic review of the literature - sources obtained through search on Pubmed.gov database.

Female, 19-year-old, student, lived with her mother and stepfather. Developed a poor relationship with her body image due to dental problems during high school. The patient started to binge eat, exhibit compensatory behaviors, restrictive eating pattern, body dissatisfaction and emotional instability while maintaining a normal BMI. Over the last year, she started a self-destructive behavior with slight improvement of BN symptoms.

Special attention should be given to patients suffering from BN and comorbid BPD as they present greater risk of recurrent suicide attempts and non-suicidal self-injury, as well as lower rates of remission. Early interventions that target impulsivity and problematic eating behavior may mitigate risk of future borderline personality features.

No significant relationships.

The strong comorbidity between depression and epilepsy is widely acknowledged. However, depression in epilepsy can manifest atypically, leading to its low detection rate and lack of access to treatment in patients with epilepsy

To study the specifics and pattern of depression in epilepsy for its timely diagnosis and therapy and to prevent suicide risk and improve the quality of life in patients with epilepsy

Clinical, statistical, psychometric. A total of 149 patients, mean age 45.0 ± 11.7 years, 74 males, 75 females, were examined

It was found that depression was manifested in 46.3% of patients before the onset of epileptic seizures, and in 20.8% of patients it developed after treatment with some AEDs. The incidence of symptoms characteristic of depression in epilepsy, such as unstable mood, irritability, euphoria, episodes of pain and sleep disturbances, and its’ impact on the quality of life in patients with epilepsy were analysed. Gender differences were identified for a range of symptoms

The authors expanded their understanding of the clinical specifics of depressive manifestations in patients with epilepsy to allow timely detection and medical and rehabilitative care for these patients

No significant relationships.

The characteristics of the Autistic Spectrum Disorder involve deficits in social communication and repetitive patterns of behavior and that there is a growing interest in the use of new technologies for neurorehabilitation.

This research aimed to verify the possibility of using Virtual reality for the treatment of Autism.

Scientific publications were selected from the PUBMED, ScieLO, LILACS and Google Scholar databases, written in Portuguese and English, with free access, between 2014 and 2019.

A total of 19 publications were identified. Concerning their design, 26,3% of them were experimental, 21,1% qualitative, 21,1% one-group pretest-posttest, 15,8% quasi-experimental, 10,5% descriptive and 5,2% of them were exploratory research studies. The studies focus on anxiety and phobias reduction, as well as teaching strategies to deal with stessful events. Eleven of the studies focused on the enhancement of independende and sef-confidence of the subjects. In five ot the studies the virtual reality was used with other technologies. In two of them the EEG was used along with virtual reality for detecting the cerebral region in activity during action.

Virtual reality was defended in most of the studies because it can provide a safe environment and offering high control of variables. Although the results indicate the use of virtual reality for the reduction of anxiety and the promotion of self-confidence and independence which aims the social deficits in autism, more research is needed to investigate the use or impact of VR on repetitive behavior.

Postpartum Psychosis is an underdiagnosticated psychiatric condition that may be suffered by mothers within a year since delivery. It is a severe syndrome in which symptoms such as delusions, hallucinations and disorganized thinking may appear. The traditional approach of admitting the mothers separated from their children has shown harmful consequences. This has led to the creation of Mother-Baby Units (MBU), psychiatric admission units dedicated to full-time housing mothers and their babies.

To evaluate the evidence available regarding the potential benefits of MBU not only for the mothers, the babies, but for the mother-baby bond. To analyse postpartum psychosis risk factors and prognosis.

A thorough review of scientific literature and databases regarding postpartum psychosis and MBU has been carried out. Additionally, international mental health care guidelines for perinatal mental disorders were analysed.

A wide range of related aspects were studied for the present work, including characteristics of the patients, differences in the self- assessment scales of depression, anxiety, postpartum attachment of the mother to the baby at admission and at discharge and the work and social adaptation. Other studies analysed the percentage of mother-baby separation at discharge, as well as the most frequent delusions, and the potential effect of childhood trauma on these patients.

The available evidence suggest that MBU may be helpful for the improvement of the mental health in women suffering perinatal mental disorders and for the building of a secure attachment style in the baby. The results of the interventions included in MBU programs also show promotion of a positive mother-baby relationship.

No significant relationships.

The use of social networks is an integral part of our daily life as a means of communication. Scientific dissemination through these kind of platforms has expanded enormously in recent years, for example in networks such as Instagram, a free photo, text messaging and video sharing social media application. Instagram has been used extensively in different fields of medicine. Initially it was limited to visually rich fields but it has been extended to others such as mental health. This tool has enormous potential as a means of more effective communication and prevention.

To analyze the role of Instagram as a tool of psychoeducation and prevention in mental health

An analysis of different mental health profiles was carried based on different items: publications, interactions, likes, commentaries, shares, accounts reached, accounts engaged and hashtags.

Mental health has become one of the sanitary fields generating more traffic on social media reaching a great number of publications per day. Topics that generated more interaction were: depression, anxiety, trauma, sleep and emotion regulation difficulties among others. However most mental health information available in social media had not been provided by proffessinals of the mental health but by many others.

Instagram is presented as a valuable mental health prevention tool and professionals should engage and adapt to new scenarios of communication. In the era where information is easy to get but knowledge is difficult to find, experts of mental health should more involved.

No significant relationships.

The noun “maieutics” derives from maia (mother, midwife) and the related verbs “maieusis” and “maieonuai” mean “giving birth” and “easing childbirth”. Socrates’ maieutics aspires to give birth to the truth in the youth. Since homeric times psychotherapy has been part of medical act. Initially, the physician’s word had a magical character. Plato rationalized this in many of his dialogues, specially in “Charmides”.

The search of the essential characteristics of this therapeutic method described by Plato, as well as its ethical implications

Hermeneutic method

The consequences for doctor-patient relationship in general and psychotherapy in particular are: 1. Remedy and “epodé” (charm) must be applied in every doctor-patient relationship. 2. The body can only be healed if the soul is cured first by a charm. 3. The openness of the patient’s soul to the physician and the physician’s beautiful speech to the patient will enable the latter to reach the state of “sophrosyne” (temperance), condition of possibility of true health.

In the discussion of the meaning of “sophrosyne”, Socrates questions disciples’ propositions and concludes that the only thing one can be sure of is that “sophrosyne” is a way of searching virtue (arete). Later, in Theaetetus, Plato adds another element: temperance is a “homoiosis theó”, that is, the assimilations of patient to God. With this Plato seals the ethical character of psychotherapy for ever.

No significant relationships.

North East London NHS Foundation Trust (NELFT) provides an extensive range of integrated community and mental health services for people living in London serving a population of 1.5 million people. With an annual budget of £325 million NELFT is one of the largest community service providers in the United Kingdom (UK). NELFT is responsible for the education and training of the entire workforce and in August 2016, it employed a nurse fellow to work with the medical education fellows so it could focus on multidisciplinary team (MDT) teaching.

• (1) Providing MDT teaching by delivered by a MDT medical education team.

• (2) Improving the training experience of all trainees, nurses and allied health professionals in NELFT.

• (3) Improving physical health knowledge for mental health staff.

• (4) Improving mental health knowledge of physical health staff.

Two psychiatrists and one nurse manager worked together on joint projects to deliver the MDT teaching. Teaching sessions where at least one psychiatrist and nurse manager delivered teaching on serious incidents affecting patient care, identification and management of sepsis in community settings and empathy training using an old age simulation suit.

Multiple teaching sessions were delivered to MDTs within the Trust. Staffs were receptive to learning in MDTs rather than traditional splits according to professions. Due to the success of this teaching and the reputation of the medical education team, neighboring Trusts have expressed an interest in working in partnership with the team to further enhance teaching and learning in acute and community settings.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

The addictive behaviors can be seen as attachment disorders. To our knowledge, the literature on the relationship between pathological gambling (PG) and attachment styles is still poorly represented. However, in addicted patients, the identification of secure or insecure attachment styles seems to have serious implications for the therapeutic alliance and the treatment.

To examine the clinical role of attachment styles in the PG patients.

To study the relationships between the different attachment styles and PG and the severity of PG.

We recruited 33 patients with GP according to DSM-IV-TR criteria; all patients were abstinent from addictive behaviors at least since one month, the experiences in close relationships (ECR) was administered to investigate attachment styles, the South Oaks Gambling Screen (SOGS) to investigate the severity of gambling.

The subjects showed the following attachment styles (Table 1). Ambivalent attachment style correlates with high scores to the SOGS (P < 0.001), and with a shorter period of abstinence from PG (P = 0.022). Patients with ambivalent attachment style have increased severity of PG at SOGS, correlating with higher raw score on the anxiety factor of ECR and lower raw score on avoidance factor (for both P = 0.036).

Patients showed ambivalent attachment, and anxiety factor correlates with a greater severity of PG. Attachment style could be a severity index of PG. Our findings need to be replicated in larger groups, also widening the target of other addictions both chemical and behavioral.

The authors have not supplied their declaration of competing interest.

Trauma experiences during childhood and adolescence (Gibb, 2002; Ansel et al., 2011; Musliner et Singer, 2014; Hopwood et al., 2015), the experience of shame (Rubeis et al., 2008; Cunha et al., 2012; Rosso et al., 2014; Stuewig et al., 2015) and gender (English et al., 2004; Rosso et al., 2014) had been considered as predictors of depressive symptoms.

To observe intra-indidual variability of trauma, external shame, gender (as predictors) and depressive symptoms (as dependent variable).

To test the predictive value of trauma, external shame and gender on depressive symptoms at 6 months, in adolescents.

A sample of 325 adolescents (ages ranging from 12–18) completed the Child Depression Inventory, the Childhood Trauma Questionnaire and Other as Shamer, adolescents version. The results were analysed by the hierarchical multiple regression method (SPSS Inc., 22).

The model – shame (b = 0.63; P < 0.001); affective abuse (b = 0.15, P = 0.001), gender (b = 0.12; P = 0.001), sexual abuse (b = 0.12, P = 0.002), and emotional neglect (b = 0.10; P = 0.013) – explained 63% of depressive symptoms variance.

The data indicate that the higher the level of shame and trauma, the higher the level of depressive symptoms at 6 months. The present study can add important information that sheds light to the role of mechanisms underlying the vulnerability to depressive symptoms and that might have impact in the existing therapeutic interventions.

The authors have not supplied their declaration of competing interest.

Clozapine use is not deprived of serious complications that can condition treatment strategies, particularly hematological. Recognizing the time it takes for these effects to set, can therefore help to better screen their appearance, improving healthcare.

To study the time of onset of hematological adverse reactions in patients treated with Clozapine.

A longitudinal, retrospective and descriptive study on a period of 20 years starting from the first of January 2000, at the psychiatry department A of the Razi hospital in Tunisia. This study was conducted on patients treated by Clozapine. The data was collected from patients’ medical files using a pre-established sheet.

The studied sample included 64 patient. Hematological disorders were found in 21 patients (32.8%). The mean time of onset of hematological adverse reactions was 119.71±126.56 days. Indeed, some patients had presented more than one hematological disorder and this at different times. Mild to moderate neutropenia had a mean time of onset of 502.57±908.32 days. The time of onset of eosinophilia was 937.75±1725.87 days, 297.67 ± 444.93 days for thrombocytopenia, 741±1268.85 days for leukopenia, 69.25 ± 48.19 days for hyperleukocytosis and 183. 33±231.80 days for anemia. Two cases of agranulocytosis were noted: one case occurred 10 years and three months from treatment beginning and the second case occurred after 7 months of treatment onset.

The time of onset of hematological side effects with clozapine varies widely and cannot be predicted with precision. Early, more frequent and regular surveillance is therefore necessary in this population.

No significant relationships.

Beyond living longer, it is increasingly important to live with more and better health during aging (1). Sexual well-being (SWB) was found to contribute to health and well-being in old age and is highly under-researched in the older population (2).

This study aims to analyze SWB in a cross-cultural way through older Portuguese and Slovenian older samples.

We interviewed 136 older participants with an average age of 71.6 years old. Participants were Portuguese and Slovenian and lived in the community. Participants were subjected to semi-structured interviews and these were subjected to a content analysis process.

The content analysis indicated nine themes related to SWB: self-reported good health; demonstrations of love; non-sexual joint activities; overall well-being and quality of life; partner support; positive self-image; being independent and active; sexual compatibility; and masturbation. Portuguese older adults experience their SWB associated mainly with self-reported good health and demonstrations of love, while Slovenians older adults associate their SWB mainly with non-sexual joint activities and overall well-being and quality of life.

The themes found in this study are fundamental evidence for cultural interventions and guidelines outlining in the context of sexual health in aging, mainly due to the scarcity of knowledge of SWB among older adults. 1.von Humboldt S et al. Sexual expression in old age: How older adults from different cultures express sexually? Sex Res Social Policy. 2020;1-15. 2.von Humboldt S et al. Are older adults satisfied with their sexuality? Outcomes from a cross-cultural study. Educ Gerontol. 2020;46:284-293.

No significant relationships.

Prescribing more than one antipsychotic at the same time is becoming common in the treatment of patients with severe mental illness (SMI), although most guidelines recommend monotherapy.

The aim of this study was to examine the prevalence of antipsychotic polypharmacy and to compare the practices of polypharmacy and monotheraphy in terms of the rationale and compatibility of the treatment.

This study included 235 patients with SMI between 18 and 65 years of age who were followed at KTU Psychiatry Department Schizophrenia-Bipolar Disorder outpatient clinic between January 2007 and December 2014. The sociodemographic and clinical data were evaluated by a chart review form which was prepared by the researcher and designed according to American Psychiatric Association treatment algorithm and National Associated Mental Health Program Directors polypharmacy classification.

138 patients (58.7%) were diagnosed with schizophrenia, 75 patients (31.9%) were diagnosed with bipolar disorder and 22 patients (9.4%) were diagnosed with schizoaffective disorder. 62 patients (26.4%) were receiving antipsychotic polypharmacy. Combinations of two second-generation antipsychotics were most common. Anticholinergic drug use was significantly more common in patients on antipsychotic polypharmacy. Reported adverse events were more common in patients on polypharmacy but did not reach the level of statistical significance. Patients on antipsychotic polypharmacy were more likely to be diagnosed with schizophrenia. Polypharmacy patients were also more likely to receive clozapine and amisulpride whereas monotherapy patients were more likely to receive olanzapine.

Our results confirm previous reports that indicate patients with SMI are most likely to receive antipsychotic polypharmacy.

The authors have not supplied their declaration of competing interest.

The purpose of this study was to investigate cognitive functioning in Borderline Personality Disorder subjects, with particular reference to the Working Memory functioning. The Working Memory seems to be relate to core features of the disturb. The final aim was to better understand the disorder and to implement a cognitive training to improve the deficits.

A literature search was conducted in April 2015. Pubmed and Scopus databases were used to find studies to include in the systematic review. The keywords used for the literature search were: “borderline personality disorder”, “borderline personality”, “working memory”, “executive functioning”. In each search, the keywords were used together with the logical operator “and”.

Three studies were included in this systematic review (Table 1). In each study, the working memory was investigated using N-back test. In two of those studies significantly differences were found between patients and healthy group in N-back task. In the third study, which used more tests to investigate working memory domain, no differences were found between the two groups.

Borderline personality disorder patients performed significantly worse on the N-back test compared to healthy controls and the impairment increased with increasing working memory load. In the third study the working memory domain was investigated using four different tests and single scores were not included therefore it was impossible to compare N-back data.

The authors have not supplied their declaration of competing interest.

Impaired sleep quality is among the most common complaints in psychopathological conditions including psychotic states. The clinical relevance of sleep disruption is, however, notoriously overlooked and considered as a secondary symptom that automatically ameliorates if the mental problem is adequately treated. Nevertheless, research findings indicate that sleep quality has a causal role in the occurrence and maintenance of psychotic states, and instead of being merely the “nocturnal impact” of an underlying mental disorder, shows bidirectional associations with mental health complaints.

Although the majority of studies examined the links between sleep and psychosis by cross-sectional assessments, sleep quality and psychotic-like experiences both fluctuate from night to night and day to day, respectively, even in non-clinical populations. The prospective assessment of these variables hence allows for the analyses of the temporal (and intraindividual) associations between sleep and psychosis. In our studies, we examined the temporal, bidirectional associations between sleep quality and psychotic-like states.

Across three experience sampling studies with participants from the general population ( N = 73 / 166 / 60), we assessed sleep quality and daytime psychotic-like phenomena every day for at least two weeks. Using mixed-effects models, we examined if sleep quality predicted psychotic-like experiences the following day, and also if psychotic-like experiences predicted sleep quality the following night.

Our findings consistently highlight the dominant direction of prediction from sleep to daytime psychotic-like experiences, whereas the inverse direction is not supported by enough evidence.

Individuals at risk for psychosis could benefit from sleep-specific interventions that could be integrated into treatment protocols.

No significant relationships.