Most women that reached menopause, experience depression. This study was done with this purpose to investigate the effects of regular aerobic exercise on depression in postmenopausal women.

In this experimental study, twenty six postmenopausal depressed women with age of 45-55 years, who sampled randomly in 2 groups (control and experimental), were participated in this investigation. The experimental group followed exercise training program including walking three times a week, for 3 months. But control group did not participate in any exercise program. depression level was measured before and after exercise.

Mean of depression in experimental group before exercise training relative to after exercise training were significantly decreased.

The results of present study demonstrated that regular aerobic exercise training decrease depression symptom. So, the authorities should apply strategies to decrease depression symptoms by changing life style from inactivity to exercise training in order to support postmenopausal women somatic health.

Poor sleep is a common complaint in postpartum depression (PPD). Depression as well as sleep disturbances may affect parenting functions and mother-infant relationship. The purpose of this study was to examine the relationship between objective sleep data, parenting stress and bonding in PPD.

Forty-five mothers (age: 34.5 ± 5.4 years SD) suffering from PPD were examined 212 ± 156 days (SD) after parturition. Depression was measured by Hamilton Depression Rating Scale (HDRS-ADS) and Beck Depression Inventory (BDI). Parenting stress and bonding were assessed by self report scales, i.e. Parenting Stress Index (PSI) and Postpartum Bonding Questionnaire (PBQ). In a subsample of 10 participants sleep parameters were assessed by actigraphy and sleep logs during seven consecutive days. Actigraphic sleep parameters were put in relation to severity of depression, PSI and PBQ scores.

Poor sleep, i.e. low total sleep time (TST) was negatively correlated to depression (HRDS-ADS) (r = -.63; p < .05). Low TST was associated with poor bonding (r = -.82; p = .02), especially attitudes of “rejection and anger”. Severity of depression (BDI) was correlated with parenting stress (r =.50; p =.005). Mothers with high parenting stress tended to have more difficulties in bonding (r =.65; p =.016). Neither sleep parameters nor parenting stress and bonding were correlated with the infant's age.

In PPD poor sleep should be recognized and treated early, because it is associated to parenting stress and disturbed bonding, which might have a detrimental impact on mother-infant relationship.

Postpartum psychosis is a severe psychiatric disorder that leads to hospital admission in about one woman per 1,000 deliveries. It coincide with the vulnerable period associated with becoming a mother and may, if untreated, lead to suicide and infanticide. Some risk factors for postpartum psychosis have been identified in previous research, such as primiparity and previous psychiatric disorder.

Knowledge on how postpartum psychosis is related to obstetric factors might be helpful in the clinical risk assessment of postpartum psychosis.

The aim of this large-scale follow-up study was to examine the association between postpartum psychosis and certain pregnancy and delivery complications and other obstetric variables, after adjustment for age, year of delivery and previous hospitalization for psychiatric disorder.

1,133,368 Swedish first-time mothers were included during a 29-year period yielding 1,413 hospitalized cases of postpartum psychosis. Several obstetric variables were analyzed separately after adjustment for possible confounders.

Respiratory disorder in the neonate, severe birth asphyxia, preterm birth, caesarean section, perinatal death and SGA infant were associated with an increased risk of postpartum psychosis. After adjustment for previous hospitalization for psychiatric disorder only preterm birth and acute caesarean section remained significant risk factors for postpartum psychosis (relative risks were 1.20 and 1.31, respectively).

The relative risk of postpartum psychosis among first-time mothers with previous hospitalization for psychiatric disorder was increased more than 100-fold.

Careful clinical risk assessments of postpartum psychosis are crucial among women with a history of psychiatric disorder whereas obstetric variables have a minor importance.

The original Profile of Mood States (McNair et al. 1971) is composed of 65 items to measure six affect dimensions. There is a Portuguese shorter version (POMS-27) for the perinatal period (Bos et al. 2013), which reduced the number of items (adjectives) down to 27. Although briefer, it still covers relevant mood states with good psychometric properties, being considered a good alternative to use during this demanding and busy period.

To test if PoMS-27, composed of four dimensions (Depression, Anxiety, Vigour, Fatigue) and one second-order factor (Negative Affect, composed by the former two) is valid and reliable to be used with pregnant women from Brazil.

After confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PoMS-27 and the Brazilian recently validated versions of Perinatal Depression Screening Scale and Perinatal Anxiety Screening Scale (PDSS; PASS; Barros et al. 2021). SPSS and AMOS software were used.

After deleting two items (20 and 22) and some errors were correlated, CFA indicated that the PoMS-25 four-dimensional model presented an acceptable fit (χ2=3.163; RMSEA=.079, CFI=.868, TLI=.849). The Cronbach alphas of the dimensions were: Depression (.82), Anxiety (.86), Negative Affect (.89), Fatigue (.80) and Vigor (.50).

Within this psychometric study we found useful, valid and reliable measure of negative and positive affect for Brazilian pregnant women. From now on we will denominate it Profile of Mood States-25Br

There is considerable evidence of cognitive impairment post COVID-19, especially in individuals with long-COVID symptoms, but limited research objectively evaluating whether such impairment attenuates or resolves over time, especially in young and middle-aged adults.

Follow-up assessments (T2) of cognitive function (processing speed, attention, working memory, executive function, memory) and mental health were conducted in 138 adults (18–69 years) who had been assessed 6 months earlier (T1). Of these, 88 had a confirmed history of COVID-19 at T1 assessment (≥20 days post-diagnosis) and were also followed-up on COVID-19-related symptoms (acute and long-COVID); 50 adults had no known COVID-19 history at any point up to their T2 assessment.

From T1 to T2, a trend-level improvement occurred in intra-individual variability in processing speed in the COVID, relative to the non-COVID group. However, longer response/task completion times persisted in participants with COVID-19-related hospitalisation relative to those without COVID-19-related hospitalisation and non-COVID controls. There was a significant reduction in long-COVID symptom load, which correlated with improved executive function in non-hospitalised COVID-19 participants. The COVID group continued to self-report poorer mental health, irrespective of hospitalisation history, relative to non-COVID group.

Although some cognitive improvement has occurred over a 6-month period in young and middle-aged COVID-19 survivors, cognitive impairment persists in those with a history of COVID-19-related hospitalisation and/or long-COVID symptoms. Continuous follow-up assessments are required to determine whether cognitive function improves or possibly worsens, over time in hospitalised and long-COVID participants.

The hypothalamus—pituitary—adrenal axis (HPA axis) dysregulation plays an important role in the pathophysiology of anxiety disorders. Salivary cortisol level is a useful indicator of HPA axis dysfunction.

Most data suggests elevated cortisol awakening response (CAR) in anxiety disorders, but there are studies indicating opposite pattern (flat CAR).

Goal of this study was to determine whether patients with anxiety and personality disorders show a specific daily cortisol patterns and weather this pattern changes after 12 weeks of intensive predominantly psychodynamic combined group and individual psychotherapy.

The studied population comprised 77 patients, mainly females (72.7%), with primary diagnosis of anxiety disorder 40.9% or personality disorder 59.1%. The Symptom Checklist “0” was used to assess the pre- and post-treatment levels of patients’ symptoms. Pre- and post-treatment cortisol levels were measured in three saliva samples collected during one day (at awakening, 30 min after awakening, at 22.00).

The obtained results were partly similar to previous research. We found four different daily CAR patterns: decreased (drop 30 min after awakening), flat (rise 0–49% 30 min after awakening), normal (rise 50–75% 30 min after awakening) and elevated (rise over 75% 30 min after awakening), two of them (flat and elevated) were considered as typical for anxiety disorders. Groups of CAR pattern differed significantly in the level of sleep symptoms, dysthymia symptoms and avoidance/dependency symptoms. The changes in the CAR pattern after psychotherapy were not significant.

Anxiety disorders and personality disorders are characterized by more than two specific daily salivary cortisol patterns.

The authors have not supplied their declaration of competing interest.

To evaluate the effectiveness of extended-release quetiapine fumarate (quetiapine XR) as once-daily monotherapy for bipolar depression.

Patients in this double-blind, placebo-controlled study were acutely depressed adults with bipolar I or II disorder (with or without rapid cycling), and were randomized to 8 weeks of once-daily treatment with quetiapine XR 300 mg (n=133) or placebo (n=137). The primary outcome measure was change from baseline to endpoint (Week 8) in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Secondary outcome measures included response (MADRS total score reduction ≥50%) and remission (MADRS total score ≤12) rates at endpoint, changes from baseline to endpoint in MADRS item scores, and Clinical Global Impressions-Bipolar (CGI-BP) severity of illness and change. Change from baseline was compared between groups with analysis of covariance using last observation carried forward approach.

Quetiapine XR 300 mg/d was significantly more effective than placebo in improving depressive symptoms, from first assessment (Week 1; P< 0.001) to endpoint (P< 0.001). Compared with placebo, quetiapine XR was associated with higher response (P< 0.001) and remission (P< 0.05) rates and greater improvements from baseline to endpoint in MADRS total score (-17.43 vs -11.92; P< 0.001), MADRS item scores for core symptoms of depression, and CGI-BP-related outcomes at Week 8. Most common adverse events with quetiapine XR were dry mouth, somnolence, and sedation.

Quetiapine XR (300 mg) once-daily monotherapy was efficacious (from Weeks 1 through 8) compared with placebo and generally well tolerated in bipolar depression.

Supported by funding from AstraZeneca Pharmaceuticals LP.

To study frequency and time until death due to general causes in groups of patients with comorbid MD, and without them as well as interrelationship of these indicators with comorbid MD and therapy with antidepressants.

Inpatients with chronic CAD (n = 333) under conservative therapy were investigated (31% females (n = 103), 69% males (n = 230), mean age 61.8 ± 9.8 years). Team of cardiologists and psychiatrists followed up patients for 7 years (2008–2014). Survival frequency was evaluated by method of life tables.

Among patients under conservative therapy of CAD the death frequency due to general causes did not differ significantly in presence (n = 80) and absence of MD (n = 253) and was 18.8% and 16.6%, respectively. Correlation of deaths with hypomanic and mixed episodes was revealed (rs = 0.3). The groups differed according to function of immediate risks: patients with MD were at high risk of death during the year after detection of affective symptoms, and in group without MD it increased over the time of observation (Р = 0.0000).

Duration of antidepressant therapy was 5.5 ± 0.5 months. Among patients receiving antidepressants (n = 20), during therapy and after one month after discontinuation there were not deaths. Difference of function of immediate risks in these subgroups was not significant (Р = 0.09).

Patients with affective disorders and chronic CAD under conservative therapy are at high risk of death within affective episode and therapy with antidepressants did not influence change of risk of death.

The authors have not supplied their declaration of competing interest.

Psychiatric disorders are often characterised by cognitive impairment. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed for routine screening of psychiatric patients and is available in several languages.

Using the German version (SCIP-G), 3 studies were conducted: 1. feasibility, reliability, and validity of the SCIP-G were investigated [Sachs et al. Schizophr. Res. Cogn. 2021: 25, 100197], 2. a confirmatory factor analysis was performed [Sachs et al. Schizophr. Res. Cogn. 2022: 29, 100259], and 3. patients with psychotic, bipolar affective, and depressive disorders were assessed before and after standard inpatient treatment including cognitive remediation.

Study 1 included patients with schizophrenia or schizoaffective psychosis and thirty healthy controls matched for sex, age, and education. Data were collected at the Medical University of Vienna, Department of Psychiatry and Psychotherapy. In studies 2 and 3, patients from the Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria, were studied. In study 3, all patients received modern pharmacotherapy plus cognitive remediation using the COGPACK® software package version 6.06; based on the ICD-10 criteria for research, 54 patients received an F2 diagnosis (schizophrenia, schizotypal, and delusional disorders), 39 patients met criteria for bipolar disorder (F30 and F31), and 50 for depression (F32 and F33).

In Study 1, significant differences in cognitive performance were found between patients and healthy controls on both versions of the SCIP. The SCIP effectively discriminated between patients and the control group. In Study 2, a two-factor solution in which the Verbal Learning Test-Immediate Recall subtests, Delayed Recall Test of the VLT, and Working Memory Test loaded on the first factor and the Verbal Fluency Test and Psychomotor Speed Test subtests loaded on the second factor yielded good model fit (χ² = 6.7, df = 3, p = .08, χ²/df = 2.2). In Study 3, SCIP total score showed significant improvement after treatment in all three diagnostic groups (p < .001), with no statistically significant interaction between SCIP total score and diagnostic groups (p = .860).

Our data indicate that the SCIP-G is a valid and reliable instrument for assessing cognitive impairment. Good model fit can be achieved with a two-factor solution for the SCIP. Our study is the first to perform a confirmatory factor analysis with the German SCIP version and to test its dimensional structure with a hypothesis-testing approach. Inpatient treatment consisting of pharmacotherapy and cognitive remediation improved cognitive deficits. This improvement in cognitive performance was observed to a similar extent in patients with psychotic disorders, bipolar disorder, and depression.

None Declared

Even at therapeutic doses, mood stabilizers do not completely address symptoms in bipolar depression. Some guidelines recommend add-on antidepressant therapy or quetiapine.

Early effectiveness of quetiapine extended release (quetiapine XR) vs. sertraline in adults with bipolar depression; treated with lithium or valproate at clinically therapeutic blood levels (change from baseline in the MADRS global score at week 2 (LOCF) endpoint). Others (secondary objectives) were measured at week 8.

Prospective, open label, randomized study of 8 weeks follow-up (D1443L00058).

27 patients were randomized to quetiapine XR (14) or sertraline (13). Mean age was 46.07 years. 17 patients (62.96%) were male. 20 (74.07%) were diagnosed with bipolar disorder type I. Mean number of previous events were 9.74. Mean baseline MADRS score was 28.23 (SD 5.86) and 29.50 (SD 5.00) for sertraline and quetiapine XR groups, respectively (p = 0.59).

Mean change in MADRS score (2 weeks from baseline) was: -6.62 (sertraline group) and -13.14 (quetiapine XR group) (p = 0.08). Final change from baseline was: -10.62 (sertraline) and -17.14 (quetiapine XR) (p = 0.1). Patients with at least one AE and one AE leading to study withdrawal were 12 and 3, respectively (quetiapine XR group); and 9 and 2, respectively (sertraline group). the most frequent AEs were somnolence, dry mouth (35.7%, 21.4%, respectively) (quetiapine XR group), and insomnia, diarrhea, dyspepsia (14.3% for each one) (sertraline group).

Numeric differences (though not significant) in favour of quetiapine XR exist for the early effectiveness of quetiapine XR in bipolar depression. Sponsorship by AstraZeneca.

Valproic acid is an antiepileptic drug used in different fields of Psychiatry. It is known mostly for its use in managing patients with bipolar affective disorder. In psychiatry of addiction, there is still no approved indications for its usage, but it is widely prescribed in treating alcohol and cocaine abuse, due to the existence of studies in these addictions.

This review aims to clarify the relation between valproic acid and dependences, particularly cocaine.

Non-systematic literature review using a PubMed search, using the following key words: “valproate”; “cocaine use”.

Cocaine dependence can decrease GABA levels in humans. Valproic acid has multiple mechanisms that favour the synthesis of GABA, potentiating its release and postsynaptic GABAergic response. Because of this, valproic acid was found effective in promoting abstinence and in reducing the use of cocaine. There are studies that support the valproic acid’s use in alcohol and cocaine dependences. Valproic acid has been shown to be promising in relapse prevention. It has also showed efficacy in the management of impulsivity and irritability, what makes it useful in managing patients with borderline personality disorder – patients at higher risk for alcohol or substance use disorders.

Cocaine addiction involves different phenomena and may respond to distinct pharmacologic approaches. Although some studies need to be confirmed by larger clinical trials, valproic acid seems a promising agent as one of some potential treatments for cocaine dependence. Further studies are required in this field to come to more reliable conclusions.

No significant relationships.

Rare diseases are chronically debilitating, possibly impairing the quality of life both of the patient and of his parents.

To examine the quality of life and the coping strategies of the parents of children affected with rare diseases comparing 30 mothers and 25 fathers of children affected by rare diseases with 30 mothers and 26 fathers of non-rare chronic diseases. Anxiety, depression, coping strategies, satisfaction about their life are assessed.

All the subjects are interviewed and undergo an evaluation with the self-report tools Satisfaction With Life Scale, Profile of Mood States, COPE, Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. The data are analyzed using the statistical package SPSS.

Our results show that subjects having children with rare diseases experience more anxiety, but not a more severe depression, worse psychological well-being and have more difficulties to face the daily living. Comparing the mothers and the fathers of children with rare diseases, the first group show higher scores in HRSA.

So the feature of uncertainty of a rare disease in terms of aetiology, course and treatment can be associated with a more severe impact on the parents’ psychological end emotional well-being.

The prevalence of obesity has become a health problem worldwide. Amidst this epidemic, obesity among pregnant women has risen dramatically. Bariatric surgery (BS) has become an important alternative for obese women planning pregnancy and should be considered in the pre-conception management of morbidly obese women. Psychological aspects related to this field are still unknown.

To understand psychological meanings of pregnancy following BS.

Qualitative study conducted with an intentional sample of women seen in an outpatient service.

Pregnancy following BS has specific emotional characteristics. There is a greater concern derived from fantasies of causing harm to the baby. There is an evident conflict between desire of eating to feed the fetus and desire of staying thin by eating little. The surprise these women experience when they learn they are pregnant relates to the ambivalence between desire of getting pregnant and fear of losing what was gained after the surgery, as well as to the perception of deviation of the eating compulsion and the inability to postpone pregnancy for the recommended period. Weight loss following BS reduces the worry with obesity during pregnancy, opening affective space for maternity.

Pregnancy following BS imposes on women intense experiences related to fears about the baby's integrity, especially about its weight; risk of losing what was gained after surgery; and ambivalent emotions towards the fetus. Surgeons and obstetricians should be prepared to deal with the complex web of affects related to this specific clinical condition marked by intense emotional reactions.

Lockdown imposed by the Tunisian government had a psychological impact such as depression, stress and anxiety, which triggered the development of eating disorders especially binge eating disorder.

To screen the binge eating disorder among general population in Gabes (south of Tunisia) and to identify factors associated with it.

We conducted a cross-sectional, descriptive and analytical web-based survey, from April 19, 2020, to May 5, 2020 on Facebook on citizens living in south of Tunisia. During this period, the total confirmed cases of COVID-19 exceeded 900 in Tunisia. We used a self-administered anonymous questionnaire containing citizen’s sociodemographic and clinical data. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used to assess Binge-Eating Disorder.

A total of 331 persons were included. They were females (65%) and singles (43,2%). 71% of our population were aged between 20 and 40 years old. Among citizens of southern Tunisia, 6,9% suffered from binge eating disorder during this period of the lockdown. Binge eating disorders were associated to past psychiatric history (2,1% vs 4,53%, p<10-3), history of eating disorder (4,5% vs 2,4%, p<10-3), social isolation (5,1% vs 1,8%, p=0,015) and lack of physical activity (3,3% vs 3,9%, p=0,025).

Our study showed that lockdown during the COVID-19 pandemic has changed the eating behavior of citizens of southern Tunisia. It is therefore important to screen them in order to manage them before complications emerge.

According to the UN Refugee Agency, around 100 million individuals were estimated to be forcibly displaced worldwide in 2022 due to violence, war or other human rights violations. This represents a doubling in the global population of forcibly displaced individuals during the last decade. War migrants are frequently exposed to multiple traumas, including direct or indirect exposure to violence, as well as extended periods of insecurities in access to housing, clothes, food, education and health care. As a corollary, war migrants face extensive health risks, including elevated risks of psychiatric disorders with potential implications for the development of other conditions, e.g. autoimmune and cardiovascular diseases. The most recent evidence of the health risks of war migrants will be reviewed along with possible mitigating factors of such adverse sequalae.

None Declared

Depression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms. PPD occurs without concomitant change in positive or negative symptoms.

We try to evaluate efficacy of Fluvoxamine, versus efficacy of mirtazapine and venlafaxine in PPD.

25 patients (17 men, 8 female), aged 18-45 years, diagnosed with schizophrenia and PPD by DSM IV criteria. All patients received a second generation of antipsychotic (SGA) .We divided in 3 groups - A (9 patients) treated with SGA + Fluvoxamine (100 mg/day), group B (8 patients) treated with SGA + mirtazapine (30-45mg/day) and group C (8 patients) treated with SGA + venlafaxine (150- 225mg/day). We use BPRS, HAMD, and CGI for severity. Period of study 2 month, with visit at every week. We evaluate efficacy in group A versus efficacy in group B and C.

in group A: 2 drop-out, 6 responders, 1 non-responders; in group B: 1 drop- out, 6 responders, 1 non- responders, in group C: 1 drop- out, 7 responders. The response was faster in group C. The treatment was well tolerated.

The results were similar in all groups, but the most responders were found in patients with family support, in first 3 years of evolution of schizophrenia, with family history of affective disorders, absence of negative symptoms. The response was better at patients who don't have traumatic stress in there children or adolescent period.

Maternal psychological stress during pregnancy has been associated with the risk for mood disorders in offspring, although there is no consensus about the influence of the timing of the stress on outcomes. We examined the relationship of prenatal stress at specific times in pregnancy to the incidence of mood disorders in offspring using data from a large birth cohort.

We linked data on 90,079 offspring born in Jerusalem in 1964–76 to Israel's psychiatric registry. We used proportional hazards models to evaluate the link between discharge diagnoses and gestational age during the Arab-Israeli war of June, 1967.

Those in their first trimester of fetal development during the war were significantly more likely to be admitted to hospitals for any mood disorders (RR = 3.01, 1.68–5.39, p = .0002), and the subgroups of bipolar disorder (2.44; 1.0–5.99; p = .054) and “other” mood disorders (3.61; 1.68–7.80; p = .001). Mood disorders were substantially increased in offspring whose mothers had been in the third month of pregnancy in June, 1967 (5.54, 2.73–11.24, p < .0001).

These findings suggest that acute maternal stress in early pregnancy may contribute to the etiology of mood disorders in offspring. They point to the third month of fetal development as a moment of special vulnerability.