During COVID 19 epidemic it has been interesting to observe the gradual transformation of the daily routine into death, sorrow and pain. The moment of transition from life to death was really changed by distressing for survivors who had to face with unexpected ways to live their mourning.

The paper would like to analyze the mounring ritual during COVID 19 epidemic.

During COVID 19 tragedy victims and survivors have been first associated by the infection and then dramatically separated by its effects. It has been necessary to re-relaborate new procedures of separation from deceased, as far for laws prohibitions it was no longer possible to use the traditional ones.

So a leaving “ritual” re-emerged very similar to the “crying ritual” of the Southern Italy folkloric culture. The traditional wailers have been substitued by the windows flash mobs trying to replace the forced absence of “pietas”, with a moment of positive sharing of physical distance between life and death, using sounds, songs, tools that always, in farming culture help to exorcise and take away death.

The relevant starting powerlessness to face the fast disease diffusion, its intrinsic seriousness, inspired surprising capabilities of immediate reaction and active mobilization in response to the attack suffered by Koerper and Leib (in Heidegger sense) which actualized in the research of a new “separation” dimension. In the end, as psychiatrists, we have to notice how this collectivization practice is actually a big distress container and wonder where and how this distress will finally arrive

Research about the depictions of psychiatry and mental disorders in popular culture has been scarce and often lacks systematized research strategies. However, this tendency has changed in the last few years and it is now possible to find articles which investigate the social representations of mental illness through the analysis of the media, music, films, and other artistic manifestations. One possible indication of the emerging relevance of this topic is the inclusion of the MeSH term ‘Medicine in the Arts’ in the database of the U.S. National Library of Medicine in 2018.

To understand prevalent ideas regarding mental illness and psychiatry in a specific time and place by using artistic and cultural productions as data sources.

Content and Thematic Analysis

In this communication I present examples from the content and thematic analysis of 7,777 Spanish Punk Songs (1981-2010) referring to psychoses, suicide and related behaviors, and other interesting issues for the psychiatric field.

The study of the products of popular culture can give us information about common ideas present in the social imaginary regarding mental disease. One advantage of this type of study is the public character of the data. In addition, the fact that artistic productions persist over time enables access to information which could not be gathered through other qualitative research designs. In this way, the products of popular culture could be seen as what I call ‘cultural fossils’, which can be ‘traced back’ to the historical time in which they were produced.

Turkish people immigrated to Germany initially as guest workers since the 1950s. Even though some Turkish immigrants resist to integrate culturally in order to preserve their traditions, those who immigrated during the last ten years considered themselves as part of the German society. It is hypothesized that Turkish immigrants experience more discrimination in the labor market and in education life since the early years of immigration. In addition, they feel more discriminated in comparison to immigrants from other nations.

This paper aims to investigate the perceptions of Turkish immigrants towards discrimination in their daily lives. Besides, the relationship between being discriminated and having mental disorders is investigated.

125 participants aged between 18 to 70 years were surveyed through a specific questionnaire. Moreover, face to face interviews were held to gain more insights into participants perception of discrimination.The relationship between being discriminated and having mental disorders was analyzed.

The preliminary findings illustrate that while the perception of the elderly Turkish immigrants towards discrimination is higher, the younger immigrants feel more integrated and in the society. Turkish immigrants mostly experience discrimination in education life (27.3 %), labor market (30. 8.%), and while house seeking (50.3 %). 38.5 % participants also indicate that they felt very depressed and stressful after they experienced discrimination during the last ten years. Turkish immigrants (58 %) feel more discriminated in comparison to other immigrants.

The results of the study demonstrate that there is a relationship between having mental disorders and being discriminated in daily life as an immigrant.

Immigration entails uprooting and this is always a destabilizing event. It includes disorders in family life and a radical break with culture, values, among others. These events create a situation of uncertainty that exacerbates stress and anxiety.

Within this framework, we wanted to inquire about the state of mental health, and more specifically, about depression, in migrants.

A cross-sectional study was carried out that includes 272 migrants from different countries of the world, during the months of August and September 2020, through an anonymous, voluntary and multiple response type online survey which included questions about sociodemographic aspects and the Beck Depression Inventory. The survey was published through social networks (Facebook and Whatapp) in migrant forums around the world, mostly Spanish-speaking, because the survey was published in Spanish.

Of the 276 immigrants surveyed, an average age of 36.63 is seen. The 30% are single. The 30.79% are unemployed. 0.72% attended an immigrant reception centre. 99.63% have Spanish as mother tongue. 33.33% emigrated alone. The results of Beck’s questionnaire, 28.98% have moderate/severe depression. Of the total respondents, 49.63% have been an immigrant for 1 to 5 years. The 85,14% were in a regular legal-inmigration situation.

The immigrant population can be a group at risk for developing anxiety or depressive symptoms, especially when there is a situation of vulnerability and the necessary adaptation mechanisms for a satisfactory migration process cannot be guaranteed.

Psychiatry is a fascinating medical specialty. Many reasons may motivate early career doctors to choose this field. However, this experience could have a different impact on their quality of life and social functioning.

we aimed to assess the impact of psychiatry as a medical career, on the psychiatrist’s quality of life, and to evaluate their feedback on their experience and how it effects their life.

This is a cross-sectional descriptive study of 68 psychiatrists. An E-questionnaire has been sent via a psychiatrist’s closed groups on social media. We collected sociodemographic data, we also used the stress perceived scale, and we explored the quality of life using the SF-12 questionnaire.

The participants were mostly females with a mean age of 32 years (range25-65). Only 10% of psychiatrists had psychiatric history mostly depression. Concerning substance use, 15% were smokers, 17% used alcohol, 10% smoked occasionally cannabis and 23 % used different psychotropic drugs. 73% our sample were interested in psychiatry during their studies. 60% of our population considered the role of psychiatrists ambiguous among other colleagues. A very high perceived stress was noted in 90 % of our sample. Physical health status was in the average of standard deviation wether mental health status was below average among psychiatrists. The most frustrating situation mentioned was the absence of intermediate structures to receive psychotic patients.

Tunisians psychiatrists are facing many obstacles during the practice of their job, that would transform their passion into demotivation and a desire to leave the country.

It is not known with certainty how different phenotypes are transmitted in groups of families divided into three generations.

Having meticulously searched for terms of psychopathogic lexicon that best translated the sterile categorical diagnosis, we obtained three dimensional groups for all six families in the three generations.

We calculated the frequencies and percentages of the three dimensional groups for the three generations of families based on sex.

The chi-square TEST attests a p-value = 0.049, statistically significant for the dimensional group “A”. (Tab. 3)

The genetics, and above all the epigenetics, of the phenotypes are periodically transmitted in group “A” and group “C” in the female and male sex. (Graphs 2.1.1 and 2.3.1) Different phenotypes indicate that the complexity of the interactions of the regulatory mechanisms of genes with the environment is extremely significant for the group with the most severe psychiatric pathology.

Vaginismus is the most common reason for unconsummated marriages in Tunisia.

To describe the socio-demographic profile and to explore the clinical and cultural aspects of sexual functioning of women with vaginismus.

It was a cross-sectional study established over a period of 3 months from the November 1st, 2019 to January 31st, 2020. This study focused on a population of women with vaginismus recruited from outpatient consultations of the hospital’s gynecology and psychiatry departments at the regional hospital of Gabes. We used a pre-established sheet exploring socio-demographic data, medical and gyneco-obstetric history and informations concerning the partner, the marital relationship and the woman’s sexual activity.

35 women were included. They had a mean age of 30 years, jobless (54.5%) and with a secondary or university education (91.1%). The mean duration of marriage was 2.4 years. Partner had mean age of 36 and suffering from sexual dysfunction (21.3%). Among women, 12.5% had been sexually abused, 51.6% had suffered “Tasfih”, 70% had attended discussions about painful defloration. Vaginismus was primary in 85.7% and total in 50% of the cases. About the received thoughts of the women, 40% thought that vaginismus requires medical treatment, 13 of them (40%) thought that the disorder could be resolved spontaneously and 20% believed in a story of witchcraft. 85% consulted a physician and 24.2% a traditional therapist.

Vaginismus seems to be influenced by psychological and sociocultural factors so that a good psychoeducation of brides could reduce the incidence of this sexual disorder.

No significant relationships.

Child abuse is associated with a wide range of mental disease including psychotic disorders. Few studies have investigated the role of child abuse in contributing to increase the risk of psychosis in migrant population.

To explore the risk of first episode psychosis (FEP) in migrants and natives for each type of trauma i.e. physical abuse (P.A.), sexual abuse (S.A.), emotional abuse (E.A.), physical neglect (P.N.) and emotional neglect (E.N.).

Within a large case- control incidence sample of FEP from the EU-GEI study (The EUropean Network of National Schizophrenia Networks Studying Gene–Environment Interactions) we evalued the assocition of childhood trauma with FEP in migrants and natives. Associations were adjusted for age, gender, social status, level of education, family history of psychosis and cannabis use. Trauma was assessed through Childhood Trauma Questionnaire (CTQ).

CTQ mean score was higher in FEP migrants (45.4, sd 15.6) than in FEP natives (41.7, sd 13.9) (p = 0.002). In natives every type of child abuse was associated with FEP. In migrants P.A., S.A., P.N. were associated with FEP. We found a dose – dependent relationship between trauma and FEP.

Child abuse is common in individuals with psychosis. FEP migrants are more exposed to childhood trauma. Clinicians should routinely assess patients for childhood trauma. When treating a FEP migrant patient, clinicians must be aware of an underlying traumatic childhood adversity more than of a traumatic migration history.

Conventional psychiatric services are not always acceptable to indigenous communities and people.

To present successful models of interactions of psychiatrists with indigenous patients and communities based upon our work with five communities in Maine.

We reviewed the strategies that worked for community interaction from our project for supporting indigenous communities to implement medication-assisted treatment and we reviewed the literature to see what other strategies are reported successful.

Psychiatrists working in these communities may need to share more personal details than to what they are usually accustomed to be accepted. They may need to acknowledge local culture and spirituality and work with traditional knowledge holders to create collaborative healing approaches. As part of this, a narrative approach appeared to work best in which the psychiatrist worked within the stories and beliefs of the community which required taking the time in dialogue to learn those stories and beliefs. Specifically, we address the challenges of flying into northern, rural, and remote communities, of academic physicians consulting to tribal-based opiate treatment programs, of modifying usual counseling techniques such as motivational interviewing to an indigenous population, and of the changes made in practice styles when taking into account the critiques made by indigenous people about medicine in general and psychiatry in particular.

We propose that participatory action-based approaches can improve service delivery to indigenous people. Indigenous cultures share a collectivist mindset in which the needs of the group supersede the needs of individuals, a reliance upon stories, and commitment to a biopsychosocial and spiritual approach.

Cultural differences exist among indigenous and mainstream peoples about the nature of mind and how one achieves mental health.

We aimed to determine what is important and different for indigenous communities from non-indigenous communities.

We assembled a focus group of 109 indigenous and non-indigenous mental health counselors who worked in indigenous communities to meet weekly for 90 minutes via an internet platform (Zoom) for 810weeks with asynchronous communication between meetings.

The metaphor of the Four Directions, represented with different colors, attributes, and animals, was important in indigenous communities. Participants emphasized the idea of relational, non-local mind which places identity in the relationships between people rather than an individual body. Illnesses were seen as conscious beings who visit people and bring teachings. The healing, participants said, comes from reaching within the suffering and the pain to find the answer from within which makes meaning from an illness. People are expected to make offerings and sacrifices to the spirit of the illness to move toward wellness. These sacrifices can include lifestyle changes that the person might otherwise not make. Using substances without the proper protocols and prayers was likened to sorcery or witchcraft which can become a powerful incentive to stop disrespecting these substances and to find meaning in setting them aside with the help of a supportive community.

What participants saw as important for indigenous populations was different from what is usual for non-indigenous mental health services. Participants stressed the importance of non-indigenous providers understanding this and not dismissing these ideas.

In DRC, the North Kivu province has been plagued by recurring humanitarian crises for nearly two decades, with multiple displacements of populations triggered low intensity armed inter-communal conflicts spread throughout nearly all territories. 818,605 people (displaced, returnees and indigenous) affected by these movements are in alarming psychosocial vulnerability.

In 2019, the NGO Action contre la Faim started a psychological intervention with the objective to contribute to reducing the vulnerability of conflict-affected populations.

Participants have been identified through psychoeducation sessions in the community in which people recognizing corresponding symptoms in themselves were evaluated through a short one-on-one interview. Persons identified as particularly in distress, including those who have experienced gender-based violence, have been involved in a short group therapeutic intervention. Two different options have been proposed in order to evaluate the most effective for the specific context: six sessions with a weekly or bi-weekly frequency.

767 people participated in the psychosocial intervention, 457 with weekly frequency and 310 bi-weekly. The measures of post traumatic symptoms (PCL-5), anxiety and depression (HAD) and resilience (CD-RISC) show that the two approaches have the same positive effects. This is very important in volatile contexts with difficulties of access to the population due to security problems.

The fact that even a short intervention focused on a bi-weekly frequency, can reduce the distress and increase the psychological resilience of populations living in contexts of conflict, gives us the possibility of intervening in areas with limited access, while guaranteeing therapeutic efficacy.

In a globalizing world, the need for humans to understand one another is fundamental. Transcultural Psychiatry aims to bridge the differences due to culture, norms and values between doctors and patients.

To study the beliefs of Eastern and Western populations on the subject of religion, the paranormal and its relation to mental health.

The study was conducted targeting citizens of Eastern and Western countries (target sample size 200). A survey and 2 case studies were distributed, aimed to determine respondent’s level of belief in cultural superstitions and practices, views on mental disorders and opinions on treatment. A chi-square statistical test (significance set at ≤0.05) was performed to test validity.

are tabulated in Table 1. In the case studies, P-value =4.68x10-6 proves a strong relationship between East/West populations and their viewpoints on mental illness vs. possession. There is a strong relationship (p=3.37x10-5) between respondents’ beliefs in spiritual healing and its effectiveness in treating mental illness.

The study revealed that Eastern populations are far more superstitious and religious than their Western counterparts, and also have higher belief in the effectiveness of spiritual healing to treat mental disorders. This difference demonstrates the importance of integrating culture into diagnosis and treatment of mental illnesses, and further explore methods for more inclusive treatment plans.

Acute marital psychosis is an acute psychotic episode occurring in a particular context which is marriage. In fact, marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. This event can, in some people, induce a relapse of certain psychiatric disorders, particularly psychotic ones. We propose in this work to report two clinical observations concerning two brothers who both presented, a few years apart, an acute nuptial psychosis with two different evolutions.

Studing the characteristics of nuptial psychotic episode in a one family and the different evolution of each one.

Reporting two clinical cases of two brothers who represented both acute psychotic episode in a nuptial context with different evolution.

The two patients are brothers with common psychiatric background which is their mother treated for chronic psychotic disorder. They were hospitalized in our psychiatric service for acute psychotic episode occuring in a nuptial context with chronic evolution for the first one and a partial recovery for the second one.

Marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. In thiscontext, acute psychotic episode can occur with different evolution for patients predisposed. Studing socio-cultral circumstances related to psychotic episode can help mental health professional to improve the quality of health care service.

In Spain, we are forced to familiarize ourselves with Arab-Muslim culture to properly treat our patients. The diagnosis becomes complicatedbecause western health professionals are not usually familiar with thisform of symptom presentation.

The objective of this work is to study the influence of Arab culture and Muslim religion on the psychopathological symptoms presented duringa psychotic episode.

We present two cases of psychosis in two brothers of Maghreb originwho were treated for the first psychotic episode in the acute psychiatricunit in a Spanish regional hospital. Then, we carried out a litle researchfrom the literatura.

The common psychopathological symptoms presented by two brothersof 26 and 27 years were: symptoms of thought, control and influence of the self. Delusional ideas of self-referential harm and persecution. Auditory and cenesthetic hallucinations. In the literature we find that patients with Islamic backgrounds whosuffer hallucinations can attribute these experiences to different beliefssuch as geniuses (jinn), black magic and the evil eye. One of the siblings was diagnosed with a psychotic episode withoutspecification, while the other brother got the schizophrenia label. Webelieve that this may be related to the fact that mental healthprofessionals generally tend to label fantastic stories as mind-blowingor delusional in nature.

1. Religious beliefs and fantastic tales of Muslim culture can be considered psychotic symptoms if healthcare professionals are notfamiliar with this culture. 2. Teamwork between mental health professionals, translators and religious counselors can improve care for Muslim patients.

Under-diagnosis of depression is a concerning problem for Latvia. According to our previous research at least 115 000 new cases have to be diagnosed each year, but the data of National Health Service show that most of the cases remain undiagnosed and untreated.

To determine the point prevalence of depressive episode and associated factors in Latvian general population.

Computer assisted face-to-face interviews were carried out between November 2019 and March 2020 to gather information on a representative sample of the Latvian adult population (n=2687). The study sample was selected using a stratified random sampling method. The participants were interviewed using the Patient Health Questionnaire-9; a score of ≥10 was defined as indicating the presence of a clinically relevant depressive symptoms. Multinomial logistic regression was applied.

There were 1238 males (46.1%) and 1449 females (53.9%) recruited. Mean age of respondents was 49.9 (SD 18.2). The point prevalence of depressive episode in general population was 6.5% with statistically significant difference between genders: 4.8% in men and 7.7% in women (p=0.02). Lower level of education (p<0.001) and unemployment (p=0.01) were statistically significant associated factors for depressive episode among women. The odds of having depressive episode were higher in male urban dwellers (p=0.03) (but not in the capital city) and in man, who live separately, are divorced or widowed (p=0.004).

Females, especially unemployed women and those with unfinished education, are at particular significant risk of depression, which should be adressed in developing prevention strategy and screening programmes of depression.

The deficiency of polyunsaturated fatty acids (PUFAs) and an alteration between the ratio of omega-6 and omega-3 PUFAs may contribute to the pathogenesis of depressive disorders.

To investigate the levels of omega-3 and omega-6 in red cell membranes (mPUFAs) and plasma (pPUFAs) of patients with treatment-resistant (TRD) and non-treatment resistant depression (non-TRD).

TRD and non-TRD consisted of 75 patients enrolled at the Psychiatric and Clinic Psychology Unit of the University of Rome Tor Vergata, Rome, Italy, and met the DSM-IV criteria for major depressive disorder (MDD). A group of healthy controls (HC) matched for agender and age was enrolled. All blood samples were performed in conditions of an empty stomach between 07:00 am and 09:00 am. For each subject were obtained 5 ml of whole blood with the use of tubes for plasma with EDTA as an anticoagulant. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for omega-3 and arachidonic acid (AA) for omega-6 were measured.

Levels of pPUFAs did not differ between the three groups. The mPUFAs were altered in the MDD. TRD and non-TRD had lower EPA and AA values respect to the HC. DHA in red cell membranes was lower in TRD than non-TRD and HC.

Changes in levels of PUFAs in red cell membranes, but not in plasma, may be an important factor to evaluate the resistance to the pharmacological treatment.

In Cameroon, skepticism and neglect of doctors towards patients with mental disorders is noted. In order to change this, it was important to have an objective assessment. Depressive disorders are the most common form of mental disorders and Douala has the second largest number of general practitioners in the country. Thus, we proposed to evaluate the behaviour of general practitioners in Douala in front of patients with depressive disorders.

Evaluate the frequency of depressive disorders in outpatient general consultation Evaluate the competence of general practitioners at diagnosing depressive disorders Evaluate the practices of general practitioners towards depressive disorders Evaluate obstacles faced by general practitioners regarding depressive disorders

We conducted a cross-sectional descriptive study from February to June 2017 in the outpatient department. For each general practitioner include, we had 3 patients who complete the patient health questionnaire to find out if the patient has depression. During each consultation, we filled out a clinical fact sheet to determine if the general practitioner had diagnosed a depressive disorder. If so, what care has he taken? Finally, we gave the general practitioner a questionnaire to know his difficulties when facing depression.

We obtained a frequency of 32.5% of depressive disorders in consultation of general medicine in Douala and a rate of diagnosis by general practitioners of 1.92%. Diagnosed cases have just received counseling.

in Cameroon, despite the low interest in depressive disorders, they constitute a public health issue in Douala, and surely in Cameroon; Because of its frequency and the harm, they inflict on patients.

I don’t have any conflict of interest

There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear.

This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm.

The study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history.

The main findings of this study include statistically significant time x group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation.

These findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity.

Major depressive disorder (MDD) is a severe, disabling condition with unknown etiology. Misdiagnosis is common when clinical symptomology criteria are used solely. Considerable evidence suggests that the upregulation of inflammatory factors and cortisol, and a decrease in neurotrophic factors, are involved in the pathogenesis of MDD.

This study explored the application of platforms composed of these serum proteins in the objective diagnosis of MDD.

Serum samples from all participants including 30 MDD patients and 30 well-matched healthy controls were collected at enrollment, eight serum proteins selected initially according to previous studies were analyzed with ELISA. A logistic regression model with these proteins was built to construct the diagnostic platform for the MDD and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic potential of the model.

Among the eight selected proteins, three (TNF-alpha, IL-6 and IL-1beta) were removed because the measurements in more than 1/3 participants were below the detectable limits of ELISA kits. Forward logistic stepwise regression analysis screened out three serum proteins including BDNF, cortisol and IFN-gamma to build the model. The regression equation was Z = 1/[1 + e−(1.438+0.005(BDNF)-0.049(cortisol)-0.007(IFN-gamma))], and the diagnostic efficacy of thees three proteins-combined achieved an area under the ROC curve of 0.884 with sensitivity of 86.7% and specificity of 83.3%.

The results of this study provided a more reliable method to diagnose MDD, and the combination of serum BDNF, cortisol and IFN-gamma may provide an objective diagnostic platform for MDD.

The environment at medical colleges is competitive and typically generates higher stress levels. Both academic and psychosocial stresses appear to play a role, and the resourceful students who are able to employ effective coping strategies to deal with their stress are shown to outperform their peers in the academic settings.

Objective: To determine the Association of Perceived Stress and Coping Strategies with Depressive symptoms in students at a private medical college in Islamabad

Fourth and Final year medical students of Foundation university medical college were enrolled in the study. Beck’s Depression Inventory was used to assess the depressive symptoms, Perceived Stress Scale (PSS) was the tool used to look for the perceived stress and the coping strategies were assessed using the Brief COPE Inventory. Association of Perceived Stress and Coping Strategies with Depressive symptoms and other sociodemographic factors was established.

Out of 262 medical students studied, 211 (80.5%) had no or mild depressive symptoms while 51 (19.5%) had moderate to severe depressive symptoms. 66 (25.2%) had low stress, 127 (48.4%) had moderate stress while 69 (26.3%) had high stress. Chi-square test revealed that perceived stress, self-distraction, active coping, denial, substance use, behavioral disengagement, positive reframing, acceptance, religion/ spirituality and self-blaming had statistically significant relationship with presence of depressive symptoms among the target population.

Considerable number of medical students had presence of moderate to severe depressive symptoms in our study. Perceived stress and some specific kinds of coping strategies had significant association with presence of depressive symptoms among target population