Information about the relationship between personality disorder and ethnicity or migration is sparse. The few studies regarding the prevalence of borderline personality disorder (BPD) in immigrants compared to an indigenous population are inconsistent.

The aim of the present study was to compare the frequency of a BPD diagnosis in psychiatric inpatients with and without an immigrant background.

2494 consecutive patients over a 3-year period at a psychiatric university hospital were reviewed. Data included socio-demographic and clinical variables and also information about an immigrant background. The psychiatric diagnosis was limited to information available from the digital documentation system of the psychiatric clinic and additionally from discharge letters. The diagnosis of borderline personality disorder was based on ICD-10 criteria.

374 individuals (15%) of the study population had an immigrant background. The rates of BPD were 6.5% in the indigenous group (n = 2120) vs. 3.5% in the immigrant group (n = 374). The difference between the indigenous and the immigrant group regarding the rates of BPD-diagnoses was statistically significant (chi2 = 5.02, df = 1, p = 0.025).

The findings suggest that in a clinical sample BPD was diagnosed less frequently in the immigrant group than in the indigenous group. Therefore, our results do not support the concept of immigration as a risk factor for BPD. However, future investigations with a prospective study design and at epidemiological levels need to be conducted in order to get more precise information about the prevalence of BPD in different immigrant groups.

Vortioxetine (Lu AA21004) is an investigational antidepressant, a multimodal 5-HT3, 5-HT7 and 5-HT1D receptor antagonist, 5-HT1B receptor partial agonist, 5-HT1A receptor agonist and inhibitor of the 5-HT transporter.

To compare efficacy and tolerability of flexible-dose treatment with vortioxetine versus agomelatine in MDD patients who presented with an inadequate response to SSRI/SNRI monotherapy.

The primary efficacy endpoint was the change from baseline to Week 8 in MADRS total score analysed by MMRM using a non-inferiority test. Secondary endpoints included assessment of anxiety symptoms (HAM-A), global clinical judgment (CGI), and overall functioning (SDS).

Randomized, double-blind comparator study (NCT01488071).

Eligible patients were randomized (1:1) to vortioxetine (10-20mg/day) or agomelatine (25-50mg/day) for 12 weeks of double-blind treatment. On the primary efficacy endpoint, vortioxetine (n=252) was statistically significantly superior to agomelatine (n=241) (p< 0.05) by 2.2 MADRS points. Significant differences in favour of vortioxetine were found for the MADRS, HAM-A, CGI-S, CGI-I, and SDS from Week 4 onwards (FAS, MMRM; p< 0.05) and robustness was confirmed by significant differences by ANCOVA (FAS, LOCF). Fewer patients withdrew due to adverse events with vortioxetine (5.9%) than agomelatine (9.5%). Adverse events with the highest incidence were nausea, headache, dizziness and somnolence.

The primary efficacy endpoint of this comparator study was met, with vortioxetine also showing a significant benefit compared to agomelatine in MDD patients who changed antidepressant after an inadequate response to SSRI/SNRI treatment. Statistically significant differences were seen from Week 4 onwards. This study confirms that vortioxetine is efficacious and well-tolerated.

Duration of untreated psychosis (DUP) is one of the few potentially modifiable predictors of outcome in schizophrenia. The long DUP and its relation to poor short-term outcome of schizophrenia has been studied in meta-analyses, but the conclusions remain unclear regarding the long-term effects of DUP.

To study the association between DUP and long-term outcome in a meta-analysis.

A systematic literature search of studies on DUP and long-term outcome in schizophrenia was performed using seven electronic databases. Studies were included if the follow-up was at least two years, the majority of subjects had a diagnosis of schizophrenia and DUP was studied with at least one of the following outcome categories: positive, negative, general and total symptoms, need of treatment, social functioning, employment, global outcome, quality of life and remission. Random effect methods were used to pool the effects of original studies.

2636 unique publications were identified of which 37 met our pre-defined selection criteria. Long DUP correlated with more severe positive (number of studies n=16; r=0.17), negative (n=17; r=0.14), general (n=4; r=0.29) and total symptoms (n=7; r=0.14) and with poor social functioning (n=13; r=0.13), poor global outcome (n=15; r=0.22) and less likely remission (n=16; r=0.14). The association between long DUP and decreased need of treatment was close to statistical significance (n=12; r=0.12). Employment (n=5) and quality of life (n=5) were not associated with DUP.

Severe symptoms and decreased functionality does not seem to increase the need of treatment or decrease the quality of life or employment.

Under contemporary social circumstances, there is a tendency to increasing of amount of persons disposed to addictive behavior (AB) as a mean to remove psychoemotional tension and to solve their significant problems. This tendency raises in patients with neurotic disorders (ND) that influences on clinical manifestations of the pathology and impedes diagnosis and timely care for this category of patients.

To investigate AB in the structure of neurotic disorders (F44.7, F40.8, F48.0).

Assessment of personal addictive status with AUDIT-like tests to detect disorders related to substance and non-substance abuse; 109 patients with ND (main group) and 52 persons without ND (control group) were examined.

It was revealed that patients with ND had significantly higher risk of AB formation (59.73% compared with 21.15% in healthy persons; P < 0.0001). According to the group comparison, in patients with ND levels of AB expression on parameters of “Job” (12.06 points), “Food” (11.98 points), “Internet” (11.10 points), “TV” (8.82 points), “Shopping” (6.59 points) were significantly higher than in healthy persons (9.73; 9.23; 9.00; 7.38; 4.25 points, respectively; P < 0.05). However, levels of keenness on computer were significantly higher in healthy persons (3.48 points) than in patients with ND (2.34 points; P < 0.05). AB connected with substance abuse was not registered in the groups.

The results suggest that the patients use AB in forms of food, Internet, job, TV, shopping dependencies as a subconscious mechanism substituting unsatisfied needs and decreasing motivation-emotional tension under conditions of a frustration conflict.

The authors have not supplied their declaration of competing interest.

Depression and suicide risk are disturbing issues within the medical community. In many countries, physician’s mental health is not a concern, due to the fact that many do not even consider medical staff as potential mental health patients. However, health care providers are an at risk population for phycological affliction due to their heavy workload.

We aim to describe the prevalence of depressive symptoms and suicidal risk among medical residents from health centers of Santiago de los Caballeros, Dominican Republic.

A cross-sectional descriptive study was made, between the months of February and May 2021, using the Beck Depression Inventory II (BDI-2) and the Plutchick Suicidal Risk Scale.

There was a total population of 507 residents, where 231 completed the survey. Of these, 1 recanted his participation, and 14 were excluded according to the study’s criteria, resultingin a total of 217 residents. The overall prevalence of depressive symptoms was 24.9% and suicidal risk was 22.94%. Residents who worked in a private center had 3.83 times more risk of suffering depressive symptoms compared to those who belonged to the public sector. Furthermore, residents from Internal Medicine (39.5%) had a higher prevalence of depressive symptoms, and residents from Anesthesiology (42.2%) suffered a higher suicide risk compared to other medical residences.

A disturbing percentage of the medical residents suffer from depressive symptoms and suicidal risk. Therefore, residency programs should offer assistance to help prevent and manage mental health disorders.

No significant relationships.

Risperidone-ISM is a new long-acting intramuscular formulation intended to achieve sustained plasma concentrations over 4 weeks without oral supplementation. The clinical efficacy to risperidone has been associated with 65–80% occupancy of dopamine D2 receptor (D2RO) and a mean Cmax between 7.5 ng/mL and 80 ng/mL.

Use a population PK/PD model to predict the PK and the D2RO for Risperidone-ISM in schizophrenic patients and to characterize the relationship among doses, in order to guide dose selection for a future Phase-III trial.

A population PK/PD analysis for Risperidone-ISM using Monolix software was conducted based on 6641 plasma samples from two Phase-I studies (17 healthy subjects and 31 schizophrenic subjects, respectively) and 1 Phase-II study (60 schizophrenic subjects). Simulations were subsequently undertaken predicting the steady state PK and D2RO after multiple Risperidone-ISM doses administered every 28 days for 12 weeks.

Doses of 75 and 100 mg, administered either in gluteal or deltoid muscle, were predicted to result in median Cmax and Ctrough that stayed between 7.5 ng/mL and 80 ng/mL. At steady state 75 mg and 100 mg dose (gluteal) achieved a D2RO average [min–max] of 70.8% [61.4–80.4] and 74.3% [66.2–82.1], respectively; a 75-mg and 100-mg dose (deltoid) achieved a D2RO average [min–max] of 69.3% [56.5–80.3] and 73.0% [61.8–82.1], respectively. The model estimated that the 65% D2RO occurs within first 8 h after treatment.

Simulations were carried out supporting doses of 75 mg and 100 mg Risperidone-ISM to show the greatest efficacy and safety potential to be assessed in the future Phase-III trial.

The authors have not supplied their declaration of competing interest.

Obsessive-Compulsive Disorder (OCD) is a mental disorder characterized by obsessions and/or compulsions. Although some epidemiological studies take part in literature, which claim that traumatic life events in childhood ages are observed more in patients with OCD compared to healthy population, the number of these studies is limited. In this study, it is aimed to compare OCD patients with healthy volunteers in terms of traumatic life events in childhood ages.

With 25 consecutive patients who are diagnosed as OCD and whose treatment continues, 25 healthy controls equivalent in terms of sociodemographic features are included in the study. Sociodemographic Data Form, Childhood Age Trauma Quarter (CTQ) and Maudley Obsessive Compulsive Question List (MOCQL) are applied to the participants. Significance Value in statistical level is accepted as P < 0.05.

In OCD patient group, CTQ scores are found high in statistical level compared to healthy controls. It has been determined that there is a significant relationship between total score of MOCQL slowness subscale scores, subscale scores of sexual and emotional abuse, MOCQL rumination subscale scores and CTQ sexual abuse scores.

Compared to healthy controls, more findings of traumatic life event in childhood age are observed within OCD patients.

The authors have not supplied their declaration of competing interest.

Thyroid dysfunction is relatively common in patients with schizophrenia.This study seeks to determine the prevalence and pattern of thyroid dysfunction and thyroid antibodies presence in a group of adult psychiatric inpatients with chronic schizophrenia.

Thyroid function tests and thyroid antibodies measurement were performed on 88 patients hospitalized in Psichiatric Clinic of UHC “Mother Teresa” from december 2006 to december 2007.

55 of them (62,5%) were females and 33 of them (37,5%) males. A median age of 43 years (range16 to 70 years) and a median duration of hospitalization of 10 years (range 1 to 30 years) was assessed.

TAb were found in 22 patients (25%), of which 18 females and 4 males. 16% of them resulted with positive anticorps for Hashimoto Thyroiditis; 9% for Graves‘disease.

70% had normal test, 8% had elevated TSH: 3% of them with low thyroid hormones and 5% with normal thyroid hormones. 20% of cases had low TSH: 5% of them with high level of thyroid hormones, 15% with normal thyroid hormones. Hypothyroidism was more frequent in elderly patients ( > 60 years old), and in those treated with Risperidone. Most of cases (73%) with thyroid disorders resulted from endemic geographic areas. 37% of them mentioned familial history for thyroid pathology, and 23% for diabetes mellitus type 1.

Thyroid abnormalities are common in patients with chronic schizophrenia.This fact call for caution in the use and interpretation of thyroid function tests in these patients.

To study (a) if children with Language delay (LD) or Typical Language (TL) at 2½ y of age had persistent or transient language difficulties at 6 y of age and, (b) whether or not children with LD at 2½ y of age had language or neuropsychiatric impairments at school age.

At the 2½-y language screening 25 children with LD and children with TL were recruited. At 6-y 22 children from the LD group and 77 children from the TL group were examined. The 7-8-y follow–up concerned 21 of the 22 children with LD who participated at age 6 y. The 6-y examination included several tests of language and linguistic awareness. The 7-8-y follow-up consisted of a multidisciplinary examination of language, intellectual functions and neuropsychiatric disorders.

The 6-y examination showed a highly significant difference between the children with and without LD. At age 7-8 years 62% of the LD children had a neuropsychiatric diagnosis (ADHD or ASD). Half of them also had marked problems with narrative skill according to the Bus Story test and the NEPSY Narrative Memory Subtest independently of co-occurrence of neuropsychiatric disorder.

All children with LD at age 2½ y appeared to be at later risk of ADHD or ASD. Remaining language problems at age 6 y predicted the presence of neuropsychiatric disorders at age 7-8 years. The observed difficulties in the LD children indicate that these children are at high risk of developing problems concerning reading and writing.

Brain health has garnered increasing attention as a requisite condition for healthy aging. The rapid growth in mobile health and increasing smartphone ownership among older adults has paved the way for smartphones to be utilized as effective tools for improving mental fitness.

There are few studies that have explored the efficacy of smartphone-based cognitive training. The present study examined the memory-enhancing effects of smartphone-based memory training for older adults.

We explored whether newly developed application “Smartphone-based brain Anti-aging and memory Reinforcement Training (SMART)” improved memory performance in older adults with subjective memory complaints.

A total of 53 adults (mean age: 59.3 years) were randomised into either one of two smartphone-based intervention groups (SMART vs. Fit Brains®) or a wait-list group. Participants in the intervention groups underwent 15–20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and executive function (inhibition, fluency, etc.). In addition, we included self-report questionnaires to assess levels of subjective memory complaints.

The performance on WM test increased significantly in the SMART group (t[17] = 6.27, P < 0.0001) but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only (t[18] = 2.12, P = 0.048).

Use of an 8-week smartphone-based memory training program may improve working memory function in older adults. However, objective improvement in performance does not necessarily lead to decreased subjective memory complaints.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Psychiatry in the UK has longstanding recruitment problems (1). Evidence suggests the positive effects of clinical attachments on attitudes towards psychiatry are often transient (2). We therefore created the Psychiatry Early Experience Programme (PEEP) where year 1 medical students are paired with psychiatry trainees and shadow them at work. Students will ideally remain in PEEP throughout medical school, providing consistent exposure to psychiatry and a broad experience of its subspecialties.

1. 1. To present PEEP

2. 2. To assess:

   1. a. Students’ baseline attitudes to psychiatry

   2. b. PEEPs’ impact on students’ attitudes to psychiatry

Design

A prospective survey based cohort study of King’s College London medical students.

PEEP started in 2013. In this cohort all students that signed up were accepted.

Students’ attitudes towards psychiatry were assessed on recruitment using the ATP-30 questionnaire (3), and will be re-assessed annually.

127 students were recruited. Attitudes were positive overall. 73% listed psychiatry in their top three specialities. 95.3% agreed or strongly agreed that ‘psychiatric illness deserves at least as much attention as physical illness.’ 84.3% disagreed or strongly disagreed that ‘at times it is hard to think of psychiatrists as equal to other doctors.’

Baseline attitudes to psychiatry were positive. By March 2015 we aim to collect and analyse data on students’ attitudes after one year in PEEP. Through on-ongoing analysis of this and future cohorts, we aim to assess the impact of PEEP on improving attitudes to psychiatry and whether this will ultimately improve recruitment.

Parental schizophrenia will potentially cause dysfunction in mother-child relationships, and it will also cause difficulty in adapting to motherhood.

We aim to study the implications of the relationship between mothers with schizophrenia and their children. The psychosocial environment and the impact of dysfunctional relationship in social skills development may cause behavioral disorders in children and further development of severe mental illness taking into account genetic factors and biopsychosocial factors.

Non systematic literature review, through the Pubmed and Medline database, with time constraints.

The development of schizophrenia is related to genetic and environmental factors. Children of parents with schizophrenia are at increased risk of developing psychiatric disorder compared to the general population. It was found early behavioral disorders, starting between 5 and 8 years old and the difficulties in social interaction may arise at this age and remain until adulthood.

It is important to assess the level of acquisition of social skills in children and families when there is a direct relationship with schizophrenia. It may be important in the future, monitorize the development of these children, as well as be aware of the surrounding social and family environment, to identify and manage early in the presence of behavioral disorders and possible development of serious mental illness. An early intervention at the level of social deficits in children can be a preventive intervention of later schizophrenia development.

The authors have not supplied their declaration of competing interest.

Dissociative disorders are characterized by disturbances of integration of memory, perception, consciousness or identity. They were linked to psychological stress or trauma across various cultures. Dissociative amnesia and fugue, depersonalization disorder, dissociative identity disorder and dissociative disorder not otherwise specified (such as Ganser syndrome) belong to dissociative disorders in DSM-IV-TR. in contrast to DSM-IV-TR, ICD-10 also subsumes the conversion disorder under the category of dissociative (conversion) disorders.

This work's objective is establishing greater recognition of the neural correlates of dissociative disorders.

We review neuroimaging data pertaining to dissociative amnesia and fugue, depersonalization disorder, dissociative identity disorder (multiple personality disorder), Ganser syndrome and various forms of conversion disorder, which were obtained with functional and structural imaging techniques, including diffusion tensor imaging or magnetization transfer ratio measurements.

In addition to own imaging data from patients with dissociative amnesia and fugue, a comprehensive review of the scientific literature on the neuroimaging of dissociative disorders was performed.

Neuroimaging research data point to metabolic and sometimes even structural brain alterations in dissociative disorders, involving regions that are agreed upon to play roles in mnemonic processing, self referential processing (including body schema), perception, consciousness and/or emotional processing.

The use of functional and newer structural brain imaging methods has improved and will continue to further our understanding of the neural correlates of dissociative disorders and has provided evidence that environmentally-driven (stress-related) alterations of cognition, identity, body schema, perception, affectivity and behavior are accompanied by metabolic and even structural brain changes.

Olanzapine is an atypical antipsychotic medication, previously expected to be safe in terms of hematological side effects and an alternative choice to clozapine in patients who develop hematotoxicities. However, since olanzapine was introduced to the market, a lot of cases reports have been published revealing it could cause hematoxicity. Some of them indicate that olanzapine induces agranulocytosis. Because of that, it raises the concerns about hematological safety of olanzapine.

To date, no review discusses this topic specifically, so we conducted a systemic review to explore and address this issue.

We searched Pubmed, Google Scholar, Ovid and Medline databases for articles between 1998 and 2015 that include keywords olanzapine, leukopenia, neutropenia, and agranulocytosis.

A total of 38 publications were identified. The case reports included patients aged 16 to 83 years. Doses ranged from 2.5 to 30 mg. After starting treatment, onset of hematotoxicity varied from the first day to 2–3 years, but most commonly within the first month. Also, olanzapine could induce leukopenia in patients who have never developed drug-related leukopenia.

Among antipsychotic medications, olanzapine is the third leading cause of neutropenia and the second leading cause of atypical antipsychotic medication. Because of the small body of literature regarding the hematotoxic side effects of olanzapine, we encourage further research to understand the mechanism by which olanzapine causes granulocytopenia. The identification of risk factors could facilitate the development of new surveillance guidelines in patients taking olanzapine. We recommend that the guidelines of using and monitoring olanzapine need to be reconsidered.

The authors have not supplied their declaration of competing interest.