Most of the validated Italian scales for assessing psychotic symptoms don’t analyze specific symptoms like delusions and hallucinations in detail, but rather measure a wide range of experiences and behaviors in a general way. Scales such as PANSS, SAPS, and Sistema3 include only a few items on delusions and hallucinations, without considering the multidimensional characteristics of these symptoms, such as the degree of conviction, distress, duration, and perceived reality of the hallucinations. The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used scale globally for measuring the severity of hallucinations and delusions through a semi-structured interview, but it has never been translated into Italian.

The aim of this study is to conduct a preliminary evaluation of the psychometric properties of the Italian version of the PSYRATs.

The participants were recruited from among adult patients who were able to communicate fluently in Italian and were admitted to the Psychiatry Department of the Cesena Hospital. Eligibility depended on the presence of persistent delusions or auditory hallucinations in the week prior.

The hospitalized patients were assessed using the Italian version of the PSYRATS, the Positive And Negative Syndrome Scale (PANSS), and the Brief Psychiatric Rating Scale (BPRS). The reliability of the scales was assessed using Cronbach’s Alpha, and the relationship between the variables was analyzed using Spearman’s correlation.

The sample consisted of 25 participants (5 female, 20 male), with a mean age of 43 years and an average educational level of 11 years. A good internal consistency was observed for the “Auditory Hallucinations” scale (Alpha = .92) and for the “Delusions” scale (Alpha = .97). Spearman’s correlation analysis revealed that the “Total PSYRATs” scale has strong correlations with the “Auditory Hallucinations” scale (Rho = .93; p = .001) and the “Delusions” scale (Rho = .45; p = .02). Valid correlation indices were also noted between the “Total PSYRATs” and “Total BPRS” scales (Rho = .62; p = .001) and the PANSS scale (Rho = .45; p = .02).

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The preliminary data demonstrate good internal consistency and convergent validity of the Italian version of the PSYRATS; therefore, this instrument appears to be a valid measure for the assessment of hallucinations and delusions. The results of this study are limited by the relatively small sample size, making it essential to repeat the analyses on a larger population.

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Shared psychotic disorder (folie à deux) is a rare mental health condition where delusions are transmitted from one person to another within a close relationship. Understanding these complex dynamics is crucial for effective diagnosis and treatment.

To present two cases of shared psychosis involving close relatives diagnosed with schizophrenia, aiming to open discussion on the complex dynamics of familial relationships and their impact on mental illness.

2 case reports.

We present two cases of shared psychosis involving close family members. The first case involves two sisters, aged 43 and 48, both diagnosed with paranoid schizophrenia. The 43-year-old sister was admitted following a suicide attempt and exhibited active psychosis with paranoid delusions. During her hospitalization, the older sister displayed identical delusions and refused her sibling’s treatment, leading to her own admission. Both sisters, previously untreated and highly educated, were managed with antipsychotic medications. While the delusions were encapsulated during treatment, concerns remain about their shared living environment and its potential influence on their ongoing recovery.

The second case involves a 33-year-old woman with a decade-long history of schizophrenia who was brought to the emergency room malnourished and uncommunicative, having not eaten for over a week. She was fed via a nasogastric tube during her lengthy hospitalization and placed on a regimen of Clozapine. The patient exhibited severe negative symptoms and behaviors suggestive of auditory hallucinations. Her mother, also of low educational and socioeconomic status, was present throughout her stay but displayed delusional beliefs that interfered with her daughter’s treatment. Following restrictions on the mother’s access to the patient, the daughter showed slight improvement and began eating independently.

These cases highlight the significant impact that familial relationships and shared psychosis can have on the progression and management of schizophrenia. The challenge in treating shared delusions lies not only in addressing the symptoms but also in mitigating the interpersonal dynamics that may perpetuate them. Further investigation into family-based psychosis and its treatment is warranted.

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Melatonin is a neurohormone plays a role in the development and course of schizophrenia.Melatonin also has an important role in regulating circadian rhythms, so melatonin secretions have been suggested as markers for circadian dysfunctions in schizophrenic patients. Some studies have assessed the circadian profiles of melatonin secretion in schizophrenic patients, showing that the nocturnal circadian rhythm of plasma melatonin secretion was disrupted in medicated chronic schizophrenics (Jiang H. K. & Wang J. Y. Diurnal melatonin and cortisol secretion profiles in medicated schizophrenic patients. Journal of the Formosan Medical Association. Taiwan yi zhi 1998 97(12), 830–837). Nocturnal plasma melatonin secretion was also reduced in the drug-free schizophrenic patients (Monteleone P. et al. Depressed nocturnal plasma melatonin levels in drug-free paranoid schizophrenics. Schizophrenia research 1992;7(1), 77–84). These findings could suggest the presence of abnormal melatonin rhythm in schizophrenics, which may be related to the pathophysiologic process itself. However, it is not known whether there are melatonin secretion significant differences in acute phase and clinical stabilization phase of schizophrenic patients.

The aim of this study is to assess the melatonin secretion profile in acute phase and clinical stabilization phase of schizophrenic patients to know if exists circadian rhythm and to compare both measures.

Our sample consists in 48 patients that have been study in two clinic phases: acute phase and after discharge,clinically stabilized. Blood samples were collected in the morning (12:00 hours) and at night (00:00 hours) by venipuncture in reclined position with mask that covers the eyes. Serum levels of Melatonin were measured in acute phase and stabilized phase, after discharge. Melatonin was measured by means of ELISA (Enzyme-linked immunosorbent assay) techniques. The relationship between quantitative variables at two times of the same marker were analyzed by T-Student test.

All comparisons reach a degree of statistical significance, which we can interpret as meaning that there is a circadian rhythm at the two moments measured. Furthermore there significant difference between acute phase of the schizophrenia respect control phase, three months after discharge.

In this study we can hypothesize that Melatonin has circadian rhythm when the patients are in acute psychosis and when are stabilized. MLT levels increase at control, a fact that we can interpret as there is an increase in antioxidants levels in the clinical stabilization phase, this increase being even greater at the three-month control, which may be attributable to the treatment due to its antioxidant properties or to the disease itself. The results of this biomarker could be interpreted as is useful variable for the prognosis.

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Numerous studies have highlighted the unmet needs in intimate and sexual relationships among patients with schizophrenia. Although research shows that patients with schizophrenia express a desire for romantic and sexual connections, they encounter difficulties in forming and sustaining these relationships. However, the underlying causes of deficits in sexual and romantic functioning remain unknown and unexplored.

The study aims to assess whether difficulties in forming intimate relationships could be connected to a decreased ability to interpret courtship signals.

49 male participants (36 patients, 13 controls) and 27 female participants (14 patients, 13 controls) were exposed to our experiment „Does she like me?” task. The task involves a video stimuli that depicts a woman/man displaying different nonverbal behaviors (rejection, courtship, and neutral attitude). Each participant evaluated the woman’s sexual interest/ man’s sexual interest on a nine-point scale. In addition, eye movements and pupil dilation were measured using the eye-tracking device Eyelink 1000plus. Patients and controls were compared on subjective report and psychophysiological eye tracking markers. For data analysis, we used Repeated measures ANOVA.

There was no statistically significant difference between the control group and patients in their assessment of women´s interest (F (2, 94) = 1.28, p = 0.28, ηp2= 0.03) or men’s interest (F (2,50) = 0.24, p = 0.79, ηp2= 0.01). Also, there was no difference in average pupil size. However, while both groups correctly identified the nonverbal cues and responded accordingly (with the greatest assessments of interest for positive stimuli, lesser for neutral stimuli, and the least for negative stimuli), male patients on average tended to overestimate women’s interest in all conditions (positive, neutral, negative) compared to the control group.

According to our results, the ability to interpret courtship signals does not differ significantly between patients and controls. However, male patients tend to overestimate women’s sexual interest on average, which may be one of the reasons why they face challenges in intimate relationships. Further research is needed to explore this.

The study was supported by the Czech Health Research Council, no. NU21J-04-00024 and by the Charles University, Fac Med1, GAUK no. 56123.

None Declared

Psychosis has long been known to have an association with epilepsy. Slater’s 1963 descriptive case series provided the first modern definition of epilepsy-related psychosis, described as psychotic symptoms developing after the onset of epilepsy and occurring in clear consciousness, not exclusively during or right after a seizure. Up to 7% of individuals with epilepsy have a co-morbid psychotic illness. Consensus guidelines by the International League of Epilepsy recommend treating epilepsy-related psychosis similarly to other categories of psychosis. Despite the widespread consensus that the prescription of an antipsychotic is possible without risk in an epileptic patient treated with AEDs, there have always been special considerations about prescribing antipsychotics for seizure-related psychosis. Furthermore, a review article by Adachi et al. specifically warns that concerns regarding seizure threshold can lead to the undertreatment of this particular type of psychosis.

Case report.

Case report.

Case presentation: Our patient has generalized epilepsy, with several incomes due to generalized tonic-clonic seizure and mild diffuse encephalopathy since childhood. By the age of 15 years, he started developing suspicion, self-reference, persecutory and damage delusions, visual hallucinations and episodes of aggressiveness towards people surrounding him. He had been treated with multiple antiepileptics and antipsychotics drugs, without achieving a long-term stabilisation until now. While the seizures were controlled in his early ages; ever since the onset of the psychosis both the psychotic symptoms and the seizures got impossible to handle, mainly because of his lack of tolerance to almost every antipsychotic used. Our primary hypothesis is that these antipsychotics lowered the seizure threshold, triggering new episodes of tonic-clonic seizures and arousing the patient’s desire of abandon the treatment -the latter has been confirmed by the patient-. At this point, we considered the recently released brexpiprazol as a potentially efficient treatment. After a proper explanation of our clinical reasons to prescribe this new drug, especially its unique pharmacodynamics, we adquired the patient’s consent to start with it. So far, the response is being excellent, which is particularly impressive given the fact that he is taking the maximum daily dose of brexpiprazol (4mg). Not only the psychotic symptoms are restrained, but also he has not experienced any seizure since the introduction. As a key outcome, the patient has developed a significant insight regarding his condition and the need of treatment.

The treatment of epilepsy-related psychosis is a really delicate subject. Brexpiprazol is a modern drug, with an innovative pharmacodynamics and an excellent side-effect profile, and should be taken into consideration in every patient with seizure-related psychosis.

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Charles Bonnet syndrome, first described by Charles Bonnet in 1760, is characterized by visual hallucinations in cognitively normal patients who are typically elderly and often visually impaired.

This case has been evaluated as a typical Charles Bonnet syndrome characterized by multisensory hallucinations (visual, auditory, olfactory hallucinations) observed in a patient with NF-2 diagnosis. In this respect, this case analysis might make an important contribution to the literature, as it might expand the understanding of CBS in the context of complex neurological disorders. Consideration must be put into the possibility of associating the patients’ multisensory hallucinations with organic pathology due to the presence of occipital and temporal meningiomas.

In this section, data obtained from our own case will be included. Additionally, a literature review was conducted using PubMed, restricting the search to studies published between 2014 and 2024. The search term “Charles Bonnet Syndrome” was used to identify relevant articles. Furthermore, a detailed anamnesis of the disease process was obtained from the patient’s mother.

A 31-year-old female first presented to our psychiatry outpatient clinic in July 2024, with her relative reporting a diagnosis of neurofibromatosis type 2. It was documented that the patient underwent surgery in November for diffuse meningiomas (both supra- and infratentorial, involving the temporal and occipital regions). Also, the patient experienced total hearing loss due to vestibular schwannomas in the right region and suffered from visual loss during the pre-operating period. She reported a distressing increase in the acute perception of the smell and taste of food and beverages. Her first psychiatric examination was conducted postoperatively. Olanzapine 2.5mg/day was commenced as a treatment for relative auditory and olfactory hallucinations, and the dose of the drug was gradually increased to 10mg/day. The final examination was conducted on August 26, 2024. According to reports from the patient’s relatives, there was a noted decrease in the frequency and intensity of the hallucinations. Throughout the medical examinations, communication with the patient was partially facilitated using tactile cues.

A typical Charles Bonnet syndrome is a disorder characterized by visual loss accompanied by visual hallucinations. In this case, olfactory, auditory and alpha-factor hallucinations that developed after visual and hearing loss were detected and resulted in the involvement of more than one sensory organ, shedding light on the current literature. In this case, the fact that the person already had neurofibromatosis type 2 disease further complicates the etiology of these symptoms and requires detailed follow-up and treatment.

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Schizophrenia is a severe mental illness manifested by various symptoms. Negative symptoms (NS) are associated with disability and poor function of patients. The study of NS neurobiology is complicated by their heterogeneity. Factor analysis revealed two distinct NS subdomains with different pathophysiological mechanisms: volitional pathology, including avolition and apathy (AA), and diminished expression (DE). Inflammation is one mechanism that may underlie NS, including their heterogeneity.

To investigate the differentiated associations between polymorphisms of interleukin genes IL-1β (rs16944), IL-4 (rs2243250), and IL-10 (rs1800872, rs1800896) and adverse childhood experiences (ACE) with NS of schizophrenia, specifically the factors of AA and DE. We hypothesize that genetic variants, which may aggravate the inflammatory response, are associated with higher NS and NS factors scores.

Data from 564 patients diagnosed with schizophrenia or schizoaffective disorder were included in the study. NS factors were calculated based on the Positive and Negative Syndromes Scale. The two-way ANOVA (sex, genotype) with Bonferroni post hoc test was used to examine the effect of the genotypes on the PANSS-derived NS subdomains.

The high-expressive allele of IL-1β and low-expressive alleles of IL-4 and IL-10 are associated with more severe NS. However, a differentiated association with the AA and DE factors was found only for the IL-10 rs1800872 polymorphism. Among carriers of the low-expressive AA allele with ACE, there is a trend towards increased ED scores, but not AA scores.

The findings confirm that the imbalance between pro-inflammatory and anti-inflammatory cytokines may be a key mechanism influencing the severity and heterogeneity of NS.

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The efficacy of yoga as an adjunctive treatment for schizophrenia spectrum disorders (SSD) has garnered interest, however, meta-analytic findings exhibit heterogeneity. While yoga may positively influence various symptom domains, further investigation is needed due to the limited number, quality, and generalizability of studies. Yoga-based Group Intervention (YoGI) was specifically developed together with persons with SSD through a participatory approach and its mechanisms and processes were explored within qualitative studies.

This pre-registered randomized controlled trial (RCT) assessed the acceptability and feasibility as well as preliminary outcomes of YoGI compared to a commprehensive treatment as usual (TAU) in an inpatient setting.

Fifty inpatients with SSD received either treatment as usual (TAU, n = 25) or YoGI+TAU (n = 25) for four weeks. Preliminary analyses examined rater-blinded positive and negative symptoms, self-rated depressive and anxiety symptoms, body mindfulness, mindfulness, psychological flexibility, subjective cognition, social functioning, quality of life, and medication regime at baseline and post-intervention.

Outcomes showed a 95% protocol adherence, feasibility and retention rates of 91% and 94%, respectively, and a dropout rate of 6%. ANCOVA revealed significant between-group post-intervention improvements for YoGI+TAU in positive symptoms, depression, cognitive fusion, and a mindfulness subscale. Medium-to-large pre-to-post intervention effects were found for body-mindfulness, positive, negative, and general symptomatology, depression, anxiety, stress, cognitive fusion, attention, and quality of life in YoGI+TAU, while within-group changes were consistently smaller in TAU. No severe adverse events were reported.

This trial contributes to the growing evidence supporting the feasibility and acceptability of yoga for persons with SSD in an inpatient setting. Furthermore, preliminary evidence suggests that YoGI may provide additional benefits beyond TAU alone, across various self- and rater-based outcomes. These outcomes include improvements in body mindfulness, mindfulness, and psychiatric symptomatology, including positive and negative symptoms, subjective cognition, depression, anxiety, stress, social functioning, and quality of life. Additional fully powered RCTs are warranted to further elucidate the efficacy and potential mechanisms of action of YoGI for SSD, which should also assess the cost-efficiency of YoGI and explore longitudinal changes associated with the intervention. Such comprehensive research endeavours will not only enhance our understanding of the therapeutic potential of YoGI but also inform clinical practice and intervention strategies for persons with SSD.

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Schizophrenia is a severe psychiatric disorder characterized by disturbances in perception, thinking, affect, behavior, and negative symptoms. Depression in patients with schizophrenia worsens disease outcomes by increasing suicide risk, complicating the clinical picture, and reducing social functioning quality. Treatment is challenging, as monotherapy with modern antipsychotics is not always successful. Adding antidepressants may improve outcomes, but the effectiveness of such augmentation often requires further evidence.

This study aimed to examine the effects of combining second-generation antipsychotics (SGA) with vortioxetine, a novel multimodal serotonergic antidepressant, on various aspects, including quality of life, anhedonia, cognitive function, and overall symptom improvement in schizophrenia patients.

We conducted a comprehensive search of PubMed, Embase, Cochrane and Web of Science databases up to September 2024 for studies using Vortioxetine with standard treatments for schizophrenia.

We screened 371 studies and our review included six studies gathering 508 patients. Study type, sample sizes, and follow-up time varied across studies (Figure 1). All studies involved adding Vortioxetine to existing antipsychotic treatments, with dosages ranging from 5-20 mg/day. Study durations varied from eight to 48 weeks. Common scales across multiple studies included: PANSS (Positive and Negative Syndrome Scale), WHOQOL-BREF (World Health Organization Quality of Life Assessment), CDSS (Calgary Depression Scale for Schizophrenia), and various cognitive function tests (e.g., WCST, Verbal Fluency Test, Stroop Task). Overall, the studies reported positive effects of vortioxetine in schizophrenia patients (Figure 2): Improved quality of life, Reduced anhedonia, Enhanced cognitive function, Improved depressive symptoms, Reduced negative symptoms. Most studies reported good tolerability of vortioxetine with minimal side effects.

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The findings suggest that Vortioxetine may be a promising adjunctive treatment for schizophrenia, potentially improving various domains including quality of life, cognitive function, negative symptoms, and depressive symptoms. However, larger and more robust studies are needed to confirm these findings.

None Declared

Patients with schizophrenia frequently have difficulties in defecation which may lead to adverse health consequences. Many interventions have been proposed to resolve the problems but not usually effective. Kombucha tea has been advocated for their effects on gut microbiota and thought to improve the stool passage in healthy population. However, the relevant evidence was insufficient in patients with schizophrenia. In this study, the research team tried to evaluate the effectiveness of Kombucha tea in the clinical settings.

This study aimed to evaluate both subjective and objective amelioration of stool passage in constipated patients with schizophrenia.

Schizophrenic inpatients who took laxative medications or had subjective difficulties in stool passage were eligible for the study. The protocol was approved by the IRB of Tsao-Tun Psychiatric Center and registered on the trial registry of Clinicaltrial.gov. After obtaining consents and initial screening, the recruited participants were randomly allocated into either the control or intervention groups. Participants in the control group were provided with flavored lemon tea while those in the intervention group drank commercial Kombucha tea. Every morning during 8-week period, participants in both groups were provided with the drinks bottled in opaque plastic bottles filled with the same volume (200ml) and similar taste.

The multidisciplinary team collected the demographic profiles, clinical details, kinesiological data, cognitive condition (measured with the MoCA) and psychiatric status (measured with the BPRS). The outcome data were collected through interview and medical record review by the researchers independent from allocation of the groups, and were computed with the statistical software JASP with the statistical significance at the 5% level (p<0.05).

79 schizophrenic patients were enrolled in the study, and the key data were illustrated at the attached Table. All the variables at the baseline showed no statistical significance between groups. In terms of the outcomes, the means of objective measurement of stool passage showed no statistical significance between groups. In contrast, the subjective measurement showed the ease of defecation difficulties, trending towards ‘smoother and easier defecation’ (p<0.05).

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Our preliminary analyses indicated that Kombucha tea improved the subjective outcome of stool passage in schizophrenic patients with constipations after taking Kombucha tea drinks while no statistical significance was observed in the objective measurements. To the best of our knowledge, this study is one of the very few studies exploring the effectiveness of Kombucha tea in ameliorating difficulties in stool passage in the patients with schizophrenia and it shed the light of future research.

None Declared

Psychotic disorders have a negative impact on people’s lives, including their financial situation. Limited studies indicate that people with psychosis also have lower subjective evaluations of their financial situation, such as perceived financial needs.

This study aimed 1) to examine differences in unmet financial needs between people with psychosis, parents, siblings, and controls, 2) to examine whether family clustering contributes to unmet financial needs, and 3) to examine to what extent substance use, demographic, economic, psychiatric, functional, and cognitive characteristics predict unmet financial needs in people with psychosis.

Data of the first assessment of people with psychosis (n=956), siblings (n=889), parents (n=858), and controls (n=496) of the Genetic Risk and Outcome of Psychosis study were used. Group differences were assessed with Kruskal-Wallis tests (aim 1). We performed mixed-effect logistic regression analysis and explorative and confirmative ordinal logistic regression analyses for aim 2 and 3, respectively.

People with psychosis reported significantly higher levels of unmet financial need (24%) compared to siblings, parents, and controls (all <10%; table 1). We found no evidence of familial clustering in unmet financial needs. Cannabis and tobacco use significantly and consistently predicted higher levels of unmet financial needs in people with psychosis. Demographic, economic, psychiatric, functional, and cognitive characteristics were no significant predictors.Table 1.

Levels of meeting financial needs of people with psychosis, siblings, parents, and controls.

Relatively high levels of unmet financial needs occur in a heterogeneous group of people with psychosis, especially when they use cannabis or tobacco. Unmet financial needs can have serious consequences for mental health, leisure time, and social activities. Thus, it is pivotal to recognize unmet financial needs, especially combined with substance use, as a stressor for people with psychosis.

None Declared

Correlation between cannabis decriminalization and some psychotic disorders, specifically Acute and transient psychotic disorders (ATPD), Schizophrenia, and Psychotic disorder with delusions due to known physiological condition. It will cover overview of these disorders, challenges in differential diagnoses and the effects of drug abuse on mental health.

Impact of cannabis decriminalization on selected psychotic disorders: Acute and transient psychotic disorders (ATPD), Schizophrenia, and Psychotic disorder with delusions due to known physiological condition.

• - Quantitative, Retrospective Analysis: Analysis of archived medical records from 2013 to 2023 at “Center for Mental Health and Prevention of Addiction” in Tbilisi.

• - Examination of Prevalence Changes: Focus on ATPD, Schizophrenia, and Psychotic Disorder with Delusions due to Known Physiological Condition.

• - Statistical Comparisons: Comparison between pre-decriminalization (2013-2018) and post-decriminalization (2019-2023) periods.

• - Analysis of Drug User Patient Cases: Assessment of the increase in drug user cases within the mentioned diagnoses.

• - ATPD Cases: Increased significantly by threefold (from 195 to 594).

• - Schizophrenia Cases: Decreased slightly by 21% (from 2068 to 1627).

• - Psychotic Disorder with Delusions due to Known Physiological Condition: Remained relatively stable with a 14% decrease (from 473 to 408).

• - Drug User Patients: Increased dramatically by about 3.5 times following cannabis decriminalization.

• - The findings suggest a potential link between increased substance use, including cannabis, and the rise in ATPD cases.

• - Decriminalization may have indirectly influenced accessibility and use of various narcotics.

• - The lack of public education about the potential mental health risks of narcotic use could be a contributing factor.

• - The observed decrease in Schizophrenia and Psychotic Disorder with Delusions due to Known Physiological Condition cases might be due to other factors requiring further investigation.

• - These findings highlight the need for comprehensive research on the long-term consequences of cannabis decriminalization on mental health.

• - Targeted public health interventions and mental health support services are crucial to address the challenges of rising narcotic use in Georgia.

None Declared

The rapid change a variety of the clinical picture in case of autoimmune encephalitis remain a diagnostic challenge.

Diagnostics and therapeutic process as of the atypical psychosis.

A 40-year-old woman, since 2 weeks she expressed catastrophic delusions and dysphoria. Next she revealed tinnitus, psychosensory disturbances, disorganization of thinking and behavior and the first grand mal seizure occurred. In the neurology ward were described psychogenic disorders and she was referred to the psychiatric ward, where catatonic schizophrenia was diagnosed. She was disoriented, with periodic episodes of arousal and freezing, negativism and command automatism. She was hallucinating visually, auditorily, olfactorily, and cenesthetically, expressed delusions of catastrophe, influence, and persecution. Despite modifications of treatment (aripiprazole, haloperidol, olanzapine, quetiapine, clozapine, valproate) she didn’t improve. In the 4th week of hospitalization, an episode of fever of unknown etiology occurred and she was transferred to a higher referral psychiatric ward. Next fluctuating disturbances of consciousness, myoclonus, bilateral palmomental and Babinski’s sign and swallowing disorders were observed. Due to the lack of therapeutic effect tiapride was administer with slight improvement.

Laboratory tests: CRP, VDRL, anti-HIV antibodies - absent, ceruloplasmin, ANA, anti-TPO, anti-TSHR antibodies, tumor markers – normal range.

No changes in contrast-enhanced MRI head. In EEG moderate-grade, extensive changes in the fronto-central and frontotemporal leads bilateral.

CSF examination – normal range, negative result for 14-3–3 protein

In a panel for antibodies typical of autoimmune encephalitis - presence of anti-NMDA antibodies. Then autoimmune encephalitis was diagnosed. She was initially treated with immunoglobulins, with slight effects. Subsequently, effective immunosuppressive treatment with mycophenolate mofetil and methylprednisolone was administered. Further, the psychosis resolved, with the normalization of the neurological signs. The patient’s in stable mental and somatic condition was discharged without further psychopharmacology.

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In anti NMDA receptor encephalitis affective symptoms, psychosis, catatonia, consciousness disorders, as well as neurological symptoms occurred. In majority of cases no changes are observed in brain imaging. EEG examination shows non-specific changes in 90% of cases. About 80% of patients recover without functional impairment, but in 7% disease is lethal. Crucial is to determine the etiology of atypical symptoms in order to implement adequate therapy as soon as possible.

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Comprehending metabolic syndrome (MetS) risk factors in schizophrenia patients is pivotal for devising effective treatment strategies.

This study aims to explore the relationship between MetS and psychological resilience in schizophrenia patients.

A total of 140 schizophrenia patients with no hospital admissions or treatment changes in the last 6 months were enrolled in the study. For metabolic syndrome screening, patients’ blood pressure, height, weight, waist circumference, and hip circumference measurements were taken; these data, along with blood lipid levels and fasting glucose, were recorded on the sociodemographic and clinical data form. Patients were categorized into two groups based on the presence or absence of MetS. The Positive and Negative Syndrome Scale (PANSS) and the Resilience Scale for Adults were applied cross-sectionally.

MetS was identified in 33.6% of the included patients, with 88.6% exhibiting abdominal obesity. There were no statistically significant differences between groups in terms of gender, marital status, education level, employment status, type of antipsychotic, and use of single or multiple antipsychotics. In the MetS group, PANSS negative symptom scores were significantly higher. No significant differences were observed in psychological resilience between the groups.

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The demonstration of the relationship between the presence of MetS and the severity of negative symptoms is one of the significant outcomes of our study. These outcomes may contribute to formulating personalized treatment approaches.

None Declared

The cognitive model of psychosis suggests that psychotic symptoms may arise due to biases in information processing. Cognitive biases such as jumping to conclusions (JTC), belief inflexibility (BI), selective attention to threat (AT), and external attribution (EA) are dysfunctional ways of thinking in which distortions are observed in data collection, processing and interpretation. Cognitive biases are known to be associated with the occurrence of positive psychotic symptoms, but evidence for the influence of other cognitive processes on this relationship remains lacking.

This study aimed to examine the relationship between cognitive biases and psychotic symptoms in schizophrenia spectrum disorders and the cognitive factors hypothesized to influence this relationship, such as intolerance of uncertainty and insight.

65 patients with schizophrenia spectrum disorder were included. Sociodemographic data form, Davos Assessment of Cognitive Biases Scale (DACOBS), Intolerance of Uncertainty Scale (IUS) Anxiety Sensitivity Index-3 (ASI-3), and Beck Cognitive Insight Scale (BCIS) Positive and Negative Syndrome Scale (PANSS) and Beck Anxiety Inventory were applied. Ethics committee approval was obtained (no: 2023-40). Statistical analysis was performed with SPSS 25.

The mean age of the participants was 39.27 ± 12.21 years. 63.1% were male (n: 41) and 36.9% (n: 24) were female. Disease duration was 16.95 ± 12.80 years. Hierarchical regression analysis determined that PANNS positive scores were predicted by DACOBS external attribution subscale and IUS, ASI-3 and BCIS scores had a moderator effect (F: 3.51 p<0.001).

Our results showed that external attribution bias is the only cognitive bias associated with positive psychotic symptoms. Intolerance of uncertainty and anxiety sensitivity also play a role in the prediction of positive psychotic symptoms. Targeting intolerance of uncertainty and anxiety sensitivity with cognitive interventions may be useful in the treatment of positive psychotic symptoms in schizophrenia spectrum disorders.

None Declared

Symptoms of schizophrenia are associated with dysregulation of the dopaminergic systems of the central nervous system. Negative symptoms, including those related to emotions and mood, result from reduced activity in the mesocortical system, while positive symptoms result from increased activity of the mesolimbic system. Disorders in the reward system, composed of dopaminergic neurons, play an important role in the pathogenesis of addiction development. Nicotine activates the presynaptic parts of the neurons that make up the system to secrete dopamine, which translates into a feeling of pleasure and stimulates the development of addiction.

The aim of the study was to demonstrate the relationship between the degree of development of nicotine and the severity of symptoms related to emotions and mood with patients suffering from schizophrenia.

The study involved 75 patients diagnosed with schizophrenia (F.20 according to ICD-10). The study was conducted from October 2023 to September 2024 in CZPiLU in Gliwice. During the study, the Frankfurter-Bejindlichkeits-Skala was used to assess the appearance and severity of symptoms related to emotions and mood. The analysis of the development of addiction was made possible by the Fagerström Test for Nicotine Dependence.

Based on statistical analysis, a significant relationship was noted between the severity of addiction to nicotine and the presence or absence of symptoms related to well-being. In addition, a correlation (p<0,001) was noted between the degree of nicotine and the severity of symptoms related to emotions and mood. Patients with strong negative symptoms of schizophrenia developed a high level of addiction to nicotine (p=0,001), while those with mild (p=0,001) or moderate symptoms (p=0,005) related to well-being achieved lower scores on individual addiction scales. All patients included in the study had at least a mild level of addiction to nicotine.

The presence of schizophrenia symptoms related to well-being has a significant impact on the initiation of addiction development to nicotine. Furthermore, the level of advancement of symptoms related to emotions and mood translates into the severity of nicotine, especially in the group of patients in whom strong negative symptoms translate into a high level of addiction advancement. Patients suffering from schizophrenia require psychological and psychiatric care and diagnostics for addictions and appropriate prevention before their development.

None Declared

Schizophrenia remains a complex psychiatric disorder characterized by varying symptoms and levels of insight. The Frankfurt Complaint Scale (FBS) and the “My thoughts and feelings” questionnaire provide quantitative measures of symptom severity and insight, respectively. Previous literature has emphasized the importance of these tools in both clinical assessment and therapeutic planning.

Exploring the Relationship Between Schizophrenia Symptom Severity and Insight based on the Frankfurt Scale and the “My thoughts and feelings” Questionnaire.

The study utilized data extracted from an Excel dataset comprising demographic information and specific scores from the FBS and the Insight questionnaire. The sample was divided into four subgroups based on their FBS scores, and the average Insight score for each subgroup was calculated.

The study found the following average Insight scores across FBS-defined subgroups: Mild symptoms: 9.67, Moderate symptoms: 8.25, Severe symptoms: 8.22, Very severe symptoms: 9.29. The correlation analysis revealed a weak and non-significant correlation between FBS scores and Insight scores (r = -0.017, p = 0.925). The demographic analysis showed a prevalence of male patients (n=20), with the most common age group being 36-45 (n=11). Most participants resided in large cities (n=16), with the highest educational attainment being a Bachelor’s/Master’s degree (n=12), and the majority were single (n=21). The study group displayed diverse demographic characteristics,

with a significant male predominance and a concentration in urban environments. This demographic distribution may influence the generalizability of the findings and provides a context for interpreting the varied experiences and perceptions of illness within the group.

This study underscores the complexity of schizophrenia, where symptom severity does not straightforwardly correlate with insight into the illness. It highlights the importance of using a range of assessment tools to fully capture the multifaceted nature of patient experiences. Future studies should explore these relationships further to refine the tools used for assessments and to tailor intervention strategies effectively.

None Declared

Background and aims: There is a lack of research regarding the topic of childhood sexual abuse trauma on men population. Childhood experiences and traumas can have a great impact on various life domains, including mental state and addictions.

This study examines the impact of childhood sexual abuse on men diagnosed with schizophrenia – regarding the age of the disease’s appearance, the appearance of additional PTSD diagnosis and substance use throughout life.

This study can contribute to the development of more effective treatment and prevention strategies for men who have experienced childhood sexual abuse and are diagnosed with schizophrenia.

Participants: 60 Male patients hospitalized in the closed wards for men, aged 18-50 at ‘Merhavim’ - Mental Health Center.

Data Collection: A one-time meeting with the research team, which included completing several questionnaires regarding their current state and childhood experiences.

The influence of childhood sexual abuse was significant in all subjects we examined. Patients of suffered from sexual abuse in their childhood were more likely to develop PTSD or develop schizophrenia at a much younger age. Also, they were more likely to suffer from substance abuse throughout their life.

- Childhood sexual abuse has a significant impact on the onset of schizophrenia symptoms (age of first hospitalization), PTSD symptoms and substance abuse throughout life.

- Traumatic childhood experiences have a significant impact on mental symptoms that appear in adulthood as well as on various behaviors throughout life.

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Aripiprazole, a novel antipsychotic drug with partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors, as well as antagonist activity at 5-HT2A receptor, has demonstrated fewer side effects, including extrapyramidal symptoms, hyperprolactinemia, and metabolic disturbances, compared to other antipsychotic drugs.

The aim of this study was to examine the dose-dependent impact of aripiprazole on sexual dysfunction and prolactin levels in patients with schizophrenia. Patients with schizophrenia under aripiprazole monotherapy were recruited into this study.

Patients with schizophrenia under aripiprazole monotherapy were recruited into this study. Psychopathology and sexual dysfunction were evaluated using the Positive and Negative Syndrome Scale and the Arizona Sexual Experiences Scale (ASEX), respectively. Fasting blood samples were analyzed to measure metabolic parameters and prolactin levels.

We recruited 128 patients with schizophrenia, comprising 86 females and 42 males. The prevalence of hyperprolactinemia, hypoprolactinemia, sexual dysfunction, and metabolic syndrome was 12.5%, 47.6%, 39.1%, and 36.7%, respectively. Patients with sexual dysfunction exhibited higher prolactin levels and a higher prevalence of hyperprolactinemia compared to those without sexual dysfunction. The ASEX scores showed a positive correlation with prolactin levels and a negative correlation with aripiprazole dose. Multivariate analysis revealed that prolactin levels and age were associated with ASEX scores. Prolactin levels were negatively correlated with aripiprazole dose and metabolic parameters. Multivariate regression analysis indicated that aripiprazole dose was associated with prolactin levels.

Aripiprazole exhibited inverse dose-dependent effects on prolactin levels and ASEX scores in patients with schizophrenia. Regular monitoring of prolactin levels and sexual function is recommended for patients with schizophrenia receiving aripiprazole treatment.

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A person with “high-risk mental status (HRMS)” indicates that the person, usually young people between the ages of 14 and 25, is more likely to develop psychosis. These people have attenuated psychotic symptoms without reaching the intensity or frequency of a frank psychotic episode. It is suggested that psychological trauma could favor neurochemical and psychopathological changes in a vulnerable individual. It would be interesting to study the role of psychotherapeutic interventions in the course of high-risk mental states and their possible evolution to a psychotic disorder.

We present the case of an 18-year-old adolescent whose diagnosis was high risk of psychosis.

This work has several objectives. On the one hand review current information on high-risk mental status (EMAR). On the other hand, develop a discussion about whether the EMAR category should be a diagnostic entity or just a condition.

A bibliographic search has been carried out in the main sources of medical information such as Pubmed, Uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed in order to expose its own experience in this field, defining specific interventions as well as results.

The case presented is of an 18-year-old female patient. She states that the main reason for consultation is something that happened last Sunday, at which time he had “an identity crisis” in which he did not know if he was a girl or a boy. The reasoning behind this fact is that “as Pablo Alborán likes him, perhaps he is a boy”. Given the bizarreness of the explanation and the patient’s particular contact, I explore a previous psychopathological situation. She says that since last year she feels more insecure, with diffuse fear that it is difficult to specify or nominate something specific: “in class and that is very difficult for me, public presentations”, she says that “everything scares me”, she says that she has a non-specific fear that has been maintained even increasing over the months and that has led him to have greater anguish. Even though the patient dates the beginning of the picture on Sunday, it is noteworthy that the previous Thursday she had requested a consultation with psychology in the private circuit that although she does not know how to specify the reason “because of fears” it seems that the anguish resulting from this fear had been increasing, having greater difficulties for the presentations in class. The contact is psychotic and the situation that the patient describes is typical of a “treme” situation, cataloged in the current literature as a High-Risk Mental State.

High-risk mental states are not a diagnostic category according to current classifications, although it is necessary to reach a consensus on what the diagnosis implies and what would be the way to proceed when a patient presents these symptoms.

None Declared