It is not clear if there is an interaction between psychotherapy and pharmacotherapy. First, there may be no interaction at all, meaning that the effects of both are independent of each other. Second, antidepressants may reduce the effects of psychotherapy, and third, antidepressants may increase the effects of psychotherapy. We examined which of the three is correct.

We conducted random effects meta-analyses of randomized trials comparing psychotherapies for adult depression with control conditions. The proportion of users of antidepressants was used as a predictor of the effect size in a series of meta-regression analyses, while adjusting for relevant moderators, such as type of control group and baseline severity.

We included 300 randomized controlled trials (353 comparisons between treatment and control; 32,852 participants). The main effect size of psychotherapy was g = 0.71 (95% CI: 0.64; 0.79) with high heterogeneity (I2 = 82; 95% CI: 80; 84). We found no significant association between the proportion of antidepressants users and effect size (p = .07). We did find a significant association with some other predictors, including the type of control group and risk of bias. The use of antidepressants was associated with higher response rates within the control conditions, but not with the relative effects of the treatments compared to the control groups.

We found support for the independent effects of psychotherapy and pharmacotherapy, which is good news from a clinical perspective. Apparently, patients can start with psychotherapy and do not have to be afraid that this will reduce the effects of the therapy.

Among medical students the rate of depression varies between 5-32% and it is known that the suicide rate is higher than in the general population.

Clear and current data are needed to design studies for the diagnosis and treatment of students and residents of Medicine with psychological and psychiatric disorders in order to reduce rates of suicidal behavior in this population group.

A systematic search for articles on the UpToDate, PubMed and Mendeley platforms has been conducted with the keywords “suicide”, “suicidal behavior”, “suicidal ideation”, “medicalschool” and “medical students”. We found 435 items from which a total of 42 items were selected.

The prevalence of depression is 27.2%, of which only 15.7% of them are under treatment. Burnout, has a high prevalence of 45-50%. The prevalence of suicidal ideation in the last year is 11.1%. The most commonly used method is medication overdose. Suicidal behavior is greater among students who choose to choose Psychiatry or Family and Community Medicine as a specialty.

The rate of suicidal ideation among medical students is 11.1%. Nearly one out of every three medical students suffers from depression in some degree, and only one in five is treated. The similar prevalence of burnout at all levels supposes poor management of stress from the faculty. Medical schools should reduce the associated stigma and should encourage depressed students to seek treatment.

Dealing with art requires an active sensual involvement and, furthermore, art creates form and meaning. Research in phenomenological psychopathology finds, that schizophrenic psychopathology develops from a destruction of the patient's very primary sense of self (ipseity) leading to a breakdown of meaning. Art therapy may therefore be useful in the treatment of schizophrenia.

Art therapy research is very sparse and inconclusive although it is used rather extensively in psychiatry. The lack of a common theory and practice within this field may be an obstacle for further investigation.

This study describes a phenomenological based art therapy and presents a qualitative analysis of possible connections between the art making and the psychopathology.

Two groups of five patients received art therapy during one year. The logbooks, pictures, interviews and evaluations were used for a narrative description and a hermeneutic, phenomenological analysis.

All patients found the art therapy helpful. Common trends were that the patients obtained a more clear sense of who they were or that they accepted themselves and their illness better. In addition, the paranoid patients experienced a subjective reduction of anxiety while painting. These effects seem to be connected to the active and sensing interaction with the art material and the creation of meaning in the paintings.

The study shows that art making may affect psychopathology. A possible connection between art and psychopathology was established via phenomenological psychopathology and the philosophical concept of primary sense of self.

ASD is a multifactorial disease. They arise from the interaction of various genetic and environmental factors. These factors affect specific neuronal circuits, oxidative stress, neuroinflammation, mitochondrial dysfunction. This disrupts the development of the nervous system, the formation of synapses, the connection between brain regions, and the size of the brain. Almost 80% of patients with ASD suffer from mitochondrial dysfunction. Therefore, mitochondrial dysfunction plays a crucial role in the pathogenesis of ASD.

Deficiency of adenosine-triphosphate (ATP) and abnormal levels of Reactive oxygen species (ROS) cause mitochondrial dysfunction in ASD. This leads to metabolic disorders, disorders of synaptic plasticity and disorders of the immune response

The negative association between pathogenic mtDNA mutations and IQ is specific for children with ASD / MD. The overall prevalence of these abnormalities is 1.2 times higher in ASD / MD. ASD, researchers reaffirm that autistic probands carry the burden of mutations in mtDNA, especially mutations that are prone to deleterious effects on OXPHOS. According to a number of researchers, all children with ASD should be screened for MD, given: the high prevalence of abnormal markers of mitochondrial function in ASD compared with the control group; relatively high prevalence of MD in ASD; some children with ASD who have MD may be phenotypically indistinguishable from typical children with ASD; the potential clinical significance of MD in children with ASD.

According to a number of researchers, all children with ASD should be screened for MD, given: the high prevalence of abnormal markers of mitochondrial function in ASD compared with the control group; relatively high prevalence of MD in ASD; some children with ASD who have MD may be phenotypically indistinguishable from typical children with ASD; the potential clinical significance of MD in children with ASD.

The pathophysiological mechanisms of ASD are multifactorial. They are largely unclear. But the mitochondrial hypothesis of the pathogenesis of ASD is being clarified. Mitochondrial dysfunction has been identified as a hallmark of diseased neurons in ASD patients, suggesting a critical role for mitochondrial dysfunction in the pathogenesis of ASD and allowing the development of ASD correction by normalizing mitochondrial functions.

None Declared

Stress is an integral part of parenting. The stress of parenting is especially increased at parents of children with developmental disabilities, which can have negative effects on the health of the parents, the relationship with the child and total parental behavior. The objective of this work is to assess the level of stress of parenting among parents of children with developmental disabilities. Parents were involved in workshops support within a regional project. The workshops were conducted twice a month, in the duration of two hours, during the one-year period. The workshops were led by experts in various fields, and work with parents was psycho-educational and supportive. The assessment was made using the questionnaire Parenting Stress Index-Short Form, within the two time frames, at the beginning of the project and after 12 months. The results showed that nearly two-thirds of parents of children with disabilities were under clinically significant stress at the beginning of the service. By retesting after twelve months, it was found that parental stress decreased, and the decrease is particularly evident in the parental competence experience. Although stress is reduced to some extent by the way the parent is experiencing emotional exchange with the child, its level still remains high.

Our experience shows that supportive workshops, which we participated in significantly, but insufficiently contributed to the stress reduction among parents. This paper discusses other possible interventions, which would specifically be aimed at developing strategies for reductions of clinically high level of parental stress.

The authors have not supplied their declaration of competing interest.

Faced with the global health emergency, a product of Covid-19, the educational system was forced to change its dynamics, assuming new challenges and adapting to virtual environments (Sierra, López, Azar & Trevethan, 2020). In this sense, the teaching task from home supposes an increase in the hours dedicated to their work, since they have seen the need to be trained in digital platforms to be able to respond to the changes derived from confinement; which can quietly generate professional wear and tear.

Analyze the relationship between professional burnout and increased workload on teachers

A cross-sectional study of correlational scope was carried out in 60 (n = 60) teachers, working actively at a higher education institution. A sociodemographic scale was designed to identify the hours dedicated to work before and during confinement and to evaluate professional burnout, the adaptation of the MBI instrument for the Colombian population was used (Barbato, Córdoba, González, Martínez & Tamayo, 2011)

A 50% increase in the workload of teachers was observed during confinement, besides, a statistically significant correlation between professional burnout and the increase in hours dedicated to work (Table 1)

It was possible to conclude that the significant increase in the workload in teachers correlates positively with levels of emotional exhaustion and depersonalization; however, no correlations were observed between workload and personal achievement of higher education teachers.

A psychosomatic disorder, Stendhal Syndrome, causes tachycardia, dizziness, sweating, disorientation, fainting, and confusion when someone is looking at artwork with which he or she connects deeply emotionally. In 1817, a French author named Marie-Henri Beyle, whose pseudonym was Stendhal, described his experience visiting the Basilica of Santa Croce in Florence and feeling overwhelmed by all the beauty and rich history surrounding him. Over a century later, visitors to Florence continued to suffer from similar symptoms. In 1979, Dr. Graziella Magherini, Chief of Psychiatry at the Hospital of Santa Maria Nuova in Florence, observed more than 100 tourists who were hospitalized after looking at art in Florence and coined the term Stendhal Syndrome.

To review literature on Stendhal syndrome, a bizarre travel-related syndrome.

PubMed and Google Scholar search using the keywords Stendhal syndrome, travel syndromes, culture shock

Victims are typically impressionable, single people between 26-40 years old, who are stressed by travel and may be struggling with jet lag. For art lovers, the thrill of arriving somewhere like Florence that gathers so much famous art is like meeting all your heroes at once. This strange aesthetic sickness is surely evidence of the special power of Renaissance art.

Stendhal Syndrome does not currently appear in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Psychiatrists have however, documented the syndrome in medical journals and advise that tourists pace themselves in art museums and get enough rest in between viewings of Italy’s breathtaking, powerful masterpieces.

To examine the influence of gender on burden experience and depression among informal caregivers of frail older people.

The study was part of a large survey in private households in Germany headed by TNS Infratest Social Research. Based on a probability sample of the German population (n = 52,916), we contacted all people who were 60 years of age and older and who screened positively for at least one deficit in a range of activities of daily living as well as for cognitive impairment. Characteristics of the frail person and the care situation were assessed and - if an informal caregiver was available - burden measures and the CES-Depression Scale were applied.

The care of the frail old people (n = 306, attrition: 39%; mean age: 80.2 years; female: 68.6%) was provided mostly by family caregivers (n = 262; mean age: 61 years; female: 73%). Both the burden experience and the depressive symptoms were higher among the female than among the male caregivers. Multiple linear regression analyses confirmed that caregiver's gender was one of the strongest predictors of burden experience as well as of depression. Structural equation modeling suggested that burden mediates depression; it further proposed that there should be separate models for female and male caregivers.

The results provide a basis for the development of strategies to reduce or even prevent serious distress and psychiatric disorders among informal caregivers. Furthermore, they point to the need for gender-specific interventions in this field.

Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.

A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.

The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.

Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.

Experimental studies support a neurotrophic hypothesis of major depressive disorder (MDD). The aim of this study was to determine the effect of Val66Met brain derived neurotrophic factor (BDNF) polymorphism on the white matter fibre tracts connecting hippocampus and amygdala with the prefrontal lobe in a sample of patients with MDD and healthy controls.

Thirty seven patients with MDD and 42 healthy volunteers were recruited. Diffusion tensor imaging (DTI) data with 61 diffusion directions were obtained with MRI 3 Tesla scanner. Deterministic tractography was applied with ExploreDTI and Val66Met BDNF SNP (rs6265) was genotyped. Fibre tracts connecting the hippocampus and amygdala with the prefrontal lobe, namely uncinate fasciculus, fornix and cingulum were analysed.

A significant interaction was found in the uncinate fasciculus (UF) between BDNF alleles and diagnosis. Patients carrying the BDNF met-allele had smaller fractional anisotropy (FA) in the UF compared to those patients homozygous for valallele and compared to healthy subjects carrying the met-allele. A significant 3-way interaction was detected between region of the cingulum (dorsal, rostral and parahippocampal regions), brain hemisphere and BDNF genotype. Larger FA was detectable in the left rostral cingulum for met-allele carriers when compared to val/val alelle carriers.

We provide evidence for the importance of the neurotrophic involvement in limbic and prefrontal connections. The met-allele of the BDNF polymorphism seems to render subjects more vulnerable for dysfunctions associated with the UF, a tract known to be related to negative emotional-cognitive processing bias, declarative memory problems, and autonoetic self awareness.

The European Psychiatric Association (EPA) is an organization that speaks on behalf of its individual members and members of National Psychiatric Associations (NPAs). The aim of this study to identify and investigate current contents of ethical codes and practices in the countries belonging to EPA.

The study is an expert survey sent out to 44 representatives of 30 NPAs covering the following topics: the existence of national bodies dealing with ethical issues in psychiatry, the availability of documents relevant to ethical issues, the types of ethical issues addressed at the national level, and the current and envisaged ethical debates.

Out of 44 experts invited to participate in the study, 31 NPAs from 30 countries responded (response rate 70.45%). In the majority of countries, the general mission statement serves as the main document covering ethical issues in psychiatry. Most frequently, internal documents were reported to address medical malpractice, workplace bullying, plagiarism, academic fraud, sexual abuse, and discrimination/racism. Furthermore, internal documents cover the ethical assessment of potentially controversial procedures, including psychosurgery, euthanasia, and pregnancy termination. The most important topics for debate at the level of NPAs/EPA were associated with violations of clinical practice standards and human rights.

NPAs are active in the field of professional ethics, defining ethical standards related to interactions among professionals and services provided by mental health care professionals. Future collaboration of NPAs, under the umbrella of the EPA, could allow to develop a database of local ethical documents that would be translated into English and accessible to all EPA members.

Young people can receive mental health care from many sources, from formal and informal sectors. Caregiver characteristics/experiences/beliefs may influence whether young people get help and the type of care or support used by their child. We investigate facilitators/barriers to receiving formal and/or informal care, particularly those related to the caregiver’s profile.

We interviewed 1,400 Brazilian primary caregivers of young people (aged 10–19), participants of a high-risk cohort. Caregivers reported on young people’s formal/informal mental health care utilization, and associated barriers and facilitators to care. Data were also collected on youth mental health and its impact on everyday life; and caregiver characteristics—education, socioeconomics, ethnicity, mental health, and stigma. Logistic regression models were used to examine the relationship between caregiver and young people characteristics with formal/informal care utilization.

Persistence and greater impact of youth mental health conditions were associated with a higher likelihood of care, more clearly for formal care. Caregiver characteristics, however, also played a key role in whether young people received any care: lower parental stigma was associated with greater formal service use, and lower socioeconomic class showed higher odds of informal care (mainly from religious leaders).

This study highlights the key role of the caregivers as gatekeepers to child treatment access, particularly parental stigma influencing whether young people received any mental health care, even in a low resource setting. These results help to map barriers for treatment access and delivery for young people, aiming to improve intervention efforts and mental health support.

Adolescents’ Internet gaming disorders might influence on their social and psychological developmental tasks and physical health negatively. Depression is the commonly co-existed conditions with addictive Internet gaming, but not much research has been reported whether depressive symptoms would precede the addictive Internet gaming in this population.

This prospective observation study was performed to make clear whether adolescents’ depressive symptoms precede their addictive Internet gaming.

Adolescents’ 1-year incidence of the addictive Internet gaming was calculated, and test their depressive symptoms increase the incidence.

In Korea, whole students of the 1st grade in three middle schools were participated in this study. Baseline assessment of 508 students was performed via standardized self-reported questionnaire on May–June, 2015. Internet game use-elicited symptom screen (IGUESS) was used to addictive Internet gaming conditions. IGUESS is the 9-itemed DSM-5 diagnostic criteria-based instrument to screen high risk of Internet gaming disorders. Depressive symptoms was measured by Child Depression Inventory (CDI) group. One year after the baseline assessment, follow-up assessment was performed. Four hundred and forty-eight students have been participated in the 1-year check up without addictive Internet gaming at baseline.

In total, 4.7% of subjects had depressive symptoms at baseline, and incidence of addictive Internet gaming was 9.2%. After adjusted by sex, Internet game use per week, and self-control status, depressive symptoms of baseline increased the 1-year incidence of addictive Internet gaming significantly (OR = 3.5, P = 0.034).

Depressive adolescents have higher possibility they could experience the addictive Internet gaming.

The authors have not supplied their declaration of competing interest.

The present research have done with concentration on examining the impact of selected and divided attention-shaping training in reinforcing attention and the academic improvement and self-efficacy of primary school children with attention deficit-hyperactivity disorder.

The research method was a quasi-experimental design with per- and post-test and follow-up with control group. Statistical society contained all of the primary school children with attention deficit-hyperactivity disorder in Rafsanjan City. Forty children with attention deficit-hyperactivity disorder were chosen by the method of random sampling and randomly assigned in control and experimental groups (20 children in experimental group and 20 children in control group). At first in pretest stage used academic self-efficacy questionnaire and the software of selected and divided attention. For measurements of academic improvement were used the scores of a teacher build test mathematic and spelling. Then, experimental group take 8 sessions education of selected and divided attention-shaping Training. The data were analyzed by analysis of variance with repeated measurement test.

Results of this research show that selected and divided attention training improved the amount of divided and selected attention and academical improvement of children < but it's not effective significantly on reaction time and academic self-efficacy of children with attention deficit disorder-hyperactivity.

Attention training can be effective to increase attention and academical achievement in children with ADHD.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Le Metacognitions Questionnaire-30 (MCQ-30), développé par Wells et Cartwright-Hatton (2004) [1], est une échelle de mesure multidimensionnelle de facteurs métacognitifs impliqués dans le développement et la persistance de troubles psychiques. La théorie définitoire inhérente à cette échelle est résumée par Wells et Matthews [2] dans le modèle Self-Regulatory Executive Function (S-REF). Dans la dépression, une rumination pathogène serait induite par des pensées (croyances métacognitives évaluées par le MCQ-30) et des stratégies de contrôle qui perpétuent une cognition et des stratégies de coping inadaptées. Le but de notre étude est d’adapter et de valider une version française du MCQ-30 en évaluant ses propriétés psychométriques dans un échantillon de patients qui ont un diagnostic de dépression.

L’adaptation française de l’instrument a été réalisée après une traduction back-forward permettant une bonne validité de face. Elle est en cours de passation dans un échantillon de patients hospitalisés ayant un diagnostic de dépression établi selon les critères du DSM 4 TR. Le nombre de sujets nécessaires est estimé à 150 [3]. Une analyse factorielle confirmatoire permettra de vérifier la structure dimensionnelle à 5 facteurs retrouvée dans l’étude de validation de la version originale. Pour l’évaluation de la validité convergente, nous étudierons la corrélation des différents facteurs du MCQ-30 avec une mesure de l’anxiété d’état (Penn State Worry Questionnaire), de la rumination (Rumination on Sadness Scale), et de la dépression (Beck Depression Inventory). Hypothèses sur le comportement de l’échelle : en accord avec les validations étrangères, nous supposerons une corrélation positive et significative de la MCQ-30 avec les échelles sus-citées.

Des résultats partiels seront présentés et discutés à la lumière de la taille de l’échantillon.

Current categorical classification systems of psychiatric diagnoses lead to heterogeneity of symptoms within disorders and common co-occurrence of disorders. We investigated the heterogeneous and overlapping nature of symptom endorsement in a population-based sample across three of the most common categories of psychiatric disorders: depressive disorders, anxiety disorders, and sleep–wake disorders using unsupervised machine learning approaches.

We assessed a total of 43 symptoms in a discovery sample of 6,602 participants of the population-based Rotterdam Study between 2009 and 2013, and in a replication sample of 3,005 participants between 2016 and 2020. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index. Hierarchical clustering analysis was applied on test items and participants to investigate common patterns of symptoms co-occurrence, and further quantitatively investigated with clustering methods to find groups that may represent similar psychiatric phenotypes.

First, clustering analyses of the questionnaire items suggested a three-cluster solution representing clusters of “mixed” symptoms, “depressed affect and nervousness”, and “troubled sleep and interpersonal problems”. A highly similar clustering solution was independently established in the replication sample. Second, four groups of participants could be separated, and these groups scored differently on the item clusters.

We identified three clusters of psychiatric symptoms that most commonly co-occur in a population-based sample. These symptoms clustered stable over samples, but across the topics of depression, anxiety, and poor sleep. We identified four groups of participants that share (sub)clinical symptoms and might benefit from similar prevention or treatment strategies, despite potentially diverging, or lack of, diagnoses.

Tattoo prevalence among young people assumed epidemic. It transformed into tattoo-addiction (tattoo-mania) and influences significantly on personality psychology and mind. Youth addict-audience with searching, delinquent and psychopathy-like radicals, generated drug addictions is one of tattoo configurations habitation key cohorts.

was to study tattoo-addiction prevalence scale and clinical peculiarities for identification in narcology as sustantional addiction new form.

for the research were information sources: 1) mass media; 2) Internet-monitoring results; 3) own research of students' youth cohort; 4) testing cohort of chemical and substantional addicted respondents.

of the research gave evidence that tattoo-problen in modern human has pivotal constituents of addiction syndrome conforming to ICD-10 clinical criteria: 1) specific tattoo-sensations search («acute intoxication»); 2) stable desire for tattoo-designs persistent refreshing (pathological drive syndrome); 3) (psychological and emotional discomfort sensation on the eve of new tattoo-interventions (withdrawal syndrome psychic equivalent); 4) expansion of dimensions and volumes of tattoo-design and colour scale (tolerance symptom); 5) thirst for tattoo-rage while covering the body with diverse patterns, combined tattoo and piercing (dipsomaniacal state symptom); 6) change of integument localization zones at tattooing (rotation of sensations); 7) tattoo-aggression consequences evidence (skin defects, chronic septic foci, innervation disorders, mental, behavioural disorders). Large-scale involvement, stability and further spread of tattoo-phenomenon: 12% of youth assess situation as «bad» and «awful», the rest 88% – as «excellent», «good», «not bad».

New problem of tattoo-addiction emerged in clinical narcology requires study, identification, working out the program of treatment, prevention and needs considering in new ICD-12 Version.

Attention Deficit Hyperactivity Disorder (ADHD) prevalence in the general adult population is estimated to be between 2–4%. Despite the high prevalence, until recently there was only one validated semi-structured interview available for the accurate diagnostic assessment of ADHD within the adult population: the Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID).

To examine the concurrent validity of the DIVA 2.0 interview comparing the diagnostic rate with the CAADID interview. To analyse the criterion validity of the DIVA 2.0 in the Spanish language in an adult sample.

The aim of this is to study was to evaluate criterion validity of the DIVA 2.0 in an adult sample comparing with the CAADID and other ADHD severity scales.

A transversal study was performed to check the criteria and concurrent validity of the DIVA 2.0 compared to the CAADID.

Forty patients were recruited in an adult ADHD program at a university hospital. The DIVA 2.0 interview showed a diagnostic accuracy of 100% when compared with the diagnoses obtained with the CAADID interview and goods correlations with three self-reported rating scales: the WURS, the ADHD Rating Scale and Sheehan's’ Dysfunction Inventory.

The DIVA 2.0 has good psychometric properties and is a reliable tool for the assessment of ADHD in adults.

The authors have not supplied their declaration of competing interest.