Breastfeeding is an important determinant of both mother and child healths regarding its physical and psychological benefits. Working mothers usually consider the work as a barrier to breastfeeding, thus this population needs a particular attention to enhance their breastfeeeding rate.

Determining the prevalence of breastfeeding among active women in Tunisia and evaluating their perceptions and their practices towards this process.

We have conducted a descriptive and cross sectional study. Data were collected during one week through an online questionnaire designed by Google Forms and distributed via Social media. It had included active women who had a child aged between 6 months and 5 years. Exclusive breastfeeding (EBF) is feeding the baby only breast milk (not any other foods or liquids).

A total of 51 active mothers had participated with a mea age of 32.4±3.8 years. A proportion of 47.1% worked in healthcare facilities. Nineteen participants were doctors. All the participants had experienced breastfeeding with a mean duration of 12.7 ±7.5 months [ranging from 2 to 25 months]. The mean duration of EBF was 3.1±2.0 months [ranging from 0 to 6 months]. A percentage of 64.7% had experienced mixed feeding. Regarding breastfeeding perceptions, 92.2% of women always believe that breastmilk was the right option to feed their babies. Tweenty two (43.1%) always believe that they could successfuly breastfeed their child and sixteen (31.4%) consider that they was usually sure that they were able to balance between work and breastfeeding. Participants mothers had returned to their job within a mean of 12.7 ±7.5 months [ranging from 2 to 25 months]. After returning to work, 56.9% of participants consider that breastfeeding represented a big challenge. EBF was negatively associated to the number of working hours /week (p=0.026).

The participation of women in the labor force makes the continuation of breastfeeding a challenging option. Thus, promoting and supporting breastfeeding in the workplace are essential and have the potential to ameliorate babies and mothers lives, and to positively affect the employees productivity and well-being.

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Co-occurring substance use disorders (SUDs) among individuals with schizophrenia are a prevalent and complex psychiatric comorbidity, which is associated with increased symptom severity, worsened illness trajectory and high rates of treatment non-adherence. Recent evidence suggests that the use of depot antipsychotics may provide an effective treatment option for individuals with this dual-diagnosis.

Hypothesis testing: “Depot antipsychotics are associated with i) reduced hospitalizations, ii) improved quality of life and iii) improved patient functionality in dual diagnosis of psychosis and SUD”.

68 patients in community of Eastern Crete (Greece) participated (Male to Female ratio corresponds to 2.4:1). All of them manifested psychosis (24 with F.20 ICD-10 and 44 with F29.0 ICD-10). The median age was 41 years. 29.41% had dual diagnosis of psychosis and alcohol use disorders, 7.35% had dual diagnosis of psychosis and cocaine use disorders, while 26.47% had dual diagnosis of psychosis and cannabis Use disorder. 80.88% were on aripiprazole LAI, 8.82% on paliperidone LAI, 2.94 % on risperidone LAI and 7.35% on haloperidol LAI. For the evaluation of our hypotheses the instruments WHOQOL-BREF questionnaire and the CGI-S scale were used. The quality of life and the functionality of the patients and also the number of their hospitalizations were compared in each patient, before the initiation of the LAI medication and during the active treatment period. The minimum of follow-up period was 6 months.

In our sample of 68 patients with depot antipsychotics therapy administrated at least for 6 months: a) Hospitalizations decreased statistically significantly from 1.01 ±1.54 to 0.01±0.12 (Paired Samples Wilcoxon Signed Rank Test p-value<<0.001), b) The CGI-S score decreased statistically significantly from 5.72 ±0.88 to 2.94±1.33 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001), c) The score of the WHOQOL-BREF scale increased statistically significantly from 0.57 ±0.53, to 3.35±0.84 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). The same sample with depot antipsychotic treatment administrated at least for 3 months: a) The CGI-S score decreased statistically significantly from 5.72 ±0.88 to 2.34±0.89 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001), b) The score of the WHOQOL-BREF scale increased statistically significantly from 0.57 ±0.53, to 2.3±0.89 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001).

Depot antipsychotics medication significantly reduces the number of hospitalizations, when patients with psychosis and substance use disorders remain in therapy at least for 6 months. In addition, the administration of depot therapy, at least for 6 months, improves the quality of life and the functionality of these patients.

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Morbid obesity is correlated with hypertension, dyslipidaemia, prediabetes and T2DM. If lifestyle modifications and pharmacotherapeutic or mixed interventions fail, bariatric surgery is advised for morbidly obese patients. Psychological characteristics of such patients, especially after bariatric surgery, are a vastly under-researched area.

This research presents the short-term results of the LASAGNE trial (LAparoscopic Single-Anastomosis duodeno-ileal bypass with Gastric plication (SADI-GP) in the maNagEment of morbid obesity) regarding psychopathological values.

This study used a cohort of consecutively admitted patients to assess complication rates and efficacy of SADI-GP. Patient recruitment began in October 2018 and ended in June 2019. Preoperative evaluation followed by surgery and postoperative follow-up visits (at 1, 3, 6 and 12 months) with Minnesota Multiphasic Personality Inventory (MMPI-2) recorded at 12-month follow-up. Participants’ age was between 18 and 65 years, with BMIs of > 40 (without comorbidity related to morbid obesity) or > 35 (with comorbidity related to morbid obesity, especially glucose metabolism). Psychological characteristics of patient groups were analyzed based on weight loss outcomes and Body Mass Index (BMI) changes. Substance Use Disorder was among other exclusion criteria.

Scales of affective function deficit (RCd, RC1, RC2, RC7) were elevated at 13 cases, scales of behavioural dysfunction (RC4, RC9) were elevated at 11 cases, scales of thought dysfunction (RC3, RC6, RC8) were elevated at 8 cases, RC2 and RC7 showed emotion dysregulation tendencies (Table 1). No subject scored within the normal range on the Introversion/Low Positive Emotionality (INTR/LPE) scale (Table 2). We distinguished and compared the low and high scorers on the INTR/LPE scale (Table 3). This study has limitations regarding sample size, higher-than-expected dropout rate, strict exclusion criteria, male-to-female ratio, short-term results, no longitudinal data on psychological characteristics.

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Our results suggest that the majority of bariatric surgery patients, 12 months after the procedure, show signs of affective dysfunction, thought dysfunction and emotion dysregulation, all signs of a depressive state. Greater weight loss carries a greater probability of depression along with a lesser likelihood of positive emotional experiences; therefore, psychological support during follow-up is necessary to maintain weight loss.

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Digital studies based on the continuous monitoring of patients in their natural environment help to refine the suicidal phenotypes. Studies using ecological momentary assessment revealed the existence of different patterns of suicidal ideation (SI) based on both their severity and variability. Specifically, variable SI may be a frequent pattern of suicidal ideation that appears to be related to some clinical features (social withdrawal, impulsive aggression, suicide attempts), rooted in childhood trauma and serotonergic dysfunction and associated with the reactivity to stressful life events. Some individuals, in response to stress could experience both psychological pain and decision-making impairment in social contexts, leading to suicide risk. Then, the description of the suicidal pattern may help to define clinically and biologically homogeneous groups of at-risk patients.

In this sense, experimental studies where patients are submitted to a social stress task reported that patients who were more sensitive to a social stress, as measured with a higher salivary cortisol response, were less depressed, more impulsive, and made suicide attempts with a higher intent. Investigating the regulation of the immune inflammatory response to the social stress task, we recently reported that suicide attempters and ideators showed less dynamic inflammatory stress responses in comparison to psychiatric controls, and that platelet activation responses to stress were blunted in individuals with suicidal ideation. Last, we will present new data of cardiovascular and emotional responses to the virtual Trier Social Stress Test in women with a history of depression and with or without a history of suicide attempt. Combining digital and experimental studies could help to refine the suicidal phenotypes and reduce the heterogeneity of suicidal behaviors that are led by different processes, in order to develop specific therapeutic approaches for a better suicide prevention.

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The University of Bristol Medical School, United Kingdom, has student-selected components (SSC) making up a substantial proportion of its curriculum. This practice is common among UK medical schools. SSCs can inspire interest in specialities that students may have less exposure to during undergraduate training, such as psychiatry. Psychiatry has a broad range of sub-specialities and themes which can be explored in an SSC. The author supervised one such project in which a student researched and produced a series of podcasts about the science of happiness.

To explore the use of student-selected components (SSC) in increasing exposure to psychiatry in the undergraduate curriculum

To explore the impact of student-selected components (SSC) in increasing recruitment into psychiatric training

An initial literature review was performed with the following keywords using Medline on OvidSP.

Fourteen papers addressed the use of psychiatry student-selected components (SSC) in undergraduate medical education and their influence on career specialty choice.

Student-selected components (SSC) are an important strategy for increasing exposure to psychiatry in undergraduate medical education and recruitment into psychiatry.

Medical undergraduate education, elective, student-selected components, special study modules, psychiatry, mental health.

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Tattooing is a mode of bodily expression that belongs to both tradition and modernity. This form of expression is rich in variant and variable meanings for women in general, and women with psychiatric disorders in particular. Their popularity and prevalence are increasing rapidly, particularly among young people. However, despite this expansion, the social perception of tattoos, particularly among women, remains a complex and often stigmatized subject. Hence the interest in knowing the characteristics of tattoos among women in Morocco, the different perceptions of the latter as well as the correlation of tattooing with psychiatric disorders.

To study the characteristics, meaning and perception of tattoos among Moroccan women, past and present. In an attempt to better understand the potential health implications of this mode of expression and its correlation with mental health.

A descriptive cross-sectional study was carried out among women of different profiles. Data were collected using a form sent online and distributed in paper form. The form collected socio-demographic data, descriptive characteristics of the tattoos and the women’s mental health status. Statistical analysis was performed using Jamovi 2.3.

Our results focused on the socio-demographic characteristics of our population, it was carried out on 52 women, 57.7% of whom were aged between 25 and 40, 62% of our sample were single and the majority(92%) had a level of education higher than the baccalaureate. Also, almost 30% were unemployed. ours study results focused essentially on the tattoo characteristics, summarized in Image 1. Image 2 shows the results concerning the psychiatric history of our population.

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Tattooing is a means of expression and a form of body modification, rich in cultural and personal significance, with a dual affiliation to tradition and modernity. It is highly prevalent among women, and has implications for both mental and physical health.

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Gardner-Diamond Syndrome (GDS), also known as psychogenic purpura, is an uncommon psychosomatic disorder characterized by painful, ecchymotic, purpuric lesions that typically appear after a period of stress, surgical operations or hard physical work, predominantly affecting women. The pathophysiology of GDS is still poorly understood, and diagnosis is often challenging due to its overlap with other hematological, dermatological, or psychosomatic disorders. Appropriate diagnosis is essential for symptom management and patient risk reduction.

This review aims to synthesize the current knowledge on GDS, encompassing its etiology, clinical presentation, diagnostic criteria, and treatment approaches while identifying areas for future research.

We performed a narrative literature review by searching PubMed, Google Scholar, and ScienceDirect articles written in English. Relevant studies, case reports, and reviews published from 1955 to 2023 were included.

Gardner-Diamond Syndrome predominantly affects middle-aged women, but the literature has also published reports concerning men and children. It is often associated with psychological stress, anxiety, or depression. Many authors suggest the presence of histrionic personality traits and a tendency toward somatic reactions in affected individuals. In 1955, Frank Gardner and Louis Diamond identified and described Gardner-Diamond Syndrome after observing four women who experienced recurrent bruising, accompanied by localized pain, erythema, and swelling, following minimal or no trauma. The spontaneous bruising observed in GDS lacks a hematological cause, with most studies suggesting a psychosomatic origin. The diagnosis is made with a detailed medical and psychiatric history, physical examination, laboratory examination, and exclusion of other possible causes. Psychological therapies, such as cognitive-behavioral therapy, alongside pharmacological treatments, have shown variable success in symptom management. However, most patients experience long-term cycles of remission and relapse, and a standardized treatment protocol has yet to be established.

Gardner-Diamond Syndrome represents a complex interaction of psychological and somatic factors, highlighting the importance of a multidisciplinary approach to both diagnosis and treatment. Diagnostic challenges persist due to the absence of definitive biomarkers and reliance on exclusionary criteria. Also, GDS lacks treatment options. While psychological interventions play a central role in management, further research is needed to clarify the underlying pathophysiology and improve therapeutic outcomes. Most patients benefit from a combination of cognitive behavioral therapy and antidepressant treatment. Increasing clinician awareness may help reduce diagnostic delays and improve the quality of life for patients.

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There is an urgent need to improve early accessibility to psychoeducational interventions for informal caregivers of individuals with eating disorders (EDs). We adapted the BREF programme, a short, single-family, psycho-educational intervention originally developed for caregivers in severe mental disorders, to EDs (BREF-ED) and assessed at diagnosis announcement. We hypothesised that it has a good acceptability and effectiveness in reducing short-term caregivers’ self-reported levels of burden and depressive symptoms.

Data of caregivers who participated in the BREF-ED programme were analysed. Adherence, satisfaction, and perceived usefulness were evaluated. Changes in self-reported burden and depression symptoms were measured pre-, post-, and 3 months after the intervention using the Zarit Burden Interview (ZBI) and Center for Epidemiological Studies – Depression scale (CES-D).

Of the 53 caregivers included in the study, 52 participants completed the BREF-ED programme. As compared to baseline, ZBI scores showed a significant reduction after the intervention (Cohen’s d = 0.61, p < 0.001), and at the 3-month assessment (Cohen’s d = 0.62, p < 0.001). The CES-D scores also significantly decreased by the end of the third session (Cohen’s d = 0.83, p < 0.001) and at the 3-month follow-up (Cohen’s d = 0.77, p < 0.001). Satisfaction scores were high, with 90.1% of participants reporting being “very satisfied” and 9.9% “satisfied.”

Preliminary findings demonstrated high adherence rates, caregiver satisfaction, and a positive impact on burden and related depressive symptoms immediately after the programme and at short-term follow-up. This time- and resource-efficient programme has the potential for easy dissemination.

Cannabis use is elevated in youth with depression and attention-deficit/hyperactivity disorder (ADHD), but drivers of this increase remain underexplored. The self-medication hypothesis suggests cannabis is used by patients for mood regulation, a common difficulty in ADHD and depression. This study aimed to examine associations between mood instability and cannabis use in a large, representative clinical cohort of adolescents diagnosed with ADHD and/or depression.

Natural language processing (NLP) approaches were utilised to identify references to mood instability and cannabis use in the electronic health records of adolescents (aged 11–18 years) with primary diagnoses of ADHD (n = 7,985) or depression (n = 5,738). Logistic regression was used to examine mood instability as the main exposure for cannabis use in models stratified by ADHD and depression.

Mood instability was associated with a 25% higher probability of cannabis use in adolescents with ADHD compared to those with depression. Following adjustment for available sociodemographic and clinical covariates, mood instability was associated with increased cannabis use in both ADHD (aOR: 1.61 [95% CI: 1.41–1.84]) and depression (aOR: 1.38 [95% CI: 1.21–1.57]) groups.

This was the first study to explore the differential impact of mood instability on adolescent cannabis use across distinct diagnostic profiles. NLP analysis proved an efficient tool for examining large populations of adolescents accessing psychiatric services and provided preliminary evidence of a link between mood instability and cannabis use in ADHD and depression. Longitudinal studies using direct measures or tailored NLP techniques can further establish the directionality of these associations.

This analysis evaluated potential differences in subjective well-being (SW) among patients with early-phase schizophrenia (SZ) randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone within the “European Long-acting Antipsychotics in Schizophrenia Trial” (EULAST).

A total of 478 patients were followed for up to 19 months. SW was measured using the Subjective Well-being under Neuroleptic Treatment scale (SWN). Linear mixed-effects models assessed treatment differences. Comprehensive analyses included age, sex, symptomatology (Positive and Negative Syndrome Scale [PANSS]), and side effects (Systematic Monitoring of Adverse Events Related to Treatments [SMARTS] and St. Hans rating scale [SHRS] for extrapyramidal syndromes) on SWN changes.

Overall, SW improved over the course of the study. No significant differences emerged between LAI and oral administration (p = 0.1533) or between aripiprazole and paliperidone (p = 0.2008). Similarly, age and sex were not relevant in this regard. In contrast, negative, positive, and affective symptoms (all p < 0.0001) as well as the overall side effect burden (SMARTS sum-score, p < 0.0001) showed significant inverse associations with SW. Certain SHRS subscales correlated with SW in partial models, but associations disappeared in the fully adjusted model.

Patients with SZ initiating LAI or oral treatment with aripiprazole or paliperidone reported comparable SW improvements. Findings emphasize that treatment choice should be guided less by formulation or substance and more by individual patient needs, prioritizing symptom control while minimizing adverse effects. A patient-centered approach remains essential to optimize both clinical outcomes and subjective well-being in early-phase SZ.

Certain prescription drugs used during pregnancy are associated with offspring autism spectrum disorder (ASD). Nonetheless, ASD risk following prenatal exposure to most drugs remains unknown. Furthermore, methodological challenges and ethical concerns hinder the scope for causal inference.

We used a case-cohort study design of a nationally representative sample from Israel to examine the associations between maternal prescription drug use during pregnancy and offspring ASD. To scrutinize these associations, the analyses were (a) adjusted for indication proxy (level 2 Anatomical Therapeutic Chemical (ATC) codes), (b) repeated using shared pharmacological targets as exposures, and (c) inspected further through target-enrichment analysis.

The sample included 1,400 individuals with and 94,713 without an ASD diagnosis. Among all drugs prescribed during pregnancy, five were statistically significantly associated with increased offspring ASD risk after adjustment for indication proxy (e.g., hazard ratio [95% confidence interval] cyproterone = 2.71 [1.17–6.25] and prednisolone = 2.10 [1.27–3.49]), and two with decreased risk (ferrous sulfate = 0.82 [0.68, 0.99] and lynestrenol = 0.43 [0.2, 0.93]). Further analysis revealed four pharmacological targets shared by these drugs, which were themselves associated with ASD (e.g., neuronal acetylcholine receptor α4β4 = 1.45 [1.05–1.99] and serotonin 2b receptor = 1.31 [1.04–1.61]). Enrichment analysis suggested the association between ASD and medications affecting cholinergic and serotonergic signaling.

Increased ASD risk followed prenatal exposure to five prescription drugs, and decreased risk followed exposure to two. Subsequent analyses suggested no confounding by indication in these associations, but further studies are warranted.

Network analysis is a promising approach for elucidating the dynamics of the transition from psychopathology to well-being. Recently, symptom connectivity strength has been proposed as a measure of plasticity – the capacity to change disease severity. Yet, empirical findings remain inconsistent. We propose that this inconsistency can be resolved by recognizing that the interpretation of connectivity strength varies along the recovery process from depression, whether at baseline or during clinical change.

We analyzed 2,710 depressed patients from the STAR*D dataset, grouped by the magnitude of change in depressive score. Symptom network connectivity was estimated from QIDS-C items at three time points: (i) baseline, (ii) change – defined as when clinical change in depression score occurs, (iii) post-change - corresponding to when the maximum clinical change is achieved.

At baseline, connectivity strength predicts the maximum clinical change, inversely correlating with its magnitude (ρ = −0.95, p = 0.001). At the change time point, connectivity strength parallels clinical change (ρ = 0.92, p = 0.002). A direct and significant association between connectivity strength and depression severity emerges only at the change (ρ = 0.98, p = 0.0003) and post-change (ρ = 0.95, p = 0.001) time points.

The interpretation of connectivity strength for predicting depression trajectories varies by timepoint: at baseline, it measures plasticity -- the capacity for change -- whereas during clinical change, it indicates the magnitude of change in symptom severity. This framework supports the reliability of this prognostic marker for designing personalized therapeutic interventions in psychiatry.

Many patients with major depressive disorder (MDD) do not respond sufficiently to first-line treatments. Due to its biological and psychological mechanisms, exercise may enhance the effectiveness of other MDD treatments. In a pragmatic randomised superiority trial, we evaluated the clinical and cost-effectiveness of exercise therapy adjunct to guideline-concordant care as usual (CAU) for MDD in specialised mental health care.

MDD outpatients (N = 112; Mage = 37; 51% female) were randomized to CAU (96.9% psychotherapy, 59% pharmacotherapy) or CAU + EX (CAU plus 12 weeks of exercise therapy: one supervised and two home-based aerobic sessions/week). Depressive symptoms were assessed using the Inventory of Depressive Symptomatology-Self Report. Remission was evaluated during follow-up by blinded assessors using the Structured Clinical Interview for DSM-5. The economic evaluation followed a societal perspective.

Patients in the CAU + EX condition were significantly more likely than those in CAU to meet the exercise prescription; however, only 22% fully adhered to it. Depressive symptoms decreased from severe to moderate depression in both conditions, with no significant difference between the conditions on symptom reduction (b = −0.22, [−0.72, 0.29]) or remission rate (OR = 0.06, [−0.20, 0.32]). Evidence for cost-effectiveness was found in the per-protocol (≥ six supervised exercise sessions) but not in the intention-to-treat sample.

Adjunct exercise therapy does not provide additional clinical benefits or cost-effectiveness in specialized mental health care. Low adherence to the exercise prescription limits its potential. Cost-effectiveness may be achievable with higher adherence, warranting emphasis on strategies to improve adherence in this population.

Chronic pain (CP) and mental disorders often coexist, yet their relationship lacks comprehensive synthesis. This first hierarchical umbrella review examined systematic reviews and meta-analyses, also observational studies and randomized controlled trials (where reviews are currently lacking) to report CP prevalence, risk factors, and treatment across mental disorders.

We searched MEDLINE, PsycINFO, Embase, Web of Science, and CINAHL, identifying 20 studies on anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, or dementia, and CP. Quality was assessed using AMSTAR and Newcastle-Ottawa Scale.

Prevalence varied widely—23.7% (95% CI 13.1–36.3) in bipolar disorder to 96% in PTSD—consistently exceeding general population rates (20–25%). Risks were elevated, with bidirectional links in depression (OR = 1.26–1.88). Risk factors included female gender, symptom severity, and socioeconomic disadvantage, though data were limited beyond PTSD and depression. Treatment evidence was sparse: cognitive behavioral therapy showed small effects on pain (SMD = 0.27, 95% CI -0.08–0.61), acupuncture with medication improved pain (MD = -1.06, 95% CI -1.65–-0.47), and transcranial direct current stimulation reduced pain in dementia (d = 0.69–1.12). Methodological issues were evident, including heterogeneous designs and inconsistent pain definitions.

This review confirms CP as a significant comorbidity in mental disorders. Clinicians should prioritize routine pain screening and multimodal treatments. Researchers need longitudinal studies with standardized assessments to clarify causality and improve interventions. Taken together, this work highlights an urgent need for integrated psychiatric care approaches, emphasizing that addressing CP could enhance mental health outcomes and overall patient well-being.

Cognitive impairment is central to psychosis and strongly linked to functional outcomes. The Brief Assessment of Cognition (BAC) app is a tablet-based, automated tool for assessing key cognitive domains but has not been validated in Spanish-speaking populations or across illness stages.

A total of 402 participants (117 with first-episode psychosis [FEP], 125 with schizophrenia, and 160 controls) completed the BAC app along with clinical and functional assessments. We evaluated internal consistency, group differences, convergent and discriminant validity, and the effects of sex, age, and education. Normative percentiles were derived from controls.

The BAC app showed good internal consistency across groups (α = 0.76–0.87) and effectively differentiated individuals with psychosis from controls (area under the curve [AUC] = 0.862), with performance declining from controls to FEP to schizophrenia. Discrimination between FEP and schizophrenia was limited (AUC = 0.649). BAC App correlated positively with estimated intelligence quotient and functional capacity, and negatively with symptom severity, particularly in FEP. Performance varied by age, sex, and education, supporting the need for stratified normative data.

The BAC app showed strong reliability and validity for cognitive assessment in Spanish-speaking individuals with psychosis. Its brevity, automated scoring, and normative data support its clinical and research applications for cognitive screening, monitoring, and treatment evaluation.

The significant heterogeneity among individuals who die by suicide complicates prevention, suggesting that a “one-size-fits-all” approach is insufficient. It is crucial to identify distinct subgroups for targeted strategies. This study aims to characterize suicide profiles based on trait impulsivity and related factors.

Data from the FRieNDS project (Factores de Riesgo en Defunciones por Suicidio – Risk Factors in Suicide Deaths), a psychological autopsy study of 408 suicide deaths, were used. After determining the optimal number of clusters via stability analysis through agglomerative nesting, a final cluster analysis was performed on 391 valid suicide deaths (defined as cases with no missing data on the variables used for clustering) using k-means on a lower-dimensional representation of the data encoded by an autoencoder. Key clustering variables included sex, impulsivity (Barratt Impulsivity Scale-11), aggression, intent to die, previous history of suicide attempts, history of substance abuse, psychotic and affective disorders, and the presence of a depressive episode at the time of death.

We identified three clusters: (1) Impulsive-aggressive (29.8%), characterized by high rates of Cluster B disorders, substance abuse, more stressful events, and low lethal intent; (2) depressive prior attempters (24.5%), which comprised mostly women and showed greater behavioural changes before death; and (3) non-impulsive/aggressive (45.7%), a group with no clear psychopathological profile, less healthcare contact, and minimal communicated intent to die, despite having few prior attempts.

Our study identified three suicide clusters with varying impulsivity levels, highlighting the need for tailored interventions and community-level research for better suicide prevention strategies.

Shared decision-making (SDM) is a collaborative process between clinicians and service users to select treatment, guided by evidence and service user preferences. SDM has clinical, economic, and ethical benefits compared to clinician-led decision-making; yet, implementation remains challenging. An important knowledge gap is the influence of culture on implementation. Cultural impacts on service user decision-making preferences have been documented, but little is known about how culture impacts clinician preferences. This study examined associations between country-level cultural characteristics and decision-making preferences of psychiatrists in routine care settings across Europe.

We analysed data from 751 psychiatrists and trainees in 38 European countries, who completed the Clinical Decision-Making Style–Staff (CDMS-S) scale. Country-level Hofstede cultural dimensions were linked to CDMS-S scores using univariate and multivariate regression models. Mixed-effects models were used to account for country-level clustering and controlling for professional and economic variables.

In univariate analyses, all six dimensions were associated with SDM preferences. However, only three remained significant in mixed-effects models. Higher levels of Indulgence and Individualism were associated with stronger preferences for SDM, while higher Power Distance was associated with more clinician-led decision-making. These associations did not remain significant in fully adjusted multivariate models, suggesting professional and systematic factors mediate cultural influences.

Indulgence, Individualism, and Power Distance are associated with psychiatrists’ decision-making preferences across Europe. Culturally sensitive SDM interventions should address not only clinician attitudes but also healthcare structures and patient expectations. Findings offer an empirical foundation for tailoring SDM training and policy to diverse cultural contexts within European psychiatry.

Measurement-based care (MBC) is widely recommended in psychiatry but remains underutilized in routine clinical settings. The Transdiagnostic Global Impression – Psychopathology (TGI-P) scale was developed to provide a brief yet comprehensive assessment of 10 core transdiagnostic symptom domains. To support more inclusive care and promote patient and caregiver engagement in treatment planning, two new versions of the TGI-P, that is, a patient-rated and a separate informant-rated, were developed, complementing the previously published clinician-rated version.

The patient and informant versions mirror the original clinician-rated TGI-P, assessing the identical 10 domains using a seven-point Likert severity scale, with results displayed via a personalized symptom map. A user satisfaction/feasibility study was conducted with 50 participants (25 patients and 25 caregivers) from the UK and US. After completing the scale, participants provided feedback on its clarity, usability, emotional impact, and comparative utility.

Most participants completed the scale in less than 5 min. Instructions were considered clear, and the format was rated easy to follow. Response options were deemed appropriate by 86% of participants, and the visual output was widely appreciated. While one-third reported mild emotional triggering, overall burden was described as manageable. Approximately, three-quarters of participants rated the TGI-P as equal to or better than other tools they had used.

TGI-P patient and informant versions were developed and, informed by the feasibility study, refined to offer brief, user-friendly tools that support multi-informant assessment as input to MBC. Both versions of the TGI-P, with their graphical output, may support shared understanding and collaborative decision making among clinicians, patients, and caregivers. A validation study of the TGI-P is underway.

The use of artificial intelligence (AI) in psychiatry holds promise for diagnosis, therapy, and the categorization of mental disorders. At the same time, it raises significant theoretical and ethical concerns. The debate appears polarized, with proponents and critics seemingly irreconcilably opposed. On the one hand, AI is heralded as a transformative force poised to revolutionize psychiatric research and practice. On the other hand, it is depicted as a harbinger of dehumanization. To better understand this dichotomy, it is essential to identify and critically examine the underlying arguments. To what extent does the use of AI challenge the theoretical assumptions of psychiatric diagnostics? What implications does it have for patient care, and how does it influence the professional self-concept of psychiatrists?

To explore these questions, we conducted 15 semi-structured interviews with experts from psychiatry, computer science, and philosophy. The findings were analyzed using a structuring qualitative content analysis.

The analysis focuses on the significance of AI for psychiatric diagnosis and care, as well as on its implications for the identity of psychiatry. We identified different lines of argument suggesting that expert views on AI in psychiatry hinge on the types of data considered relevant and on whether core human capacities in diagnosis and treatment are viewed as replicable by AI.

The results provide a mapping of diverse perspectives, offering a basis for more detailed analysis of theoretical and ethical issues of AI in psychiatry, as well as for the adaptation of psychiatric education.

Cognitive impairment represents a central component of major depressive disorder (MDD), affecting a large proportion of people living with MDD and showing a consistent negative impact on social, interpersonal, and occupational functioning and subjective quality of life. Cognitive remediation (CR) is a training-based psychosocial intervention targeting cognitive performance and psychosocial functioning that has shown consistent evidence of effectiveness in individuals with schizophrenia and that could provide significant benefits also in people with MDD: this study aimed to assess the effects of a computerized CR intervention in adults living with MDD.

Participants recruited in this single blind multicentric randomized controlled trial were allocated to receive a computerized CR intervention delivered by an active and trained therapist or to an active control condition (computer games – CG). Outcomes were measured with validated instruments by blind assessors and included cognitive performance, depressive symptoms, and psychosocial functioning. Outcomes were assessed using mixed models for repeated measures, considering baseline and end-of-treatment scores.

Hundred and one participants (CR=52 and CG=49) were included and 81 (CR=45 and CG=36) completed the study. CR produced superior results in clinician-rated depressive symptoms (p=0.023, d=042), global clinical severity (p=0.025, d=0.39), subjective depressive symptoms (p=0.005, d=0.45), working memory performance (p=0.004, d=0.34), executive functions/cognitive flexibility (p=0.020, d=0.43), and subjective cognitive impairment (p=0.006, d=0.48).

CR represents an effective intervention in MDD, improving clinical outcomes and cognitive performance in a clinician-rated and in a subjective manner, which should be more consistently implemented in clinical practice and included in MDD treatment recommendations.