Although cyberchondria was suggested as a separate phenomenon (Starcevic, Berle, 2013, Starcevic, 2017), it is by definition related to both health anxiety, general hypochondriac beliefs and behavior and Internet use (Baumgartner and Hartmann, 2011, Eastin and Guinsler, 2006, Singh and Brown 2014).

The aim was to reveal relationship between cyberchondria in adult Internet users, Internet use and hypochondriac beliefs and behavior.

126 adults (18-70 years old) filled The Cyberchondria Severity Scale (CSS, McElroy, Shevlin, 2014), checklist of activities about health online, Scale for Assessing Illness Behavior (Rief et al., 2001), Cognitions About Body and Health Questionnaire (Rief et al., 1998).

Compulsion, Distress, Excessiveness, Reassuarance Seeking scales are related to various health-related activities online including both specialized (medical web-sites) and non-specialized (Wikipedia) ones (r=.25-.48, p<.01). Compulsion is closely related to surfing in social networks (r=.41, p<.01), excessiveness – to viewing of illnesses-related pictures (r=.48, p<.01) and reassurance seeking – to reading of online reports (r=.47, p<.01). Cyberchondria is related both to health anxiety (r=.37), hypochondriac behavior (r=.19-.41), beliefs about autonomic sensations, bodily weakness, intolerance to sensations and somatosensory ampliphication (r=.25-.31).

In general population, different aspects of cyberchondria seem to reflect health anxiety and hypochondriac beliefs but are differently related to different forms of online behavior including use of more or less specialized web-sites. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

Health care workers in emergency department and intensive care are usually exposed to stressful situations, which require an early intervention.

To assess the prevalence of anxiety among health care workers in emergency department and to determine its associated factors.

It was a cross-sectional, descriptive and analytical study including health care workers assigned to emergency ward and intensive care unit of Hedi Chaker and Habib Bourguiba hospitals in Sfax and the regional hospital of Kebili. Data was collected by an anonymous and confidential self- administered questionnaire. We used hospital anxiety and depression scale (HAD) to assess anxiety and depression.

The participation rate was 48.8% (n=240). The mean age was 37 years, 59.2% were female and 62% were married. Mean work experience was 11 years. 79.2% assured night shifts (average= 1.5 night shifts per week) and 71.7% benefited of compensatory rest. Our study revealed that 32.5 % of health care workers were suffering from anxiety. In univariate study, anxiety was significantly correlated with the female gender (p=0.004), the lack of practice of leisure activities (p=0.004), with absence of compensatory rest (p=0.001), with sleep disturbances (p=0.001) and with depression (p<10-3). Multivariate study pointed that anxiety was associated with lack of practice of leisure activities (OR=2.7[1.09-6.99]; p=0.006), absence of compensatory rest (OR=2.7[1.3-5.5]; p=0.004), depression (OR=3[1.5-6]; p= 0.001) and with sleep disturbances (OR=2.8[1.4-5.7]; p=0.004).

Anxiety affected one in three emergency caregivers. Stress management programs for emergency caregivers can be of great help in dealing with this problem.

Conversion Disorder is a condition defined by the sudden appearance of neurologic symptoms without an identifiable organic cause, often thought to be associated with psychological triggers. This disorder can lead to severe distress and loss of functionality which, without appropriate treatment, can be made permanent.

To raise awareness for this unexplained and often misunderstood disorder using a clinical case as background.

Clinical history, organic evaluation, psychological evaluation and literature review.

28-year-old female, single, with two children, working from home as a call-centre operator. Previously followed and medicated for depression. Presents to the ER due to sudden loss of consciousness while working, after which her speech became hindered by stuttering. Neurologic evaluation was unremarkable and she was referred for Psychiatric assessment, resulting in a diagnosis of Conversion Disorder. Speech was at first understandable but in the following weeks became progressively worse and eventually led to aphonia, while written communication remained normal and was the patient’s method of choice.

Once a favourite of Psychiatrists, little is yet known about the underlying mechanisms behind this disorder. Experts disagree on whether to classify it as a dissociative disorder, a somatoform disorder, or its own category. Patients presenting with this condition are often mistaken for malingering and thus subject to unhelpful or outright discriminatory practices. Broadened awareness is required to ensure patients get early access to the best possible care and thus improve their quality of life.

Depersonalization during panic attacks may be a feature of a subgroup of Panic disorder. Several studies suggest that such subgroup corresponds to a more clinically severe form of Panic Disorder, with earlier onset and a higher rate of comorbidity with other psychiatric disorders, such as obsessive-compulsive disorder and generalized anxiety disorder. It is also hypothesized that depersonalization during panic attacks may lead Panic disorder to evolve into Agoraphobia.

To present the case report of a patient with severe Agoraphobia, whose only symptom of Panic disorder was depersonalization.

Description of a case report.

We describe the case of a 20-year-old woman who developed Agoraphobia after a single panic attack, during a physical education class, at the age of 13, with depersonalization symptoms only. After the attack, the patient stopped playing sports and engaging in any kind of activity in the absence of a trusted person. At the age of 20, the patient will only travel alone in the immediacies of her home, sometimes missing classes, because she cannot get a ride from trusted acquaintances. She justifies such avoidances with her fear of feeling depersonalized again. Over the course of her illness, she denied having experienced any other symptoms of a panic attack. She was treated with Paroxetine 40mg daily and cognitive behavioral therapy, having improved.

We believe this case provides good insight into depersonalization in panic attacks, supporting the view that Panic disorder with depersonalization may be a distinct and more severe subgroup of Panic Disorder.

COVID-19 is a disease with insufficiently studied diagnosis, therapy, and prevention that causes anxiety disorders in population.

To evaluate prevalence and correlates of COVID-19-related anxiety in university students during the period of their distant learning due to COVID-19 pandemic.

The on-line survey of May 2020 covered 327 Russian university students aged 17-40. The questions concerned evaluation of threats, risks and acute problems faced by the students and their closest people in the situation of COVID-19 spread. We determined the anxiety level of the students by the degree of their concern about high risk of COVID-19 infection.

We established that 17.1% of the students had maximal level of COVID-19-related anxiety that correlated with older age (r=.13), better academic performance (r=.12), expectation of higher COVID-19-related threat to their life (r=.57), to the closest people’s health (r=.44), to the aged people’s lives (r=.16). It correlated with a more serious approach to evaluating the COVID-19-related situation and dangers in the world (r=.19), in the country (r=.24), and in the region of their residence (r=.37). Students with a high anxiety level often saw in pandemic a threat to their way of life (r=.12), material wellbeing (r=.12), and plans for the future (r=.11). They more strictly obeyed the restrictions (r=.13) and they did not exclude a recurrence of COVID-19 type pandemics in the future (r=.17).

COVID-19 related anxiety is present in every sixth student and it correlates with older age and better academic performance. These students may have a high risk for depressive disorders.

Some patients present with significant subjective cognitive symptoms, sometimes interfering with day-to-day live, that are not compatible with any recognizable psychiatric, neurodegenerative or systemic condition. Recent studies have proposed that these patients can be diagnosed with Conversion Disorder (Subtype Cognitive), also known as Functional Cognitive Disorder (FCD). This is a relatively recent concept, that still lacks consensus.

Review the current state of knowledge regarding prevalence, diagnosis criteria, core clinical features and proposed treatment of Functional Cognitive Disorder.

Bibliographic review of the literature published in English in the last 5 years, in the databases Pubmed, PsycINFO and Cochrane. The keywords used were: Functional Cognitive Disorder; Cognition; Conversion Disorder. A review of the titles and abstracts of the resulting articles was made, and selected according to their relevance to the study.

Ten articles related to prevalence, diagnosis, clinical associations and treatment of Functional Cognitive Disorder were selected, of which two were systematic reviews, three descriptive studies, three cross sectional clinical studies of memory clinics attendants, one cohort prospective study and one article was a case series report.

The prevalence of FCD is estimated between 11.6% and 56% of patients presenting to memory clinics. However, the prevalence of FCD is hindered by the lack of consensus regarding its definition. Recently, Ball et al proposed a definition in line with the DSM-5 definition of Conversion Disorder with emphasis on positive criteria with the identification of positive evidence of internal inconsistency. Treatment discussion is still limited, and the approach is similar to other conversion disorders.

Psychological work with cognitive beliefs were shown to be beneficial for patients with somatoform disorders and unexplained somatic complaints (Liu et al., 2019). There is still a question of whether these results are specific or common for different kind of interventions including psychoanalytic psychotherapy (Kaplan, 2014).

The aim was to reveal dynamics of illness perception after group analysis psychotherapy comparing to psychoeducation in patients with somatoform disorders.

100 patients with somatoform disorders were randomized to psychoeducation intervention (48 patients; 15 males and 33 females) and to the group analysis psychotherapy (52 patients; 15 males and 37 females). Before and after treatment they filled Screening for somatoforms symptoms (Rief, Hiller, 2003) and Illness Perception Questionnaire - Revised (Moss-Morris et al., 2002).

2 (Groups) × 2 (Time: Before / After) ANOVA with repeated measures revealed major effect of time with both groups demonstrated equal decrease in somatoform symptoms during treatment (F=101.42, p<.01, η²=.52). Patients from both groups after treatment appraised their illnesses as having shorter duration without cycles, less severe consequences on their lives, reported increase in treatment control, understanding of their illness and decrease in emotional reactions (F=7.13-30.62, p<.01, η²=.07-.24). In group analysis condition only patients demonstrated increased beliefs that psychological and risk factors could impact their illness (interaction: F=4.58-7.24, p<.05, η²=.05-.07).

Patients with somatoform disorders almost equally benefitted from both psychoeducation and group analysis but group analysis psychotherapy led to better awareness of psychological and risk factors of their illness.

Most mental disorders tend to relapse (severe or mild pathologies such as anxiety or dystima disorders), which are potentially recoverable and yet, tend to evolve poorly, persisting residual symptoms without achieving a complete recovery.

The objective of this paper is to analyze the factors that influence process of recurrence and chronification, among which are our own therapeutic interventions.

A bibliographic search was performed from different database (Pubmed, TripDatabase) about the iatrogenic potential of our intervention (psychopharmacological or psychotherapeutic), analyzing influence and mechanisms involved, and the way to prevent them.

Anxiety is a necessary element for the development of people, both from a biological perspective (natural and adaptive psychological response that allows us to respond adequately to possible threats); as an evolutionary psychological (element involved in conflict resolution, in turn necessary for personal development). It would be a mistake to consider it as pathological and try to eliminate it through medication or psychotherapy, since we could interfere with the natural recovery processes, contributing to its chronification and preventing possibility of change. At times, anxiety can be pathological when it occurs disproportionately and exceeds ability to adapt, but we must not eliminate it but to study origin and factors involved, to achieve complete resolution.

In conclusion, we must consider possible iatrogenesis of our therapeutic interventions in process of chronification of mental disorders and try to avoid them by adequately studying individual factors and characteristics, before intervening.

Up to 80% of patients scheduled for surgery experience preoperative anxiety, which may implicate perioperative psychological and physical discomforts. Several studies focused on this phenomenon in neurosurgical setting, still controversial evidence exists.

Our aim is to synthesize this evidence, investigating prevalence, implications and therapy of preoperative anxiety in brain surgery patients.

We performed a systematic review of literature by searching PubMed, Embase, and Cochrane Library databases. Data were extracted using the PICO framework. PRISMA guidelines were applied, and the risk of bias was assessed using the RoB 2 and ROBINS tools, as was the methodological quality of the included studies, following GRADE criteria; we excluded articles with serious risk of bias and/or low quality.

We included 27 articles, accounting for 2558 patients of twelve different countries. Prevalence of anxiety before brain surgery was up to 89%, reaching higher levels in women. Anxiety concerned mostly anesthesia and surgical outcome. No correlation emerged between level of anxiety and laterality, histological type of tumor or survival rate. Before surgery, anxious patients performed worse in cognitive tasks and had worse subjective evaluation of their cognitive abilities. After surgery, preoperative anxiety was associated with depression, longer hospitalization, increase of physical disability and lower quality of life. Effective approaches to reduce anxiety were acupuncture, music therapy, virtual reality and pharmacological support.

Preoperative anxiety in brain surgery patients is a common experience that should not be underestimated to achieve a better perioperative care through early detection and adequate pharmacological or non-pharmacological management.

Mental health concerns are common in health care workers during pandemic. There are no studies of the prevalence of health anxiety in ophthalmologists in India.

To estimate the prevalence of health anxiety in ophthalmologists practicing in India during the ongoing pandemic.

A questionnaire-based online survey on the “changes and challenges during COVID-19” using Google forms was sent to all members of the All India Ophthalmological Society. Besides demographics, the survey had questions to assess the general mental and medical health status of the ophthalmologists. Short Health Anxiety Inventory (SHAI) was used to assess health anxiety.

1027 ophthalmologists responded to the study. Higher stress was experience by 83.1% compared to pre-COVID while examining patients closely (35.9%) or during surgery due to the risk of aerosol generation (29.3%). SHAI score >20 was observed in 5.6%. Only emergency services were being provided by 50% and 17% in the SHAI > 20 group were not working as compared to overall 14%.

Our findings indicate that a majority of the ophthalmologists were under stress during the COVID-19 pandemic but only a small proportion experienced health anxiety. It is likely that mental health issues may arise among ophthalmologists in the foreseeable future.

Heart failure (HF) is a worldwide public health problem and the main cause of morbidity and mortality in older people. Previous studies have demonstrated that psychological symptoms are associated with worse cardiovascular outcomes. Nevertheless, the research regarding the association between anxiety and HF is still scarce.

To analyse the levels of anxiety in HF patients and its association with New York Heart Association (NYHA) class in HF patients.

This study takes part of a wider project named Deus Ex-Machina project (NORTE-01-0145-FEDER-00026). HF patients were recruited from an outpatient clinic at a University Hospital. Patient with inability to communicate, with severe visual impairment or with NYHA class IV were excluded. Sociodemographic data and NYHA class were recorded. Anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7).

Overall, 136 patients were included, with a mean age of 57(±13) years old. Most of them were men (66%) and married (76%), with mean education of 8 years (±4). Regarding NYHA class, 36%, 49% and 15% were at class I, II and III, respectively. The mean GAD-7 total score was 6.4 (±5.2) and 32% of patients showed moderate to severe anxiety symptoms. No association between the NYHA functional class and anxiety was found (p=0.106).

The results reveal that anxiety is frequent among HF patients. However, as found in previous studies, it was not associated with more severe HF symptoms. The coexistence of HF and anxiety deserves further studies, in order to build a better understanding of this association.

In a serial compound conditioning paradigm, a sequence of several conditioned stimuli (CS) is predictive to an unconditioned stimulus (US) (e.g., CSA->CSB->US). Animal research showed that, when the US is aversive, CSA elicits the strongest conditioned response, while CSB appears redundant. These effects of primacy and proximity have never been investigated in humans.

To study the effects of temporal proximity of imminent threat and safety in serial compound conditioning.

Twenty-two participants were presented with sequences [CSA->CSB->CSC->CSD]. In 55 trials all four CS were identical vowels (e.g, [oh]), and no US was presented. In the other 55 trials, the CSA was different (CSA+, e.g., [uh]), and the CSD was followed by an electrical shock (US) 2.5 times higher than the individual pain threshold.

No ERP component distinguished between CS- and CS+ for the first three stimuli in the sequence (i.e., CSA, CSB, CSC). The last CS (CSD) elicited a strong fronto-central CNV only when it was followed by US. Moreover, already after the CSA- (which signalized that no shock would be presented on that trial) the power of alpha oscillations over the somatosensory cortex significantly increased, particularly on the side contralateral to the hand that was electrically stimulated on US trials. The alpha increment lasted up to the onset of the US.

The data indicate two possible mechanisms of adjustment to predictable threat, one of which relies on safety signals (manifested in alpha increment), and the other is related to flight response (manifested in the CNV immediately preceding the shock).

Negative consequences of social homonegativity and HIV status among older gay and bisexual men in Portugal are still to be documented.

This study seeks to evaluate depression and anxiety disparities among older gay and bisexual men, based upon their HIV status.

This is a quantitative, descriptive, comparative, and cross-sectional study. Responses were collected from a total of 201 men, with 16.9% being HIV positive, 80.6% identifying as homosexual and 13.9% identifying as bisexual. Participants responded to the Rosenberg Self-Esteem Scale, the BSI-18, and the CDRISC-10.

The sample collected revealed moderate levels of depression and anxiety that were below the average observed among the general population. Older gay men showed higher levels of depression when compared to older bisexual men. Self-esteem was negatively correlated with both depression and anxiety while being positively correlated with resilience. In contrast, depression was negatively correlated with resilience and, conversely, positively correlated with anxiety. Furthermore, anxiety was negatively correlated with resilience. Multiple linear regression models explain 33% of the general variation of depressive symptoms and 25% of the variation of symptoms of anxiety. Regarding comparisons based on HIV status, no statistically significant differences were found between HIV-positive and HIV-negative men.

This study offers a pioneering contribution to the literature on aging and mental health among older sexual minorities in Portugal, giving a voice to older HIV-positive and HIV-negative GBM in Portugal, in order to gain a better understanding of the barriers and obstacles that they face throughout the aging process.

Prevalence rates of panic attacks have been reported to be around 24-63% in psychotic patients. Common underlying biological substrates for panic and paranoia have been proposed, suggesting that delusional disorder (DD) may be preceded by the development of anxiety disorders.

The main objective of this study was to investigate anxiety comorbidity in DD. As a second objective, we set ourselves to know prescription rates for the use of antidepressants and benzodiazepines in anxiety disorders in the context of DD.

A systematic literature search was performed using PubMed (1980- September 2020) according to the PRISMA guidelines. The following search terms were used: (delusional disorder) AND (anxiety OR anxiety disorder OR anxi*). Research studies and case reports were included if they met the following criteria: DD diagnosis (DSM, ICD), publication in peer-review journal and investigations containing information on anxiety comorbidity in DD.

Four studies fulfilled our criteria, including 155 patients: 65 (42%) women, mean age 42.7 years (SD:14.96). Thirty-three of the 155 patients (21.29%) presented at least one comorbid anxiety disorder: 14 specific phobias, 9 panic attacks, 5 social phobias and 2 agoraphobias. Treatment was not reported for many patients (n= 28). Four patients received fluoxetine and 1 patient benzodiazepines. All of them showed partial improvement of symptoms.

Less than a third of DD patients showed an anxiety disorder. The effectiveness of antidepressant and benzodiazepine treatment has been poorly described. Future studies may be focused on the investigation of preceding comorbid anxiety disorders in patients with DD.

In anxiety disorders with a lot of research on the effectiveness of treatment procedure it is important to consider patients’ implicit attitude towards mental health services, especially psychological help.

To investigate the attitude towards psychological help in anxiety disorders.

In order to reconstruct an implicit attitude towards psychological help the method of color-emotional semantic associations (Kiselnikov et al., 2014) was used. Ten patients with anxiety disorders and 25 subjects from control group with no history of attending mental health services evaluated subjective differences between 15 semantic objects, 10 basic emotions and 10 colors. Factor analysis was used.

The analysis revealed the two-factor structure: “Valence” and “Arousal”. The semantic object “Psychological help” got 0.92 and 0.72 as first factor loadings and 0.26 and -0.65 as second factor loadings in anxiety disorders and in control group, respectively. The comparison showed a more intense and positive attitude towards psychological help in anxiety disorders. Contrariwise, the data for other semantic objects showed the tendency of more intense and negative evaluations in the clinical group.

In anxiety disorders a shift in the categorical structure of consciousness to more negative and intense attitudes could be associated to anxiety and threat readiness. However, the attitude towards psychological help was an exception as more intense and positive which could be considered as an important factor of the effectiveness of the treatment in anxiety disorders. The research was supported by Russian Foundation for Basic Research with the Grant 17-29-02506.

Anxiety Disorders (AnxDs) are highly prevalent in middle-aged and older individuals and are putative factors that might interfere with normal aging, by affecting cognitive functioning and neuroprogression.

This study aims to assess whether current AnxD in middle-aged and older subjects are associated with 1) lower neuropsychological performance, 2) shorter telomere length/lower plasmatic Amyloid-Beta, and 3) brain connectivity alterations, compared to subjects without lifetime psychiatric disorders (HCs).

This is an ongoing multicentric cross-sectional study. We collected preliminary data on neuropsychological performance through a standardized battery, in 60 outpatients with current AnxDs (DSM-5 criteria), 24 with psychopharmacological treatments (AnxDs+) and 36 without (AnxDs-), compared to 76 HCs, all aged 50-75 years. This study was supported by Fondazione Cariplo, grant n° 2014:0664.

AnxDs- patients showed poorer performance in the language domain, namely in semantic fluency (p=0.04), compared to HCs. No other significant differences were found between groups. Within the patients’ group, we found that a greater burden of psychiatric disorders or medical diseases, current use of benzodiazepines, or unhealthy lifestyle had significant detrimental effects on cognition, whereas current use of antidepressants, pharmacological treatments for medical conditions, and higher levels of physical activity exhibited the opposite effects.

We found only limited difference in cognitive performance between patients and controls. However, our preliminary results show that multiple factors influence cognitive performance in individuals with AnxDs, making these aspect important to monitor in clinical practice. So far, our results are provisional and further analyses in the final sample may provide more reliable conclusions.

Anxiety disorders are a mental disorder that is widespread all over the world and are associated with a high burden of the disease. While poor dietary habits are common in depression, they can lead to worsening of the illness or prolong the treatment, which also leads to a higher risk of developing chronic diseases.

With the array of the treatment modalities including monoaminergic antidepressants, benzodiazepines, psychotherapy, there is the unmet need for the effective treatment of anxiety disorders resulting in full remission and relapse prevention. Benzodiazepines can quickly resolve anxiety due to their positive allosteric GABA modulation mechanism of action. Although, they are not recommended for chronic use.

Ketogenic diet(KD) may be hypothesized as the promising strategy impacting treatment strategies, in particularly facilitating full remission, recovery and preventing relapses. In this popular high-fat diet, where daily calories intake is consists in at least 70% from fat, up to 25 % from protein and as little sugar as possible is mainly known for its helpful role in drug resistant epilepsy treatment, glucose levels balance or fast way for weight-loss.

Could be effective in anxiety disorders treatment due to its possible role in GABA:glutamate balance change in favor of GABA levels, which may enhance the anxiolytic effect in sustaining remission and preventing relapse.

KD in some anxiety disorders may provide a rewarding outcome, but more research is needed. The evidence mentioned in this paper should encourage psychiatrists to recommend KD as advice somewhere between psychotherapy, pharmacology or as an add-on to those two.

Studies of the cognitive and behavioral factors of perpetuation and quality of life in patients with somatoform disorders are important for identifying targets for psychological interventions and risk groups (Piontek et al., 2018, Dehoust et al., 2017, Schaefer et al., 2012, Flasinski et al., 2020).

To reveal beliefs and behavior in patients with somatoform disorders associated severity of somatic complaints and poorer subjective well-being.

125 patients with somatoform disorders 17-68 years old filled Screening for Somatoform Symptoms (Rief, Hiller, 2003), Cognitions About Body And Health Questionnaire (Rief et al., 1998), Scale for the Assessment of Illness Behaviour (Rief, Ihle, Pigler, 2003), and Quality of Life Enjoyment and Satisfaction Questionnairie-18 (Ritsner et al., 2005).

Severity of somatoform symptoms is higher in patients with catastrophization of bodily sensations, autonomic sensations, belief in their bodily weakness, somatosensory amplification, scanning for bodily symptoms, and disturbances in daily activities due to illness (r=.18-.38, p<.05). Adjusting for the severity of somatoform symptoms, subjective well-being was lower in patients with higher belief in their bodily weakness and somatosensory amplification, autonomic sensations, expression of symptoms, and changes in daily activities due to illness (r=.21-.40, p<.05).

The results suggests that regardless of symptoms severity poorer quality of life in patients with somatoform disorders is associated with beliefs about body and body perception that could be addressed in psychotherapy.

The recurrence of bipolar disorder due to poor treatment adherence can be explained by different factors.The poor awareness of the disorder seems to be the major cause.

To evaluate insight in patients followed for euthymic bipolar disorders and determine the factors correlated with it,mainly the self-esteem.

A cross-sectional descriptive and analytical study of 33 euthymic subjects with bipolar I and II disorders (DSM 5) and followed up at the psychiatric consultation in Hédi Chaker university Hospital of Sfax.Data collection was performed using a sheet exploring socio-demographic and clinical data. We used Birchwood insight scale to assess the quality of insight and Rosenberg’s Self-Esteem scale.

The average age of our patients was 44,52±12,99 years old.The sex ratio =0.32.Patients were followed for bipolar I disorder(60.6%).The first episode of the disease was depressive in(51.5%) of cases.The average number of depressive episodes was1.97±1.87.The last episode was depressive in(57.6%) or manic in(42.4%).There were no psychotic characteristics in(42.4%) of cases.The patients had good insight in(54.5%).The average of self-esteem score was27±7.85and it was low in 51.5% of cases.Factors correlated with good insight were bipolar II disorder(p=0.001), high number of depressive episodes(p=0.013) and absence of psychotic characteristics(p=0.003) during the last episode.In addition,good insight was significantly associated with low self-esteem(p=0.023).

Our study shows that a poor insight depends mainly on the clinical characteristics of bipolar disorders. Moreover,low self-esteem seems to be linked to it. For this reason, our attention should be focused on psychoeducation to improve insight, especially during episodes, in order to facilitate integration and increase patients’ self-esteem.

Focusing on the negative changes experienced by both patients and caregivers associatively caregiving and experiencing chronic mental illnesses, there is an increasing interest in the phenomenon of development after traumatic experiences with high levels of stress. These changes are in line with the concept of posttraumatic growth.

In the study, posttraumatic growth and psychological resilience in bipolar patients and caregivers has been examined in the context of the variables that are claimed to be related to it.

With the approval of ethics committee, 49 patients in euthymic period and caregivers, 49 healthy volunteers meeting the inclusion criterions, applied to Erenköy Mental and Neurological Diseases Training-Research Hospital outpatient clinics between July-December 2019 were included. While psychological resilience and posttraumatic growth scale were implemented to patients and caregivers only psychological resilience scale was applied to healthy volunteers. The relationship between posttraumatic growth and psychological resilience, patient and caregiver variables was examined through statistical methods.

Comparing with the patients and caregivers, respectively posttraumatic growth total scores were 57.7%-61.3% of the highest score obtained from the scale in the patients and caregivers. Considering the literature, patients and caregivers experienced moderate to high posttraumatic growth. Caregivers’ psychological resilience levels was higher than the other groups.

The results of the study are in line with the findings that, negative life experiences positively contributes to individuals. Knowing the factors affecting posttraumatic growth can make contribution to approaching patients and caregivers in clinical practice.