Most research on COVID-19 effects has focused on the general population. Here we measure its impact on Dutch FACT and autism outpatient service users during both waves.

This study aimed to: 1) investigate participants’ mental health, 2) assess experiences with outpatient services, and 3) assess respondents’ experiences with governmental measures in the Netherlands during the first and second wave of COVID-19.

Respondents (wave 1: n=100; wave 2: n=150) reported on mental health, experiences with outpatient care, government measures and information services in an online survey.

Findings demonstrate happiness was rated an average of 6 out of 10, 70% of respondents scored below average on resilience, positive consequences for mental health (ordered world, reflection time) during both waves were similar, and prominent negative consequences included decreased social interactions and increased or new problems regarding mental health and daily functioning from wave 1-2. Lifestyle changed in 50% in both waves, although only slightly attributed to the pandemic. Substance use during both waves hardly changed. Mental healthcare continuation was highly appreciated in both waves (75-80% scored ≥7 on 10-point scale). (Video)calling was the most frequently mentioned positive care experience; missing face-to-face contact with care providers considered most negative. COVID-19 measures were less doable in the second wave. Vaccination willingness approximated 70%.

Results show a nuanced, but clear picture of experiences during both waves. Continuation of services through tele-health was well-received. Monitoring of long-term impact is needed.

No significant relationships.

People with schizophrenia could be more substantially influenced by the emotional stress brought on by the COVID-19 pandemic, resulting in relapses or worsening of an already existing mental health condition because of the high susceptibility to stress.

This study aimed to assess the presence of relapse and its risk factors among patients with schizophrenia during the era of COVID 19 pandemic.

This study included 90 adults who met DSM-5 criteria for schizophrenia and were diagnosed by (SCID-I) Arabic version and who are following up at the outpatient psychiatric clinic, Zagazig University Hospital, Egypt, Positive and Negative Syndrome Scale (PANSS) measuring severity of symptoms, Compliance Rating Scale (CRS) and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). scales were conducted on those patients before COVID-19 pandemic from January to April 2019 and repeated on September to November 2020 during COVID 19 pandemic to compare clinical parameters between those two periods as to detect any deterioration in their clinical state.

The mean score of compliance rating scale (CRS) was decreased after COVID-19 pandemic compared to before COVID 19 (P<0.001).The mean score of PANSS scale positive subscale (P) had increased after COVID-19 pandemic compared to before COVID 19 (P<0.001).

There was a deterioration of the clinical state of schizophrenic patients during COVID-19 pandemic especially the positive symptoms and following up the news about COVID-19 regularly, decreased level of family support, lower level of compliance with treatment, and having a family member with COVID-19 infection or death were the risk factors for relapse.

No significant relationships.

Vaccine hesitancy has been an ongoing complex public issue in the Philippines posing threats to progress against preventable outbreaks and significant morbidity and mortality from COVID-19. Patients with cancer were not included in the initial vaccine trials against COVID-19 hence the plausible explanation behind vaccine hesitancy in this population. This study attempts to determine the factors affecting a patient diagnosed with breast cancer to receive COVID-19 vaccine based on constructs from the Health Beliefs Model (HBM).

To determine the factors affecting a Filipino diagnosed with breast cancer to receive COVID-19 vaccine, namely; perceived susceptibility and severity to COVID-19 and perceived benefits and barriers to getting a vaccination against COVID-19.

A single- center, descriptive, cross-sectional study in patients diagnosed with breast cancer was conducted to assess COVID-19 vaccine hesitancy.

A total of 85 eligible breast cancer patients were included in the analyses. Age, socio-economic factors, and presence of co-morbidities and metastasis were not significantly associated with COVID-19 vaccine hesitancy. Concerns on efficacy, safety, faulty or fake vaccine, as well as if the vaccine was taken by many in the public were significantly associated with hesitancy (p <0.05) when taken as individual factors. The perception of COVID-19 vaccine safety under the perceived barriers construct was found to be the only significant factor to predict vaccine hesitancy (OR= 4.737, CI 1.75, 12.82).

Interventions that focus on perceived barriers are most crucial in order to increase vaccination rate among breast cancer patients.

No significant relationships.

During a public health crisis, preventive measures are essential. However, to make them effective, all citizens must be engaged.

To analyse the differential role of individual and contextual variables in the adherence to public health recommendations.

1376 adults (70.5% female; mean age=35.55±14.27) completed a survey between September/2020 and May/2021 with: Adherence Scale to the Recommendations during COVID-19 (ASR-COVID19; evaluates three dimensions of adherence), Fear of Covid-19 Scale (FC19S) and Toronto and Coimbra Prosocial Behaviour Questionnaire (ProBeQ; assesses empathy and altruism).

Adherence did not differ between individuals with or without personal or family history of COVID-19 infection. ASR-COVID19 and all dimensions were positively correlated to ProBeQ’s altruism and empathy (from r=.32 to r=.54); FCV19S correlated positively to total adherence score and house sanitation (from r=.18 to r=.26; all p<.01). Linear regressions revealed that altruism and empathy (first model), as well as fear of Covid-19 (second model), were significant predictors of adherence; however, while the first model explained ≅28% of its variance, the second (FCV19S as independent variable) only explained ≅3%. Regression models performed in a subsample of participants with personal or family history of COVID-19 revealed that only empathy, but not altruism, was a significant predictor of adherence; in this subsample, fear was no longer a significant predictor of adherence, except for lockdown and use of teleservices.

Based on our results, we suggest health care providers and public health campaigns should take into consideration social solidarity and altruism, as well as previous experiences, when appealing to public’s engagement in health behaviour.

No significant relationships.

A higher risk of mental health consequences in critical COVID-19 patients is expected due to several reasons, including prolonged mechanical ventilation with exposure to high sedation. In this context, post-discharge depression has been reported in previous COVID-19 studies, with a profound impact on patients’ health-related quality of life (HRQoL).

To identify depressive symptoms in COVID-19 survivors 1-year after hospital discharge and to analyse its association with HRQoL.

As part of the longitudinal MAPA project, this study enrolled critical COVID-19 patients admitted in the Intensive Care Medicine Department of a University Hospital (March-May 2020). Participants were assessed through telephone by an intensive care nurse and a psychologist, with the Patient Health Questionnaire (PHQ-9) (depressive symptoms), EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and EQ-Visual Analogue Scale (EQ-VAS) (global health status patient record).

A sample of 55 survivors (median age=66 years; 69% males) were included, with 20% showing depressive symptoms. Pain/discomfort (67%) and anxiety/depression (67%) were the most EQ-5D-5L domains reported. Survivors scoring for depression had more problems in all HRQoL areas (mobility:91%vs.48%, p=0.015; self-care:64%vs.27%, p=0.035; usual activities:91%vs.50%, p=0.017; pain/discomfort:100%vs.59%, p=0.010; anxiety/depression:100%vs.59%, p=0.010). Moreover, they had a lower EQ-VAS median, corresponding a worse self-perception of health status (50vs.80, p=0.010).

Even after 1-year, a significant proportion of survivors presented depressive symptoms with repercussions in all HRQoL dimensions and association with worse self-perception of global quality of life. Taking this in mind, early screening and treatment of depression in COVID-19 survivors will be crucial, minimizing its impact on quality of life.

No significant relationships.

Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL).

To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL.

In the context of the longitudinal MAPA project, we included adult patients (≥ 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay ≤24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients’ clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge.

Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%; p=0.011) and considerably anxiety/depression (83%vs60%; p=0.032).

These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium long-term impacts.

No significant relationships.

Since the onset of the pandemic, nurses have been repeatedly exposed to their patients’ COVID-19-related traumatic experiences. Therefore, they are at high risk for Secondary Traumatic Stress (STS), the stress syndrome resulting from helping others who are suffering. Positive psychological outcomes following this vicarious exposure are also likely. Vicarious posttraumatic growth (VPTG) refers to the positive changes from working with patients who themselves have coped with traumatic experiences.

This study aims to examine STS and VPTG among 429 nurses during three lockdowns of the COVID-19 pandemic in Greece.

A repeated cross-sectional survey with a convenience and snowball sampling procedure was conducted. The Secondary Traumatic Stress Scale (STSS), the Post-Traumatic Growth Inventory (PTGI), the Brief Resilience Scale, and the Brief Cope (BC) were used to measure STS, VPTG, resilience, and coping strategies, respectively.

Nurses in Greece demonstrated high levels of STS at the first lockdown, significantly lower in the second one, which raised again -but not significantly- in the third lockdown. Resilience significantly decreased, whereas VPTG significantly increased across the three lockdowns. Following the escalation of the pandemic nurses in general used significantly more adaptive and less maladaptive coping strategies to deal with the crisis.

Further research is needed to clarify the longitudinal course of the negative and positive psychological effects of the pandemic on healthcare staff. Conclusions can guide the development of interventions to safeguard nurses from the deleterious impacts of the COVID-19 and support them in their process of growth.

No significant relationships.

A primary disruption of the bodily self is considered a core feature of schizophrenia patients (SCZ). The “disembodied” self would be underpinned by an inefficient body-related multisensory integration mechanism occurring in the Peripersonal Space (PPS). PPS is a plastic sector of space surrounding our body, whose extent is altered in SCZ. Although PPS represents a malleable interface marking the perceptual border between self and others, no study has investigated the potential alteration of its plasticity in SCZ.

We investigated the PPS extension and its plasticity in SCZ and their potential correlations with the clinical scales.

Thirty SCZ and thirty healthy controls (HC) underwent a multisensory task to estimate PPS boundary before and after a motor training. Patients were also administered the Positive And Negative Syndrome Scale (PANSS) and the Examination of Anomalous Self-Experience (EASE).

Data confirm a narrower PPS extent in SCZ than in HC, whereas no differences in PPS expansion was found in the two groups after the motor training (Figure 1). Positive symptoms were associated directly with PPS extent and inversely with PPS plasticity. No associations were found between PPS and EASE domains. Figure1: Graphical representation of PPS expansion in SCZ and HC. Both panels show individual normalized sigmoid fits

The present study suggests a narrower PPS extent and a preserved PPS plasticity in SCZ with respect to HC. Both PPS extent and plasticity are related to the severity of positive symptoms. These results highlight the potential role of rehabilitation interventions in order to improve patients’ weakened body boundary.

No significant relationships.

There are life events that may increase the possibilities of suffering some kind of Psychopathology. The most validated model for understanding the aetiology of psychosis is based on genetic and environmental risk factors and their interaction, likely involving epigenetic mechanisms. It is necessary to consider those events as risk factors for Mental Health.

Study of risk and prognostic factors in psychosis.

Review of scientific literature based on a relevant clinical case.

We present the case of a 28-year-old male patient from Peru, currently living in Germany. History of sexual abuse in childhood. He started taking drugs at the age of 8. In the emergency department, he reports that since the beginning of the pandemic, after listening to a speech by the Pope, he begins to interpret signals about situations occurring around him. He begins to read about mystical-religious subjects, changes the style of music he listens to and recognises changes in his personality. He says for months he has been feeling watched, persecuted and expresed someone wants to kill him. He says hears voices and that they communicate with him through bodily sensations.

Childhood trauma, immigration and cannabis use are significantly associated with an increased risk of functional psychosis. A neurotic personality also independently contributes to this risk. The accumulation of these factors increases vulnerability to mental disorders and leads to a worse prognosis and evolution of these pathologies. These findings could help to improve the prevention of psychosis and the development of specific treatment strategies in this particular population.

No significant relationships.

People presenting first-episode psychosis (FEP) benefit from early intervention programmes, although they are scarce in low- and middle-income countries (LMICs). In Brazil, there are just a few of them unequally distributed across the country.

We aimed to describe the workings of the Ribeirão Preto Early Intervention for Psychosis Programme (Ribeirão Preto-EIP) – an outpatient service for first-episode psychosis patients residents in the Ribeirão Preto catchment area in Southeastern Brazil.

A retrospective cohort of all patients attended throughout four years (2015-2018) was analysed. We excluded patients who attended only the first consultation and those with an initial diagnosis other than a psychotic disorder. Data was obtained through retrospective analysis of medical records.

Our service had 358 new referrals during the four-year period, and 237 patients were followed on average (median) by 14 months. Most of the patients were male (64.1%), single (84.8%), with a median age of 23.5 years (age ranged from 9 to 86 years). Schizophrenia was the main diagnosis (43.4%), followed by substance-induced (25.7%) and affective psychosis (18.6%). Taking follow-up diagnoses as gold-standard, initial diagnoses of bipolar disorder and schizophrenia spectrum disorders had the highest positive predictive values, 83% and 81% respectively. Most referrals to our programme were made by tertiary care (63.7%), followed by secondary (28.5%) and primary care (7.8%).

Here we presented a large sample of FEP patients in a representation as trustworthy to the reality of our programme as possible. Our analysis suggest that Early Intervention Programmes can be successfully implemented in LMICs.

No significant relationships.

The world literature presents ambiguous results regarding the conjugation of negative and depressive syndromes, due to an incomplete understanding of the main symptoms of depression in schizophrenia.

To analyze the variants of the conjugation of depressive and negative symptoms at different stages of schizophrenia.

We used the data of our own observations (238 patients with a diagnosis of schizophrenia and no more than 5 years of experience of the disease) and compared them with the previously published results of studies. As a hypothesis, we analyze the variants of the conjugacy of affect and the negative domain within the framework of a single discrete field of schizophrenia.

The analysis shows that with the apparent heterogeneity of the psychopathological structure, some depressive features, such as apathy, anhedonia and social autism (characteristic of negative symptoms), tend to the abulia factor, whereas low mood, suicidal thoughts, pessimism, show affinity for the cluster of impoverishment of expression, that is, they represent an attenuated type of negative symptoms tending to the affective spectrum.

The conjugacy of depressive and negative disorders in schizophrenia, taking into account their phenomenological similarity, allows us to formulate a hypothesis about their existence within the framework of a single continuum model. The proposed continuum model can be used to understand the processes underlying pathogenesis and formulate the principles of personalized treatment and can be used as a starting point for research on the underlying biological processes and personalized treatment.

No significant relationships.

As a part of Horizon 2020 program, RECOVER-E project activities were initiated in Montenegro in 2018. The initial step involved a thorough situation analysis of the setting and circumstances of treatment of users with severe mental health illnesses, followed by the establishment of the community mental health team (CMHT) within the Special Psychiatric Hospital Kotor. The CMHT became responsible for the treatment of a group of clients with severe mental health illnesses, based on the principles of „Flexible Assertive Community Treatment (FACT – A Dutch model).

The main objective of this research was to establish whether there were substantial differences regarding the hospital readmissions in the group of patients treated by the CMHT, compared to usual mental health care in Montenegro.

Within the RECOVER-E project, a sample of 202 patients, users of mental health services, were recruited in Montenegro. Patients were randomized into two similar-sized groups - intervention group, whose treatment was managed by the multidisciplinary CMHT, and control group where treatment as usual was continued. To estimate and follow-up the frequency of hospital readmissions, medical documentation was used.

Patients in the intervention group had less hospital days during the 18 months follow-up period. However, the differences between two groups regarding number of readmissions, and total length of hospital days were not statistically significant measured by independent T test.

This study showed that CMHT care could reduce the total length of hospital days during the treatment of psychotic disorders even dough during the COVID 19 pandemic and lock down measures

No significant relationships.

Alteration of GABergic neurotransmission is accused to be sharing in the cognitive impairment in schizophrenia. Exploring the relation between the neuronal expression of GABergic genes and cognitive impairment in living patients through modeling of schizophrenia is an important step to know more about the core of the pathophysiology of this disorder

Altered genetic expression of GAD 67 may have an important role in the pathophysiology of cognitive impairment in schizophrenia

. Reprogramming of human fibroblasts into human induced pluripotent stem cells (hIPSc) then neuronal differentiation was performed in 20 patients presenting with schizophrenia and 20 matched controls. Real time Polymerase chain reaction was done for measurement of genetic expression of GAD 65, GAD 67 and GABA beta 2. The Digit Symbol task, block design, block design task and similarities tasks from the Wechsler Adult Intelligence Scale., Trail A and Trail B making tests in addition to Rey-Osterrieth Complex Figure Test (ROCF) were applied to measure cognitive functions .

There were lower means of GAD65, GAD67 and GABA beta2genetic expression in the patients group with significant statistical difference between the 2 groups. The down regulation of GAD 67 in patients presenting with schizophrenia is positively correlated with impairment in executive functions.

GAD 67 gene expression had the most significant correlations with the cognitive assessment in both patients and controls. The presence of those statistically significant correlations in both groups points to the possible role of GAD 67 gene functioning in the pathophysiology of cognitive impairment in schizophrenia

No significant relationships.

Analysis of the first-episode psychosis remission, including post-psychotic affective and primary negative symptoms as well as personality changes, is necessary to personalize therapy and rehabilitation.

We aimed to identify different trajectories of psychosis remission in young adults.

First-episode psychosis patients (n=56, mean age 19.8±2.5 years, all males) underwent psychopathological assessment at the stage of remission.

Three trajectories of remission were identified. The thymopathic trajectory (33.93%, 19 patients) was characterized by the gradual increase of subclinical affective symptoms and resulted with a high-quality remission. In 63.61% cases in this group persistent depressed mood was present after a psychotic episode. Some patients (36.84%) became prone to depressive reactions. The pathocharacterological trajectory (39.28%, 22 patients) was characterised by personality changes with increase of existing traits or the development of traits previously not present. Types with an increase of schizoid (14.29%), histrionic (19.64%), and anxiety-hypochondriacal (5.36%) traits were identified. Patients in this group had high- as well as low-quality remission. The destructive trajectory (26.79%, 15 patients) was characterised by residual positive or single negative symptoms. Patients in this subgroup had low-quality remission with poor functioning and signs of treatment resistance.

Analysis of trajectories of the first-episode psychosis remission allowed us to choose the most effective strategy for personalized supportive treatment.

No significant relationships.

Direct gaze is the most important mediator of social interaction and communication. Existing studies have evaluated eye movements of patients with schizophrenia by presenting stimuli using photographs or pre-recorded videos, but few directly investigated gaze avoidance in real-world situations.

To investigate the correlation between gaze avoidance and psychopathology in patients with schizophrenia through eye movement measurements in real-life interpersonal situations.

We enrolled 52 clinically stable patients with schizophrenia. Psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. After presenting a visual stimulus, eye movements were measured with Tobii Pro Wearable Glasses 2, and deep learning-based emotional recognition using the residual masking network was used for neutral stimulus verification. Statistical analyses were performed using Pearson’s correlation and regression analyses.

Data of 45 participants with verified stimulus neutrality by deep learning image recognition were used for analysis. The first dwelling time was negatively correlated with the PANSS positive syndrome subscale (p=0.028), general psychopathology subscale (p=0.008), total score (p=0.008), 5-factor positive symptoms (p=0.035), and 5-factor depression/anxiety symptoms (p=0.008). The baseline-area of interest (AOI) pupil diameter change was positively correlated with PANSS 5-factor positive symptom scores (p=0.039). After adjusting for additional variables, the same items had a significant effect on the first dwelling time and baseline-AOI pupil diameter change.

Psychopathology, particularly positive symptoms, was associated with gaze avoidance and pupil diameter in patients with schizophrenia. Evaluating the characteristics of eye movements in patients with schizophrenia will enable better understanding of their symptoms.

No significant relationships.

An impairment of anticipation processes is considered as a common deficiency in schizophrenia (Kveraga et al., 2007), however its neural mechanisms remain poorly understood.

The aim of the study was to analyze CNV-like slow negative waves during the pre-target stimuli waiting period in patients with the first episode of the disease.

32-channels EEGs during “Go / No go delay” saccadic paradigm have been recorded in 16 young male patients with illness duration less than 2 years and 18 age and sex matched healthy subjects. The delay period between fixation and target (“Go” or “No go”) visual stimulus was 2800-3000 ms. The early and late components of CNV - like slow negative waves (PMN1 and 2) have been studied in 1 sec pre-stimulus interval of delay period.

As compared to norm, the patients showed significantly increased latencies of saccades to correctly discriminated stimuli and higher percent of “errors saccades”. The amplitudes of No go-PMN1 and Go-PMN2 waves were also increased in patients. The amplitude foci of these waves were diffusely distributed in patients and mostly localized in frontal leads in norm.

The findings assume some violation of anticipation for action (motor or inhibitory response) processes as well as an increase of presumably cortical activation during stimulus anticipation in the “Go/No go delay” saccadic paradigm in the early stage of schizophrenia.

No significant relationships.

Psychosis onset typically occurs during adolescence or early adulthood, coinciding with the latest stage of brain maturation. Alterations in brain functional connectivity (FC) accompany the emergence of psychiatric symptoms and cognitive impairments. Thus, age-related FC changes may be informative regarding psychosis onset.

We defined neurotypical age-related FC trajectories and hypothesized that FC of individuals at familial and clinical high risk (HR) for psychosis deviates from FC of neurotypical controls (NC).

We analyzed two independent cohorts, of (a) 356 early adult NC (yNC; age=22±2y, m:f=149:207), and 127 mature adult NC (aNC; age=38±7y, m:f=79:48), and (b) 92 yNC (age=22±2y, m:f=34:58), 33 aNC (age=36±6y, m:f=21:12), 38 early HR adults (age=20±3y, m:f=18:20). We acquired fMRI data from multiple scans (resting-state, working memory, episodic memory, and implicit emotion processing). FC was obtained by computing Pearson’s correlations between time-courses of every independent component (IC) defined by an Independent Component Analysis approach (NeuroMark). Age-varying components of interest (yNC/aNC differences on FC based on linear mixed effect regressions) were tested for differences between HR and yNC through the Wilcoxon rank-sum test.

showed age-related FC differences (yNC/aNC) in a set of 17 IC pairs (pFDR<0.05). HR showed increased FC within a network including dorsolateral and medial prefrontal cortices, and sensorimotor cortex, while decreased FC between cerebellum and the parietal and visual cortices, compared with yNC (pFDR<0.05). HR showed no significant difference compared with aNC (pFDR>0.05).

This study tested FC alterations associated with the risk for psychosis and highlighted the relationship between psychosis and potentially altered brain functional processes.

No significant relationships.

Avoidable disability associated with depression, anxiety, and impaired cognition among older adults is pervasive. Incentives for the detection of mental disorders in late life include increased reimbursement, reduced cost, and less burden for patients and families.

Mental health problems in the elderly are major public health issues around the world. Thai older adults who experience mental illness rarely seek care from mental health specialists; rather, they tend to seek help from a general physician. Primary health care is, therefore, an important setting for the detection of mental health symptoms and subsequent treatment. We describe the design and implementation of a mental health care model in the Thai primary care system. Initial results of screening for behavioral and emotional problems are reported.

This work is intended to explore mental health conditions in Thai elderly people to provide of identifying and non-pharmacological treating psychiatric conditions in the Primary care unit. The instruments used in the survey, which consists of twelve symptoms found in the elderly, developed into an online program to suit pandemic conditions.

In an effort to document mental health problems in the primary care system, 4,854 veterans (mean age 68) from 46 provinces across Thailand were screened for multiple mental health symptoms. The sample divided into 1,701 males (35%) and 3,153 females (65%).

While screening for depressed mood is now common in primary care, we found it useful to screen for specific symptoms of depression in older persons (including insomnia, change in eating habits, facial expression, and anxiety) in a primary setting.

No significant relationships.

Stress-related disorders are common and associated withsuffering and a large sociatal burden. While treatment appears to be able to reduce symptoms, evidence of interventions to improve work outcomes is inconsistent. Lack of integration different service domains has been suspected to be a barrier in return-to-work (RTW) processes.

We aimed to test the effectiveness of intergrating vocational rehabilitation and mental health care.

We randomized participants on sick leave to I) service as usual (SAU), I) improved mental health care (MHC) or III) integrated interventions (INT). Primary outcome was RTW-rates measured at 12 months. Secondary outcome were proportion in work at 12 months, RTW-rates measured at 6 months, and symptom levels at 6 months.

We randomized 666 participants. Regarding primary outcome, the SAU group was superior to both MHC and INT. Furthermore, SAU was also superior to INT and MHC on almost all other work-related outcomes. INT and MHC did not show differences on any work-related outcome. On several symptom scales, MHC was observed with lower scores than SAU, whilst INT did not differ from the two other groups.

Both the integrated intervention (INT) and the (non-integrated) mental health care (MHC) intervention lowered return-to-work rates compared with service as usual (SAU), and thereby yielded worse outcomes. However, the MHC group intervention showed a tendency towards having lower symptom levels compared with those in the SAU group; accordingly, the SAU group is not unequivocally superior. INT and MHC showed no general differences.

No significant relationships.

There is no consensus about whether late-onset schizophrenia(LOS) is a type of schizophrenia or a secondary psychotic disorder. One of the theories of the occurrence of late-onset psychoses is neurodegeneration caused by the imbalance of proteostasis.

To study the concentration and expression of alpha-synuclein in patients with LOS compared with controls.

The study involved 42 patients with the ICD-10 criteria of schizophrenia with the onset of the disease after 45 years and 104 controls with no dementia and severe somatic pathology, comparable in age and gender. The alpha-synuclein level was estimated in a lymphocytic cell fraction from patients with LOS N=42 and controls N=104 using the Human alpha-synuclein ELISA kit. The expression of the SNCA gene was studied in 22 LOS patients and 22 controls and determined by PCR using the SYBR Green Supermix kit and the CFX96 instrument in comparison with the referent genes using previously developed primers. LOS group underwent psychopathological examination including scales. Statistics: SPSS 12.0; the Mann–Whitney test; exponential regression analysis; data is given as median (min–max). The level of significance was set at p<0.05.

The alpha-synuclein level is higher in patients with LOS (9.21 (0.78-29.52)) compared to control (6,355 (0.46-35.44)), p=0.024. The mRNA level of the SNCA gene is higher in the LOS group (0.533 (0.089-1.406)) compared to controls (0.087 (0.016-0.266) , p<0.001.

Our study shows the relationship of alpha-synuclein with the manifestations of LOS. Obtained novel data can open up new targets for therapy and bring it closer to understanding the phenomenon.

No significant relationships.