Test anxiety is a multidimensional phenomenon, including concerns about conflicts lead to negative emotional and behavioral responses in academic scores.

Current study examines the influence of educating time management on decreasing exam Anxiety and educational negligence of conditioned university students on Tehran.

The method of doing study is of testing in which statistical society includes conditioned university students of Tehran. Of general statistical society, we have selected 20 persons by in access sampling method. Gathering information instrument in this study is Solomon and Roth bloom's educational negligence questionnaire and sarason test anxiety in which has been in access of studied sample after testing its stability and narration.

After education, the result of t-test dependent and co-variance analysis has shown time management education does have meaningful influence on decreasing test stress and conditioned university students negligence on Tehran universities.

Dropped students compared to other students, provided a significant contingent of students had less time management and procrastination.

The authors have not supplied their declaration of competing interest.

Down syndrome was clinically described the first time in France by Esquirol (1838) followed by Down (England, 1866), to the identification of a chromosomal abnormality in 1959 (trisomy 21), which is the most common abnormality in neurodevelopmental disorders. Life expectancy increased from 9 years in 1929 to 55 currently. This is a common cause of mental retardation, and few tools are suitable for the care of these patients, including patients with Alzheimer's disease (prevalence of 55% between 50 and 59) or depression (prevalence 30%). No study evaluates the effectiveness of cognitive and behavioral therapy (CBT) in patients with Down syndrome but it is known to be effective in Alzheimer's patients. Some cases have been reported on the efficacy of CBT on phobias in patients with intellectual disability.

To evaluate the efficacy of CBT in the treatment of a specific phobia in a patient with Down syndrome and early Alzheimer's disease.

Literature review and clinical case of a 51-year-old patient, hospitalized under constraints for behavioral disorders (agitation, body treatments refusals).

By adapting CBT techniques to the problem of intellectual disability, treatment against the phobia was effective with clinical improvement, which allowed a return home.

The tools provided by CBT are suitable for the treatment of anxiety disorders in patients with intellectual disability, especially in patients with Down syndrome. Psychiatric disorders are under-diagnosed in these patients and under-treated. CBT is an aid to the treatment. It may allow the dismantling of symptoms and reduce behavioral problems.

The authors have not supplied their declaration of competing interest.

Domestic violence against women has increasingly been recognized nationally and internationally as a serious problem. Violence against women is a troubling phenomenon in Russia. Meanwhile domestic abuse against women often results in long-term mental health problems.

The main aim of the study was to find out the psychological and psychiatric consequences of violence against women and to determine the origins of crimes committed by abused females.

A cohort of 18 females was examined by forensic psychiatrists. All women had committed crimes of violence (murders, attempted murders). Details of background, psychiatric and offending history were extracted. Each item was assessed with the help of descriptive statistics.

A research has been carried out on the basis of psychiatric and forensic psychiatric assessment of two groups of women who had a long history of violence by their husbands or partners. Clinical assessment has revealed depression, anxiety, low self-esteem, post-traumatic stress disorder, drug abuse. All women underwent forensic psychiatric assessment as they had committed serious crimes of violence. The research has revealed two types of homicides. Women of the first subgroup displayed pathological altruistic motivation of their children. Women of the second subgroup had committed homicides of their husbands and partners whose violence towards women escalated in severity.

The research shows the necessity of domestic violence prevention by legal provisions and multidisciplinary research with participation of psychiatrists, psychologists, sociologists, human rights advocates and feminist societies.

The authors have not supplied their declaration of competing interest.

N-acetylcystein (NAC), a precursor to the amino acid cysteine, has been emerging as an interesting add-on treatment in several psychiatric conditions and especially in Obsessive Compulsive Disorder (OCD). These results may be linked to its metabolic profile: antioxidant properties through glutathione production; anti-inflammatory properties; and modulation of the glutamatergic and dopaminergic systems of neurotransmission.

Review the potential therapeutic effects of NAC in psychiatry, with main focus on syndromes of the obsessive-impulsive spectrum with report of a clinical case.

Case report of a patient with OCD and Hoarding disorder, with complete clinical remission after treatment with NAC; bibliographic search using PubMed/MedLine database with the following keywords: n-acetylcysteine; OCD; hoarding.

We report and discuss the case of a 44-year-old man with a diagnosis of Obsessive Compulsive Disorder with orderliness and contamination themes, coupled with Hoarding disorder. The patient experienced gradual though slight improvement with Paroxetine (60 mg/day) to which was subsequently added Risperidone (2 mg/day) with further slight improvement. In combination with the previously given pharmacological agents, NAC (1800 mg/day) was introduced with subsequent complete remission of all symptoms.

Studies suggest that NAC may be useful in the treatment of several psychiatric conditions. Our case report suggests direct relation between treatment with NAC and remission of obsessive and hoarding symptoms. Although encouraging, additional controlled research will be required to ascertain NAC clinical usefulness.

Studies of COVID-19 pandemic biopsychosocial exposure and schizophrenia risk showed contradictory results, were undertaken early in the pandemic, and did not consider lockdowns or COVID-19 infection. Hence, we examined the association between COVID-19 biopsychosocial exposure and incident schizophrenia.

An interrupted time-series study design was implemented based on Israeli electronic health records from 2013 to 2021 with national coverage. The period coinciding with the COVID-19 pandemic biopsychosocial exposures from March 2020 to February 2021 was classified as exposed, otherwise unexposed. The effect of the COVID-19 pandemic on incident schizophrenia was quantified by fitting a Poisson regression and modeling the relative risk (RR) and corresponding 95% confidence intervals (CI). Three scenarios were projected from the third lockdown to 10 months to forecast incident schizophrenia rates and their associated 95% prediction intervals (PI).

The total population (N = 736,356) yielded 4,310 cases of incident schizophrenia over time. The primary analysis showed that the period exposed to the COVID-19 pandemic was associated with a reduced RR (RR = 0.81, 95% CI = 0.73, 0.91, p < 0.001). This conclusion was supported in 12 sensitivity analyses, including scrutinizing lockdowns and COVID-19 infection status. Two of three forecast scenarios projected an incident increase (6.74, 95% PI = 5.80, 7.84; 7.40, 95% PI = 6.36, 8.60).

The reduced risk of schizophrenia during the pandemic suggests no immediate triggering of new onsets either by the virus or the pandemic-induced psychosocial adversities. Once restrictions are lifted, the increased projected presentations have implications for clinicians and healthcare policy.

No significant relationships.

The education and training of doctors specialising in Child and Adolescent Psychiatry (CAP) varies substantially across Europe. There is a paucity of information available about training quality. This prompted an initial training survey led by Dr E Barrett (2010) which was expanded upon by the CAP working group in the 2010 EFPT international forum in Dubrovnik to create ‘country reports’ for 2010–2011.

The objectives of this study were to collect information relating to key aspects of CAP training programmes in Europe in a systematic way in order to start a ‘Training Database’ that can be held centrally by the EFPT. Information will be added to the database every year following EFPT annual international meetings.

We aim to better understand the training structures in CAP across europe to help inform best practice standards for training.

A pro-forma word document was emailed to all EFPT CAP contacts: there were 20 contacts emailed.

So far we have a response rate of over 60% and we are continuing to collect and collate relevant data. This survey highlighted a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.

This survey highlights a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.

Cost-effectiveness analysis needs to be considered when introducing new tools and treatments to clinical services. The number of new assessment tools in mental health has rapidly expanded, including suicide risk assessment. Such suicide-based assessments, when linked to preventative interventions, are integral to high-quality mental health care for people with severe mental illness (SMI). We examined the cost implications of implementing Oxford Mental Illness and Suicide (OxMIS), an evidence-based, scalable suicide risk assessment tool that provides probabilistic estimates of suicide risk over 12 months for people with SMI in England.

We developed a decision analytic model using secondary data to estimate the potential cost-effectiveness of incorporating OxMIS into clinical decision-making in secondary care as compared to usual care. Cost-effectiveness was measured in terms of costs per quality-adjusted life years (QALYs) gained. Uncertainty was addressed with deterministic and probabilistic sensitivity analysis.

Conducting suicide risk assessment with OxMIS was potentially cheaper than clinical risk assessment alone by £250 (95% confidence interval, −786;31) to £599 (−1,321;−156) (in 2020–2021 prices) per person with SMI and associated with a small increase in quality of life (0.01 [−0.03;0.05] to 0.01 QALY, [−0.04;0.07]). The estimated incremental cost-effectiveness ratio of implementing OxMIS was cost saving. Using probabilistic sensitivity analysis, 99.96% of 10,000 simulations remained cost saving.

Cost-effectiveness analysis can be conducted on risk prediction models. Implementing one such model that focuses on suicide risk in a high-risk population can lead to cost savings and improved health outcomes, especially if explicitly linked to preventative treatments.

College students seem to be a population group that is increasingly recognized to be at risk of having sleep difficulties. Some studies revealed that medical students, in particular, are believed to be more stressed and sleep deprived than their non-medical peers.

The present work aimed at investigating the quality of sleep among medical students at the University College of Medicine in Sfax, Tunisia.

The study consisted of an anonymous, voluntary survey for a sample of 74 students. A two-part questionnaire was used, including demographic criteria and the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month (a total score of 5 or greater is indicative of poor sleep quality).

The average age was 24 years (range 19–33) with a sex ratio almost equal to 1. In 47.3% of cases, students were married. These latter had at least one child in 34.2% of cases. A total of 39.4% of the students reported being smokers, while 25.6% of them admitted having regular alcohol consumption.

Poor sleep quality was reported by 63.5% of students with a PSQI average score of 9.32 ± 3.64.

The most correlated factors with poor sleep quality were parenthood (P = 0.031), alcohol consumption (P = 0.004) and stressful studies (P = 0.02).

Poor sleep quality was pervasive among surveyed medical students and this seemed to be in relationship with some factors. This study points to the need for further evaluation of medical students’ sleep problems in order to improve their performance and their quality of life as well.

The authors have not supplied their declaration of competing interest.

The focus of interest in this study is to investigate the relationship between happiness and optimism, satisfaction with life, hope, depression, and anxiety. Many efficient instruments have been used in this study, however there is no study until this date that has used the Oxford Happiness Questionnaire (OHQ) within Arabic countries and Kuwaiti samples specifically.

The aim of the study is to investigate the correlations between happiness and optimism, satisfaction with life, hope, depression and anxiety.

The sample consisted of 510 students from Kuwait University, 270 females and 240 males, with a mean age of 22.8 (SD = 4.1). The OHQ 0.90 alpha was administered to participants, in addition to the Arabic version of Life Orientation Test-Revised (LOT-R) 0.70, The Satisfaction with Life Scale (SWLS) 0.78, The Hope Scale (AHS) 0.60, Beck Depression Inventory (BDI-II) 0.87 and Beck Anxiety Inventory (BAI) 0.95. Correlations were used in this study.

The results revealed that all the correlations between OHQ and other scales were significant. Positive correlations have been found with LOT-R r = 0.50, SWLS r = 0.44, and AHS r = 0.39, while there were negative correlations with BDI-II r = −0.38 and BAI r = −0.17.

It was concluded that happiness correlates positively with other personality variables: optimism, satisfaction with life and hope, while it correlates negatively with Depression and Anxiety.

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

to examine the longitudinal effect of depression on glycemic control in a sample of patients with type 2 diabetes.

the patients were recruited from diabetes clinic in Saudi airlines medical center, in Jeddah, the base line study community consisted from 172 patients with type 2 diabetes. They were assessed for depression using BDI II, and diagnostic interview, and for diabetic control using HbA1c. We created a person-period data set for each patient to cover 6 months intervals up to 3 years. We used generalized estimation equation (GEE) for analysis of longitudinal data. HbA1C was the response variable while depression and time were the main covariates. Variables were included in GEE models based on clinical importance and preliminary analysis. Other variables included as covariates were gender, education, duration of diabetes, co-morbidity and LDL. All statistical analysis used α = 0.05 level of significance and were performed using SPSS software version 21.

Unadjusted HbA1c means were significantly higher in depressed vs. non-depressed subjects at all time points. The adjusted HbA1c means in final GEE model were significantly higher in depressed vs. non-depressed subjects. In all adjusted models depression was a predictor of glycemic control weather it was BDI score (estimate = .049, P = .002), diagnoses of MDD (estimate = 2.038, P = .000), or other depressive diagnosis (estimate = 1.245, P = .000).

This study on clinical sample of type 2 diabetic patients demonstrates that there is a significant longitudinal relationship between depression and glycemic control and that depression is associated with persistently higher HbA1c over time.

The authors have not supplied their declaration of competing interest.

Because randomized clinical trials in bipolar disorder include restricted study populations, the possibilities for generalizing to real-world bipolar patients are limited. Naturalistic long-term data can add valuable information about the diversity of treatment, outcome and risk factors in bipolar disorder.

After discharge from a psychiatric community hospital, 300 consecutively admitted ICD-10 bipolar I (n=158) and II (n=142) patients were followed-up naturalistically during for 4 years. Patients were assessed as to time to relapse, relapse in relation to index episode, prophylactic effects of prescribed medication, and risk factors for relapses such as prescribing attitudes, medication adherence, life events and alcohol use disorders.

204 (68%) of 300 patients relapsed within 4 years, with a mean of 208 days (SD=356.2) until the next affective episode. Relapses correlated in a statistically significant manner with the index episode. Using a Kaplan survival analysis, only lithium delayed time to the next affective relapse in a statistically significant way. Survival was reduced in a statistically significant manner when prophylactic medication was replaced by the psychiatrist or stopped by the patient. In a sub-analysis of this cohort life events (n=222) and alcohol use disorders (n=284) were associated with more depressive episodes in bipolar I patients.

Even though lithium seems more protective than other commonly used drugs, bipolar patients still suffer from a high relapse rate. Bad adherence, life events and alcohol use disorders are hereby major risk factors. The results urge for further and more holistic treatment approaches in bipolar disorder.

It is well known that students have several stressful situations to cope with and their coping strategies are of a wide range (Brougham et al., 2009, Zi et al., 2011, Pierceall and Cane, 2009).

The purpose of the study was to investigate how students coped with various stressful situations they faced.

One hundred participants, 60 men and 40 women, studying at TEI of Patras, Greece, were randomly selected and asked to describe their stressful situations and the ways they dealt with them.

The questionnaire used was based on “Échelle Toulousaine de Coping” (Tap et al., 1993) adjusted by Theodoratou et al. (2006).

Forty-five percent of the students could not control their feelings, while facing a difficult situation and might feel panic, but the majority of the students (63%) did not use medication to cope with a difficult situation. When facing a problem, the 45% of the students did not amuse themselves and 35% of the participants avoided communication with other people when they faced a problem. Moreover, 29% of the students chose to pray to face a difficult situation. Finally, 58% of the participants estimated that a counseling center in TEI of Western Greece would be necessary.

In conclusion, many students were overwhelmed by a negative emotion and most of them chose social withdrawal. Thus, they might feel helpless and suggested that a counseling center in their College and university might help them to overcome difficulties during their studies.

The authors have not supplied their declaration of competing interest.

Family interventions in psychosis are well established through systematic reviews and meta-analysis of outcome studies. Such reviews report that family intervention might reduce the risk of relapse, benefits in general social functioning, and reduction in levels of expressed emotion and family burden. But most previous studies are conducted in caregivers with chronic schizophrenia. Thus, the effects of family interventions in the early stages are largely unknown.

The study evaluated the effectiveness of group intervention in improving social support and reduction in expressed emotion among caregivers of first episode psychosis.

Using a quasi-experimental comparison group design, we evaluated the effectiveness of an add-on seven sessions of group interventions with treatment as usual group among 59 caregivers of first episode psychosis. Intervention included support, psycho-education, and communication components. The samples were recruited during participants’ inpatient stay at the hospital. Follow-up assessments were carried out after one moth and three months of interventions. Standardized instruments were used to measure the outcomes. Descriptive and inferential statistics were applied to the data.

Caregivers in group intervention reported significant reduction in expressed emotion (p<.007) and improvements in social support (p<.002) in one month follow-up assessment. But these benefits were not sustained at three months follow-ups. Overall, both groups showed significant changes on outcome variables over the time period.

Group intervention was effective for improving caregivers’ social support and reducing expressed emotion. Intervention need to provide longer period to sustain the benefits.

Major mood disorders are quite prevalent, but frequently underreferred, underdiagnosed and undertreated illnesses. The early recognition and appropriate treatment of unipolar and bipolar mood disorders is particularly important, since untreated mood disorders carry extremely high risk of both attempted and committed suicide. Recent studies clearly show that suicidal behaviour in patients with major mood disorders is state and severity dependent and this means that suicidality markedly decreases or vanishes after clinical recovery from major depressive episode or from dysphoric mania. However, since the majority of mood disorder patients never committ and more than half of them never attempt suicide, special clinical characteristics of the illness as well as some familial and psycho-social factors should also play a contributory role in this self-destructive behavuour.

Considering the clinically explorable suicide risk factors in patients with mood disorders (family and/or personal history of suicidal behaviour, early onset of the disorder, severe depressive episode/hopelessness, agitated/mixed depression, bipolar II diagnosis, comorbid Axis I and Axis II disorders, adverse life situations, lack of social and medical support), in the majority of the cases, suicidal behaviour is predictable with a good chance. There are also several evidences that (succesfull) long-term treatment of unipolar depressives (with antidepressants and/or lithium) and bipolar patients (with mood stabilizers and with antidepressants/antipsychotics) substantially reduces the risk of attempted and completed suicide, even in this high-risk population. Most recent studies also show that supplementary psycho-social interventions (psychoeducation, and targeted psychotherapies) further improve the results.

To find out clinical and social factors contributing to specific female crime – infanticide.

clinical, psychological, statistical.

A cohort of 12 females who had killed their children was examined. All women were victims of violence by their husbands or partners. Domestic abuse resulted in long-term mental problems of women. Clinical assessment has revealed depression, anxiety, fear, post traumatic stress disorder, alcohol abuse.

Women of the sample who had committed infanticide displayed pathological altruistic motivation of the crime. Alongside with clinical factors the research had revealed also social factors of infanticide. Women were often exposed to psychogenic situations with high level of stress (financial and housing problems, violence of the partner). In accordance with the Criminal Code of Russia the special article (106) governs infanticide. This law takes into account the psychogenic situation which caused the crime (battered women syndrome) and the fact that at the time of the child murder the mental state of mother was affected by childbirth.

In cases of infanticide the court is free to make verdict more lenient and its reflects more humane approach to such complicated phenomenon as child murder.

The study is supported by the grant 13-06-00127 of the Russian Humanitarian Scientific Fund

Cognitive impairment in patients with depressive disorder is a subject of intensive research.

This study deals with the cognitive impairment in patients with severe depressive episode with psychotic symptoms and patients with major depressive disorder during the acute state of illness.

The aim was to define domains and the level of cognitive impairment in both groups of patients.

The next aim was to compare profiles of cognitive impairment in both groups of patients.

The last aim was to find out a relationship between cognitive performance and severity of depressive episode during the acute state of illness.

We have used neuropsychological test battery (Auditory–Verbal Learning Test, Rey-Osterrieth Complex Figure Test, Logical Memory, Digit span test, Trail making test, Verbal Fluency Test, Block Design and Benton Visual Retention Test) for the evaluation of the cognitive functions in patients with severe depressive episode with psychotic symptoms (n = 5) and patients with major depressive disorder (n = 8).

We found cognitive impairment in all examined domains in both groups of patients.

More profound cognitive impairment was found in patients with severe depressive episode with psychotic symptoms, particularly in visual memory, visuo-constructive abilities, speed of cognitive processing and executive functions. We found no correlation between cognitive performance and severity of depressive episodes.

Our findings suggest a strong correlation between psychotic symptoms in depression and cognitive performance.