Secondary school students in Nigeria are under intense pressure to perform well in their academics so as to have competitive advantage in advancing their studies. This pressure has been linked to western derived psycho-pathologies such as depression, anxiety and culture bound syndrome such as brain fag syndrome.

To examine gender differences in the manifestation of brain-fag syndrome, depression, and anxieties among students about to participate in Junior Secondary Certificate Examination (JSCE) and West African Senior School Certificate Examination (WASSCE) in Nigeria.

Two hundred and nine (209) students (X age = 14.27, SD = 2.18) were administered a battery of tests comprising of the Brain Fag Syndrome Scale, Brain Fag Propensity Scale, State Trait Anxiety Inventory, Patient Health Questionnaire, Mathematics Anxiety Inventory and Test Anxiety Inventory. The data was subjected to a multivariate analysis of variance (MANOVA).

The result showed no significant gender differences in the manifestation of brain-fag syndrome, depression, and anxieties, F (6, 202) = 0.947, P ≥ 0.01; Pillai's Trace = 0.03, partial η2 = 0.02. In consonance with earlier studies, males reported higher brain fag mean scores than female participants (X = 5.46, SD = 2.06; X = 4.88, SD = 2.43).

The study has shown that adolescents who are about to take their final examinations manifest brain fag propensity and go on to manifest symptoms of the brain fag syndrome. But, there is no significant gender difference in the manifestation of brain fag syndrome among males and females.

The authors have not supplied their declaration of competing interest.

The modern Swedish crime drama series Wallander by Henning Mankell presents a good portrayal of mental health issues in 21st century post modern world, including the contribution of biological, psychological and social issues in predisposing, perpetuating and maintaining them.

The aim of the exploratory synthesis is to study the characters in Wallander focusing on the portrayal of their mental health with a view on formulating biological, psychological and social factors that play a role in their development. Furthermore, mental health is reviewed in first world culture acclimatizing itself to the themes emerging from post-modern globalised world.

The episodes of Wallander (Swedish Version) are reviewed focusing on the characters and the plots for each episode matching them with mental health diagnoses offered in International classification of diseases.

The results are collated and a general commentary is offered on the observations and motifs revealed in the portrayal. The focus will be on individual character formulations (both recurring main characters as well other side characters). In addition, there is a commentary on contributing to mental health problems in a post-modern industrial society.

The author has not supplied his declaration of competing interest.

Religion/spirituality and medicine have been related in one way or another sense the beginning of our know History. Patients’ beliefs, values and practices influence the way disease is perceived and managed. In order to provide adequate care the physician must have proper knowledge of the patients’ spiritual/religious context, otherwise it may fall prey to errors of diagnostic, inappropriate management and subsequent poor compliance.

To present the case of an adult male (a preacher whose beliefs include mediunity) with delusional ideation of mystical content and mood elation, identified during a religious ceremony.

Questioning the frontier between spiritual/religious beliefs and psychopathology.

A case report is presented and a literature review of the theme is shortly surveyed.

The case reports to a 53 years old man, who during a religious ceremony presented himself with agitation and disinhibition, removing all his cloths and living the church naked. Additionally it was identified the presence of insomnia, heteroaggressiveness, accelerated speech, mood elation and delusional ideation of mystical and megalomaniac content. Several studies demonstrate the importance of acknowledging the religious/spiritual beliefs of patients. This knowledge allows the psychiatry to correctly identify the existing psychopathology and organize an appropriate intervention plan for the patient.

Spiritual and religious beliefs’ influence the way disease is perceiver and managed. Physician should collect a brief spiritual story of the patient and learn about the different religious/spiritual beliefs and practices of their community, in order to understand the full dimension of the individual illness.

The authors have not supplied their declaration of competing interest.

Apotemnophilia or body integrity identity disorder (BIID) is defined by the uncontrollable desire to amputate one or more healthy limbs or to be paraplegic.

We reviewed the available studies of this condition in order to enhance the comprehension of this disorder and the possible need of a multidisciplinary assessment.

Relevant papers from 2000 were identified using PubMed database, with the terms apotemnophilia, BIID and self-demand amputation.

Reports of the phenomenon of amputee attraction trace back to 1933 in a series of letters and articles published in journals and magazines by erotically-obsessed persons who wanted to become amputees themselves. The first scientific report of this issue only appeared in 1977, when John Money described two cases that requested an amputation of a healthy limb, a condition he named apotemnophilia. Would-be amputees – or “wannabes” – may appear in thousands and they have their own websites. Until now, the explanation of this phenomenon has been in favor of a psychiatric etiology: a pathological desire driven by a sexual compulsion. Recently, a neurological explanation has been proposed and defends that might exist a dysfunction of the right parietal lobe, leading to a distorted body image and a desire for an amputation.

Apotemnophilia is a rare, uncommonly studied condition, which blurs the limits between psychiatry and neurology. We must be aware that this disorder is more frequent in unusual places like websites and others. A better understanding of this condition is crucial for the development of effective treatment.

The authors have not supplied their declaration of competing interest.

Analysis from cultural products has been previously reported in psychiatry field. This approach provides an understanding of the social imaginary about psychiatry and its work over a determined period of time.

To describe the representations of ECT and insanity in an Spanish underground comic of the early 80s.

We performed an analysis of complete production (1979–1994) of “Makoki”, comic by Gallardo and Mediavilla, looking for the aspects related with our interest scope (Fig. 1).

The comic analyzed is inscribed in the field of provocation and insolence. This is comprehensible in the historical context of Spanish transition, if we attend to almost forty years of cultural confinement as a result of a dictatorial regime. This cultural product could be seen as “politically incorrect” from the current perspective, given that reproduces some stigmatizing topics regarding mental illness, glorifying its alleged associations with violence and drug use, in addition to a negative view of ECT, represented as a sadistic instrument of punishment, control and subjugation (see Fig. 1).

The material analyzed reproduces the prevailing social stigma in its epoch about psychiatry and mental illness. The analysis of cultural products that reflect and built the speeches about the psychiatry and its action field, can be a useful strategy to understand the views of the general population in a given era.

The authors have not supplied their declaration of competing interest.

As the psychopathological constructs have been influenced by scientific and cultural paradigms of its time, culture reflects and determines the way of understanding health and disease. The knowledge generated is integrated to the cultural wealth and it continues its development by interacting with culture, thus the ideas of mental illness and its treatment vary according to culture and beliefs of a given population in a given time.

To propose a framework for analysis through the examination of cultural products. We argue that this strategy can give us some clues about how the general population understands mental illness and the psychiatric work.

A review of the literature available about social representations of science, medicine, illness and psychiatry, through cultural products analysis.

There are many works that address the presence of these issues in the social imaginary by analyzing cultural products. In the field of psychiatry, the analysis of films, literature and music (the last, in a lesser extent) are the most frequent.

The analysis of cultural products can be a source of additional knowledge that connects us with the social representations of our profession and its scope of practice, favoring a better understanding about what psychiatry and mental illness means for our patients and general population.

The authors have not supplied their declaration of competing interest.

This research aims at examining the relationship between anxiety, depression, and hopelessness among nonclinical Kuwaiti sample using Beck Anxiety Inventory, Beck Depression, and hopelessness inventories.

highlighting the relationship between anxiety, depression, and hopelessness among nonclinical sample of females and males and the common factor/s.

The participants were 616 (308 females & 308 males), Kuwait University students. The two genders were matched in age (18.15 ± 0.36 & 18.18 ± 0.38, t = 0.94, P > .05) and BMI (24.12 ± 3.27 & 23.50 ± 4.85, t = 0.54, P > 0.5). The Arabic versions of the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and demographic surveys were administered to participants during classes. All participants read and signed a consent form before participating. The correlation matrices, exploratory factor analysis, and reliability analysis are used in this study.

Internal consistency of scores were satisfactory for the BAI, BDI-II, & BHS inventories respectively (Cronbach's alpha (M) = 0.88, 0.75, 0.74 & (F) = 0.89, 0.84, 0.88). A correlation of (r = 0.53) between the BAI and BDI-II and (r = 0.43) with BHS. Meanwhile a correlation of (r = 0.58) between BDI-II & BHS. A principal-axis factor analysis with oblique rotation suggested one factor accounting for 67.73% of the common variance.

The results indicate that there is a strong relationship between anxiety, depression and hopelessness. This highlights the important of examining common factors between anxiety, depression and hopelessness among nonclinical sample.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Depressive and anxiety disorders are common among working adults and costly to employers and individuals and their prevalence is high. Public sector employees are also vulnerable to poor mental health, mainly where have been occurring organisational changes similar to private sector concepts.

To highlight the unmet mental needs for new vulnerable working population, government employees.

The search was conducted using PubMed, Medline, Web of Science, Scopus, B-on, Science Direct with the terms “government employees”, “federal employees”, “depressive disorders”, “anxiety disorders”. Using the PRISMA methodology, 1374 articles were considered with the search terms and if were published in the last 10 years; after a review of the title and summary, 5 eligible studies in english were included.

Mental disorders are growing public health problem, and creating an enormous toll of suffering, disability and economic loss. There are few studies about depressive and anxiety disorders in public sector and those confirm that it would be to examine to what extent national characteristics can explain why individual and organizational characteristics are more related to them in some countries than in others, especially not including military or police officers who usually are submitted to high psychological distress.

Workplace health promotion in addressing job stress is crucial to fight against to a range of mental health outcomes. Mental health screening in the public sector may contribute for changes to the traditional roles of government and its management structures and must be encouraged to find out the underlying mechanisms of developing depressive and anxiety disorders.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Major depressive disorder is one of the most prevalent psychiatric illnesses in the world affecting more than 12% of men and more than 21% of women in their lifetime. Selective serotonin reuptake inhibitors (SSRIs) are worldwide prescribed to treat depression. SSRIs drugs can cause drug-induced liver injury (DILI).

The aim of the study was to evaluate the liver function in patients treated with SSRI in order to detect DILI.

All the patients with first major depressive episode treated with the same SSRI antidepressant for at least 3 months between September 2013 and September 2015 were entered into the study. The hepatic function panel included aminotransferases, total and direct bilirubin, albumin, total protein, gamma glutamyl transferase (GGT), LDH cholesterol, hepatitis B virus (HBV), and hepatitis C virus (HCV).

Of 134 subjects with MDD according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) who met inclusion criteria, 98 patients entered into study. Seventy-seven (76.5%) were treated with SSRI for at least 3 months with mean age were 45.4 (SD = 6.3), 65 women (66.3%). Five patients (5.1%) were newly diagnosed with hepatitis, and 10 (10.2%) presented elevated values of ALT, AST. The mean duration of depressive symptoms was 9.2 months (SD = 6.9).

The treatment with SSRI seems to be effective and safe in our sample. A relative small number of patients with MDD were diagnosed with viral hepatitis during this cross-sectional study. Further randomized and controlled trials are needed.

The authors have not supplied their declaration of competing interest.

The growing rate of depressive disorders causes needs for more effective and more innovative solutions. The modern patients’ challenges make them fail mostly in the treatment compliance. Some reports have described that escitalopram orally disintegrating tablets (ODT) induce faster response and lower dropout rate than oral standard tablets (OST), although both forms have equal bioavailability.

We tried to clarify effectiveness rates between escitalopram ODT and OST treatments in depressive patients.

An open-label, 6-month, randomized, flexible-dose study was conducted for direct comparison of the effects of escitalopram ODT (N16) and OST (N15) on dropout rate and clinical outcomes in patients with major depression.

Outcome measures included Hamilton Depression Rating Scale (HDRS), Drug Attitude Inventory-10 (DAI), Clinical Global Improvement Scale (CGI), and Psychological General Well-Being Scale (PGWB). The tolerability was assessed by the UKU scale. No significant difference was found in HDRS, CGI, PGWB and GAF between the two forms of tablets. No significant difference was found in any tolerability rates. However, dropout rate favored escitalopram ODT group (N5, 31.3%) vs escitalopram OST (N7, 47.0%). DAI-10 outcomes, both in patients’ general attitude and subjective feelings, were significantly improved in ODT group (P = 0.000), comparing with OST.

Escitalopram in its classical form (OST) has become a leader in a group of antidepressants, thanks to safety of use, efficacy and tolerability. In the ODT form, escitalopram can meet additional needs, both clinical and lifestyle. ODT may reduce dropout rate and costs of long-term treatment improving the patients’ compliance.

The authors have not supplied their declaration of competing interest.

Depression is a complex disease associated with sleep, appetite and body weight disturbances as well as with the level of physical activity, all of which may be the risk factors for the development of metabolic disorders. Different physiological mechanisms as well as psychosocial factors such as gender, age, smoking, stress level, nutrition and level of physical activity can affect the metabolic syndrome (MS) development in depressed patients. It is considered that chronic stress causes depression and subsequent poor lifestyle that can lead to the MS development, which results in increased incidence of cardiovascular disease.

To determine the psychosocial and clinical characteristics of depressed patients with MS diagnosis.

Cross-sectional study was conducted on a sample of 80 patients suffering from depressive disorder. The structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and the Clinical Global Impression Scale (CGI) were used as diagnostic instruments. MS diagnosis was made according to NCEP/ATP III criteria.

Depressive patients with MS diagnosis had a significantly higher frequency of suicide attempts, while MS diagnosis significantly more frequently was present in female patients. Increased intake of carbohydrates was an important characteristic of the depression as well as MS.

Further studies are needed in order to explain the observed gender differences, and whether interventions focused on the treatment of depression may contribute to the acceptance of healthy lifestyles, particularly in changing of dietary habits, and thus indirectly contribute to the reduction of MS frequency.

The authors have not supplied their declaration of competing interest.

For most individuals, basic life requirements are met through employment. It can satisfy creative urges, promote self-esteem, and provide an avenue for achievement and self-realization.

To assess the level of depression, anxiety and self-esteem in a population of unemployed persons.

It was a cross-sectional study involving unemployed people we met in the office of employment of Sfax in Tunisia. The level of anxiety and depression was assessed by the Beck depression and anxiety inventories. The self-esteem Rosenberg scale allowed us to evaluate the level of self-esteem of our population.

The average age of oursubjects was 33 years six months. The average duration of unemployment of our population was 4 years 7 months and 38.2% of them had never worked before. The anxiety level was moderate in 38.2%, while moderate to severe depression was found in 47%. Self-esteem was low to very low in 47.1%. A low level of depression was positively correlated with a low socioeconomic level (P = 0.000), a low level of anxiety (P = 0.000) and a high self-esteem level (P = 0.000).

People with strong support systems and greater self-esteem seemed to experience less unemployment stress. Identifying those who are at high risk for psychological and physical problems and finding ways of preventing them from suffering the adverse effect of unemployment are important areas for further study.

The authors have not supplied their declaration of competing interest.

Apathy is a transnosographical symptom that is often described in psychiatric and neurological illness. The most known definition, proposed by Marin (1991), is a lack of goal-directed voluntary behavior. Apathy and depression may be present together but they are clinically independent. The confusion between signs of apathy and those of depression might reveal diagnostic and treatment issue. Our aim is to define a clinical profile of apathetic patients (Ap) with depression, hypothesizing there is a different clinic profile than non-apathetic patients (NAp).

Seventy adults diagnosed with depression were included in a comparative, non-randomized and open cohort, since November 2014. Clinical assessments targeted clinical scale evaluations (MINI, AES, MADRS, STAI, SHAPS). Patients were separated in two groups, Ap VS NAp, using a 42 points cut-off at AES score.

Ap represent 30%; n(Ap)= 21, n(NAp)= 49. Depressive severity scores (MADRS) are lower in the Ap group; W-test= 672, P= 0,044. State anxiety scores (STAI-A) are lower in Ap group; W-test= 739, P = 0,004. Anhedonia scores (SHAPS) are lower in Ap group; W-test= 412, P= 0,004. Pearson test show negative correlation between AES/STAI-A (r = -0,27; P= 0,02); AES/SHAPS (r= -0,45; P= 0,001).

Apathetic patients suffering from depression seem to present different clinical pattern in term of anxiety and anhedonia. These results are high of interest for therapeutic and further studies focus on pathophysiological issues.

The author has not supplied his/her declaration of competing interest.

Major depressive disorder (MDD) is a chronic mental illness with a considerable lifetime prevalence in adult men and women. Only a third of MDD patients remit following adequate antidepressant treatment, while most suffer from significant core depressive or residual symptoms during their clinical course. Augmentation treatment with second-generation antipsychotics (SGAs) has been one of the suggested approaches to overcome this shortage of efficacy of antidepressant therapy.

To review the role of SGAs as an augmentation strategy to antidepressant therapy in MDD.

A search of the MEDLINE/Pubmed database was conducted for articles from 2010 to 2015, using the MeSH terms “antypsichotics”, “depression” and “treatment”.

There is a general consensus in the literature that antidepressant augmentation treatment with SGAs is more effective than placebo in the management of patients with MDD who failed to respond adequately to antidepressant therapy alone. The majority of studies found no significant differences between the different studied drugs (namely, aripiprazole, quetiapine, olanzapine and risperidone). On the other hand, discontinuation rates due to adverse effects are also higher with SGAs versus placebo. However, it remains unclear if augmentation with SGAs is more effective than other therapeutic strategies, such as combination or switching to other antidepressant or augmentation with other psychotropics.

There is strong evidence that SGAs augmentation is an effective and generally safe therapeutic approach to patients with MDD who respond poorly to antidepressants. Nevertheless, more studies are needed to understand the efficacy of this treatment comparing other therapeutic approaches.

The authors have not supplied their declaration of competing interest.

Hyponatremia is one of the electrolytic disorders most comonly observed among general hospitalized populations (2% of hospitalized patients). A form of hyponatremia is the syndrome of inappropriate antidiuretic hormone secrection (SIADH). One of its diverse causes is medication. Selective serotonine reuptake inhibitors (ISRSs) can cause hyponatremia due to SIADH, particularly among elderly population.

A 81-year-old female treated with paroxetine 20 mg/day because of depression. Two weeks later she starts feeling nausea, somnolence and motor inhibition. The sodium level previous to the onset of treatment was normal but after two weeks it has decreased to 121 mEq/L, pointing to SIADH induced by ISRSs.

The incidence of hyponatremia among elderly patients treated with antidepressants of ISRSs class has increased. The prevalence varies between 0.5 and 25%. Although half of the patients are asymptomatic, the mortality is rate may reach 25%. It generally develops during the first month of treatment and is reversible between 2 and 28 days after the suspension of the ISRSs.

The authors have not supplied their declaration of competing interest.

It has been suggested that neuroinflammation and inflammatory mediators may play a crucial role in the pathophysiology of both major depression and suicidal behavior. Immunological differences have been reported between both subjects with major affective disorders and suicidal behavior.

The main objective of this review was to deeply investigate the nature of the association between inflammatory cytokines in depression and suicidal behavior. Aims: The study aimed to conduct a systematic review of the current literature to investigate the association between inflammatory cytokines, depression, and suicidal behavior.

Generally, an imbalance between pro-inflammatory and anti-inflammatory cytokines has been documented in both major depression and suicidal behavior. The presence of major depressive disorder (MDD) with suicidal ideation/attempts was associated with differences in inflammatory cytokine profile when compared to that without suicidal ideation/attempts. However, not all studies demonstrated a positive correlation between inflammatory cytokines and suicidal behavior.

The mentioned association between inflammatory cytokines, depression, and suicidal behavior does not imply the existence of a causal relationship. Further additional studies should clarify the molecular mechanisms of the immune activation pathways underlying depression and suicidality.

The authors have not supplied their declaration of competing interest.