Cognitive deficit is a significant problem in schizophrenic patients. It cannot be attenuated by any antipsychotic drugs. It has been known that changes of neuronal density is correlated with learning and memory deficits. Bacopa monnieri (Brahmi), popularly known as a cognitive enhancer, might be a novel therapeutic agent for cognitive deficit in schizophrenia by changing cerebral neuronal density.

To determine the effects of Brahmi on attenuation at cognitive deficit and on the neuronal density in the prefrontal cortex, striatum and cornu ammonis subfield 1 (CA1) and 2/3 (CA2/3) of hippocampus in sub-chronic phencyclidine (PCP) rat model of schizophrenia.

Rats were assigned to three groups; Group-1: Control, Group-2: PCP administration and Group-3: PCP + Brahmi. Rats were tested for cognitive ability by using novel object recognition test. Neuronal density from a serial Nissl stain sections of the prefrontal cortex, striatum and CA1-3 of all rats were measured by using Image ProPlus software and manual counting.

Sub-chronic PCP administration resulted in cognitive deficits in novel object recognition task. This occurred alongside significantly increased neuronal density in CA1. The cognitive deficit was recovery to normal in PCP + Brahmi group and this occurred alongside significantly decreased neuronal density in CA1.

Brahmi can be a potential cognitive enhancer against Schizophrenia. It reduces density of neuron in CA1. The reduced neuron is possibly glutamatergic neuron, which results in neuronal toxicity and cognitive deficit. Therefore, Brahmi eliminates glutamatergic excitotoxicity in CA1 and cognitive function is then recovery.

Patients suffering from severe somatic illness (e.g. burns, traumatic injuries, myocardial infarction, major surgery, acute respiratory distress, septic shock) that leads to ICU treatment face a high risk of psychiatric morbidity. There is a major challenge to C-/L-psychiatry both during acute treatment and long-term. The presentation will focus on the PTSD risk in survivors of acute respiratory distress syndrome (ARDS) and septic shock.

A literature survey on the general topic will be given in the introductory part of the presentation (1). Some major findings derived from own empirical studies on ARDS and septic shock will be summarized (2, 3).

ARDS and septic shock define medical conditions of acute respiratory insufficiency or/and systemic inflammation. Both medical conditions are often associated with multiorgan dysfunctions. As a rule, intensive care is based on mechanical ventilation often requiring high doses of sedatives and narcotics. Despite major progresses in intensive care medicine the rate of mortality is still very high among these patients. Several disabling psychological sequelae, such as cognitive dysfunctions, anxiety and mood disorders, posttraumatic stress disorders (PTSD) have to be evaluated in long-term survivors regarding a persisting negative impact on health-related quality of life. Several factors influencing the risk of PTSD in ARDS survivors may be discussed: increased CO2 triggering panic affects, mismatch of norepinephric overstimulation and Cortisol insufficiency, negative effects of high doses of benzodiazepines resulting in oversedation, prolonged phases of weaning and more frequent states of delirium, number of traumatic memories during ICU. Consolidation and retrieval of traumatic memories of the ICU stay are influenced by complex factors. From a clinical point of view prophylactic stress doses of hydrocortisone may reduce the major risk of PTSD associated with ARDS and septic shock.

ARDS or septic shock not only define a major challenge to C-/L-psychiatry but offer an interesting model to elucidate some basic neurobiological mechanisms underlying the pathophysiology of PTSD and to develop some new prophylactic strategies for this often chronically disabling psychiatric condition.

Brain-derived neurotrophic factor (BDNF) plays an important role in depression and sleep disorders. It influences the inflammatory process and may affect the interactions between psychological state and gastrointestinal symptoms.

The study aimed to compare BDNF concentrations in the group of Crohn’s disease (CD), ulcerative colitis (UC) patients, and healthy control (HC), as well as to correlate it with the severity of depression and insomnia.

The study included 94 inflammatory bowel disease patients (IBD, 57 CD, and 37 UC) and 26 HC. Each participant completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Beck Depression Inventory (BDI). BDNF protein concertation measurements were performed using ELISA. Funding: National Science Centre, Poland-2018/31/N/NZ5/03715.

CD patients had a higher serum level of BDNF (22.5 ng/mL, IQR:17.5-28.5) than UC patients (19.1 ng/mL, IQR:12.3-24.6; p=0.045). CD group had higher BDNF concentrations than HC (17.5 ng/mL, IQR:13.2-23.8; p=0.010), but no such differences were found between UC and HC groups (p=0.544). A positive correlation was found between AIS and BDNF among IBD (r=0.22, p=0.035). Additionally, patients, who obtained high BDI scores (>7 points) had lower BDNF concentrations than others (p=0.004). The patients with long sleep latency (>10 min) achieved a higher BDNF level than others (p=0.038). However. BDNF level did not correlate with PSQI results.

BDNF serum level is increased in CD, but not in UC patients. Overall, the severity of insomnia symptoms correlates positively with BDNF levels. Future research should focus on the further explanation of those observations.

In Correctional Institutions of Kosovo (CIK), the rate of suicide and attempted suicide is low (in the last six years have been six suicide).

Disturbing is the fact that during the period October 2007 to January 2009 at the Lipjan Detention Center (LDC) have been nine suicide and three attempted suicide, while in all other correctional institutions has not happened any suicide and only one attempted suicide. This level is to high when we consider the fact that the capacity of LDC is approximately 200 prisoners, while in all other correctional institutions have about 1500 prisoners.

The objective is to find reasons for such a high level of suicide and attempted suicide in LDC.

The aim is to return the low level of suicidal behavior in LDC.

Mapping:

1. 1. Survey documentation

2. 2. Interviews

3. 3. Focus groups

1. 1. Lack of detection of cases at risk for suicide during admission.

2. 2. Inadequate administrative and health management.

3. 3. Insufficient communication between staff and prisoners

Better management in early detection of cases Creation of a multidisciplinary team for management of cases referred as risky for suicide

The problem of job satisfaction connected with work efficiency and psychological well-being of professionals is especially actual in stress conditions due to COVID-19 pandemic. The stress has a negative effect on job satisfaction (Singh et al., 2019). The one of the most important criteria for successful activities is a job satisfaction (Burić & Moè, 2020). The highest level of job satisfaction can be achieved by the high adaptive potential of professionals, who have a diverse arsenal of self-regulation resources and apply them adequately to working conditions (Kuznetsova et al., 2019).

The study was held in 45 professionals from different fields, who work remotely during the self-isolation due to COVID-19 pandemic and aimed to estimate the correlation between job satisfaction and self-regulation resources of professionals under work stress.

The assessment methods included: 1) test “Job Satisfaction” by V.A. Rozanova 2) S. Hobfoll’s “SACS” 3) Ch. Spilberger’s “Trait Anxiety”.

The results revealed an average level of anxiety with a tendency to growth. Avoidance, asocial and aggressive behaviour are frequently used. The direct correlation between the level of job satisfaction and such a resource of self-regulation as a search for social contact was revealed (r=0.291; p=0.049). The general level of anxiety is directly related to avoidance (r=0. 374; p=0.011), manipulative (r=0.343; p=0.021) and aggressive actions (r=0.343; p=0.021), and negatively correlates with assertive actions (r=-0.703; p=0).

The results of the study can be used to develop programs to improve the psychological well-being and performance of employees working under stress due to COVID-19 pandemic.

To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.

A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.

A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.

Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

Recent research has shown that adiponectin levels in patients with schizophrenia vary similar to the general population. Moreover, antipsychotic medication may influence adiponectin levels, independent of metabolic parameters. We hypothesise different antipsychotics might vary in their effect on adiponectin levels independent of BMI and metabolic syndrome (MetS) status.

113 patients, with similar baseline demographic and metabolic characteristics, received either risperidone (n=54) or olanzapine (n=59). They were followed prospectively for 12 weeks. Adiponectin levels as well as general metabolic parameters were measured at baseline, 6 weeks and 12 weeks.

We observed a significant treatment by time interaction, showing an adiponectin increase in the risperidone treated patients and an adiponectin decrease in olanzapine treated patients. This effect was independent of BMI and the presence/absence of the metabolic syndrome. There was a significant association between fall in adiponectin and increase in waist circumference in the Olanzapine treated group (Figure 1).There was no change in HOMA-IR as a measure of insulin resistance in either group.

We observed a differential effect of antipsychotic treatment (risperidone vs olanzapine) on adiponectin levels over time, independent of BMI (and MetS) suggesting an effect of olanzapine on adipose tissues, similar to what has been observed in animals models. The effects on adiponectin levels may partly explain the increased rates of obesity with Olanzapine.

The purpose of this study is to examine the factors which influence schizophrenia patients’ levels of insight and functional remission.

In this study, 70 outpatients between the ages of 18–65 who applied to the Karadeniz Technical University Psychiatry Clinic and were diagnosed with schizophrenia according to DSM-IV were evaluated. Patients who have disease which affects the central nervous system, whose CGI disease severity score is above four, who were taken as inpatients to the hospital in the last two months were excluded from the study. The patients were evaluated by using socio-demographic data collection form, clinical interview structured for DSM (SCID-I), the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), the Functional Remission of General Schizophrenia Scale (FROGS), Schedule for Assessing the Three Components of Insight (SAI-E) and cognitive test battery.

Patients SAI-E levels were found to be correlated with the PANSS, Stroop Test (ST), Controlled Word Association Test (FAS) and Trail Making Test (TMT) A-B scores. In the regression analysis, FAS scores were the predictor of SAI-E total scores .The FROGS functional levels of patients were found to be related with occupational status, gender, age of onset illness, comorbid psychiatric illness, PANSS, CDS, SAI-E, FAS, TMT, ST and Wisconsin Card Sorting Test scores. In the regression analysis, occupational status, comorbid obsessive compulsive disorder, PANNS negative and general psychopathology and FAS scores were the predictors of patients’ functional status.

The effect of cognitive functioning and insight on the patients’ level of functionality is prominent.

Alcohol use disorders have been associated with an increased risk of frequent readmissions. This study aimed to examine factors that contribute to the risk for readmission within one year after discharge from an alcohol rehabilitation program.

Rehospitalization status was assessed for all patients with an alcohol use disorder as primary diagnosis (n = 468) admitted to our inpatient unit between July 1, 2012, and June 30, 2014. All patients were followed up for one year after their first hospitalization (index hospitalization) within this period. Time to readmission within one year after discharge was measured using the Kaplan–Meier method. Risk factors for readmission were examined using Cox proportional hazard regression models. Three set of variables were selected to be included in the analyses:

– demographic features at time of admission of index hospitalization;

– comorbid conditions at time of admission of index hospitalization;

– treatment-related variables in relation to the index hospitalization including observer-rated outcome measures.

Readmissions within one year after discharge from an alcohol rehabilitation program as well as the corresponding time to readmission were linked to higher numbers of previous hospitalizations and the presence of comorbid opioid use disorders.

Higher numbers of past treatments for AUD are indicators for a chronic course of the disorder, which, in turn, increase the risk of further relapses. Our findings further confirmed previous findings suggesting high rates of comorbidity among alcohol and opioid use disorders, and their link with poorer clinical outcomes.

The authors have not supplied their declaration of competing interest.

The postpartum depression screening scale (PDSS; Beck & Gable, 2002) is a widely used measure to assess women's depressive symptoms after their children's birth. Pereira et al. adapted, validated and developed a short-version of PDSS for Portuguese women (PDSS-21).

To examine the factor structure of the PDSS–21, using confirmatory factor analysis (CFA) in a sample of Portuguese women in the postpartum period.

The sample was composed of 208 women (mean age = 32.72; SD = 4.49) who completed the PDSS–21 approximately at the 6th week postpartum. CFA was used to test the model suggested by prior exploratory factor analyses of PDSS–21. AMOS software was used.

After two items were deleted and some errors were correlated, CFA indicated a good fit for the second-order factor (χ2/df = 1.793; CFI = 0.957; GFI = 0.889, rmsea = 0.062; P [rmsea ≤ 0.05] < 0.056). The 19–item PDSS showed excellent internal consistency (α = 0.92) and the four dimensions presented Cronbach's alphas ranging between good (α = 0.83) and excellent (α = 0.93).

These findings suggest that the 19–item PDSS obtained through CFA is a reliable and valid measure to assess depressive symptoms among women in the postpartum period.

The authors have not supplied their declaration of competing interest.

Recent findings demonstrated significant overlaps among major psychiatric disorders on multiple neurocognitive domains. However, it is not clear which are the cognitive functions that contribute to this phenomenon.

To find the optimal clustering solution using the two-step cluster analysis on a sample of psychiatric patients.

To classify into subgroups a cross-diagnostic sample of psychiatric inpatients on the basis of their neurocognitive profiles.

Seventy-one patients with psychotic, bipolar, depressive and personality disorders hospitalised at Psychiatric Diagnosis and Care Service of Bufalini Hospital of Cesena participated in the study. The symptomatology was assessed using Health of the Nation Outcome Scales-Roma and Brief Psychiatric Rating Scale. Cognitive functions were evaluated using Tower of London, Modified Wisconsin Card Sorting Test, Judgment and Verbal Abstract Tasks test, Raven matrices, Attentional Matrices, Stroop Test and Mini Mental State Examination. Two-step cluster analysis was conducted using the standardized scores of each neurocognitive test.

Two groups were obtained:– group 1, with good cognitive performances;– group 2, with almost all subjects having impaired cognitive performances.

Executive functions and attention are the major determinants of the cluster solution. The clusters did not differ on socio-demographic correlates. Different diagnoses were equally distributed amongst the clusters.

Two-step cluster analysis was useful in identifying subgroups of psychiatric inpatients with different cognitive functioning, overcoming other cluster techniques limitations. According to former literature, these results confirm a continuum of severity in cognitive impairment across different psychiatric disorders.

The authors have not supplied their declaration of competing interest.

This article compares in a systematic way the team's intervention choices of professionals across seven European countries: France, Ireland, Italy, the Netherlands, Portugal and Spain towards problems and needs of patients with schizophrenia and relates this to the diversity of psychiatric systems.

The clinical and social status of 433 patients was assessed by means of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Needs for Care Assessment instrument (NFCAS) which was used to determine teams' intervention choices toward the NFCAS problems.

There is no, or little, consensus across Europe on teams' intervention choices towards either the clinical or the social problems and needs of patients suffering from schizophrenic disorders. These comparisons outlined the cultural differences concerning the interventions that were proposed and should be taken into account when interpreting the number of needs and the need status since the need status relies heavily on the interventions proposed. The differences were not connected with the availability of resources; most of the comparisons show differences between centers as well as differences between groups of relatively similar resource countries.

There is an evidence indicating that women experiencing intimate partner violence (IPV) quite common suffer from anxiety and depression, but predictors and protective factors are not well known in this group of patients.

The aim of the study was to try to find factor that are connected with higher rates of anxiety and depressive symptoms in the group of female patients experiencing IPV.

The study was conducted in six randomly selected centers of primary health care (PHCs) in Lublin province. One hundred and two female patients experiencing IPV were administered a structured questionnaire and the Hospital Anxiety and Depression Scale (HADS). The sequential models were created with using backward stepwise multiple regression to investigate potential risk and protective factors connected with higher rates of anxiety and depression symptom in the group.

In a study group, 68% in Anxiety Subscale(A) and 56% in Depression Subscale of HADS (D) had positive scores. Living in the country (P = 0.003) was connected with higher scores in HADS-A (P = 0.003) but not in HADS-D. Experiencing physical violence was connected with higher score in HADS-D (P = 0.005), but not in HADS-A. Chronic physical illness (A P = 0.013; D P = 0.015), being unemployed (A P = 0.024; B P = 0.008), and experiencing economic violence (A P < 0.001; D P = 0.001) were connected with higher stores in both Subscales of HADS. Taking financial support (A P = 0.002, D P = 0.003) was the protective factor for both kinds of symptoms.

Socio-economic factors have stronger influence on anxiety and depressive symptoms in women experiencing IPV than demographic factors.

The authors have not supplied their declaration of competing interest.

Several cases of transient acute depression or manic symptoms are reported in the literature after bilateral subthalamic nucleus (STN) deep brain stimulation in patients with Parkinson's disease. Different hypothesis involve premorbid personality disorders, thymic past history or subthalamic nucleus.

We elaborate a one year prospective study to evaluate mood disorders frequency and physiological mechanisms of 20 Parkinsonian patients treated by bilateral STN stimulation. Evaluation consists of pre and post-operative psychiatric interview and scales assessing depression and mania.

At the present time, 18 patients have been operated, 17 have finished the program. Meaning age of patients: 63,1 years ± 7,3, with 5 women. No significant differences between men and women age, and duration of Parkinson disease (11,9 ± 4,4), were found (n=18).

One month before surgery, MADRS, Bech and Beck means (n=18) are respectively: 7,2 ± 4,2; 1,3 ± 1,6; 6,4 ± 3,5. At 3 months after surgery means (n=18) are: 3,9 ± 3,8; 1,1 ± 1,6; 3,1± 2,6. At 6months after surgery means (n=17) are: 6,7 ± 4,8 ;0,65 ± 1,1 ; 3,80 ± 2,6.

One patient, 70 years old, has presented a hypomanic-like episode post-operatively ; one other patient, 68 years old, presented a major anxio-depressive episode one month post-operatively (DSM-IV criteria). One patient, 53 years old, presented a moderated anxio-depressive episode, 6 months after surgery.

Data are still on analysed, but these cases draw our attention to the effects of STN stimulation on mood and behavioural disorders.