Feelings of unrealistic body parts are related to deficits in human information processing and can occur as a part of schizophrenic disorders or phantom sensations after amputation (Koide, 2008; Goller, in press). Experimentally induced sensoric illusions like rubber hand illusion (RHI) (Botvinik & Cohen, 1998) may help to understand basic information processing and could give new ideas for treatment or the rehabilitation process.

Factors that are related to modulate sensoric illusions during movement may help to develop new intervention strategies in the rehabilitation of illusory symptoms.

The goal of this study was to review the factors affecting persistence of the RHI effect during movement.

We selected 13 keywords and searched in the following www.dimdi.de data bases (CCTR93, CDAR94, CDSR93, DAHTA, DAHTA, EA08, ED93, EM00, EM47, HG05, KP05, KR03, ME00, ME60, PI67, PY81, TV01, TVPP). A total of 160 articles were found. Duplicates were removed and the remaining list was filtered with the objective to explore the influence of active or passive movement during experimentally induced RHI. Then we identified six articles which experimentally examined persistence of RHI during active or passive movements.

Results indicate that RHI are maintained during active or passive movements due to visual and temporal congruency. During active movements the RHI is more stable or global than in passive movements or during tactile stimulation.

Factores like visual and temporal congruency are related to maintain RHI and are discussed in the rehabilitation of phantom sensations or symptomes of schizophrenic disorders.

The shift to the online world supported by parents who actively encourage children to remain in the home; and typically justify the purchase of new technologies because of the danger of outside spaces as well as the educational role they are expected to play. The prevalence of social networking sites has certain implications for identity .

Determining the dominance of social networking sites (which largely of course means Facebook and Twitter at present) in the lives of the majority of teenagers which involve them dealing with three key public elements – profiles, friends and comments – which all have implications for the performance of identity.

Explaining the ways to reduce the effects of social networks on the identity crisis of youths.

The study was carried out on 150 boys and 100 girls from 11 to 15 years of age studying in schools, in Hamedan. In the 4 months of October to January,2013, the students were asked to write the summary of subjects they communicate online and the time they spent averagely online.

70% of boys exchanged songs and videoclips and photos related to sports and cinema actors of which 40% were abnormal. 40% of girls exchanged fashion and songs. Only 20% of both sexes talked about their school subjects online.

Social phobia has driven children to have a hidden identity to let them enter virtual world which can destroy their natural and real identity. It is necessary to construct special chatrooms for students to get involved in scientific and social affairs freely.

Frontal lobe deficits have often been reported in patients with schizophrenia. Recently, Dubois et al (2000) reported a short bedside cognitive and behavioral battery for assessing frontal lobe function in patients with neurological disorders. We hypothesized that cognitive functions of frontal lobe in schizophrenia could be evaluated with this battery.

27 patients with schizophrenia and 30 sex and age-matched controls were included. We performed FAB and Mini Mental State Examination (MMSE) in both groups and we correlated the scores of six subtests and the total FAB score with handedness, education level, age and duration of disease.

The FAB global score was significantly lower in the schizophrenia group compared to controls. There was negative correlation between the FAB scores and their age and duration of disease in the schizophrenia patients. Correlation between FAB scores and MMSE scores was evident in both groups.

The FAB is likely to be a useful and brief battery for assessing frontal lobe function in schizophrenia patients.

To evaluate the comparative efficacy of 3 antidepressants, each representative of a distinct psychopharmacologic class, in the treatment of depressive disorders associated to Parkinson disease with dementia (PDD).

A group of 23 patients, mean age 72.1, diagnosed with PDD for at least 2 years, who were admitted in our department for a major depressive episode (DSM IV TR), received antidepressant treatment with escitalopram (mean dose 15 mg daily, n=7), duloxetine (mean dose 45 mg daily, n=8) or trazodone (mean dose 150 mg daily, n=8). All patients received treatment for PDD with rivastigmine or donepezil continuously, for at least 12 months. The distribution of patients on the antidepressant treatment was randomized, in a single-blind manner. Patients were evaluated monthly, for 6 months, using Montgomery Asberg Depression Rating Scale, Hamilton Rating Scale for Depression- 17 items, Clinical Global Impression-Improvement and Mini Mental Status Examination.

Patients treated with duloxetine had the most significant improvement in the depressive symptoms, as the endpoint MADRS (-18.6+/-2.3, p< 0.01), HAMD (-13.2+/-1.1, p< 0.01) and CGI-I (- 3.2+/-0.5, p< 0.01) scores reflected. The differences between escitalopram and trazodone didn’t reach a significant level but, overall, both improved the depressive symptoms compared to baseline (p< 0.05). The difference between duloxetine and the other two antidepressants became significant after 8 weeks (p< 0.01). The severity of dementia symptoms didn’t vary significantly between the three groups at endpoint.

Duloxetine had proven itself more efficient than escitalopram and trazodone in the improvement of the depressive symptoms in PDD.

The aim of this study was to investigate the distribution of the regional cerebral blood flow (rCBF) in occupational related PTSD subjects and to seek for possible correlations between brain perfusion and self-rating scales (SRSs) in order to cross-check their diagnostic value and to look for their neural correlates.

Sixteen traumatized underground and long-distance train drivers developing (S) and 17 not developing (NS) PTSD after having experienced a “person-under-train” accident underwent clinical assessment and 99mTc-HMPAO-SPECT during trauma scripts. Statistical parametric mapping (SPM2) was applied to analyse rCBF changes in S as compared to NS, and to search for correlations between rCBF and SRSs scores, modeling age, months since trauma and the ratio ‘gray matter/intra-cranial volume’ as nuisance variables.

Significantly higher activity was observed during trauma script in left posterior insula, posterior cingulate, inferior parietal lobule, precuneus, and caudate in S as compared to NS. Impact of Event Scale (IES) and World Health Organisation (ten) Well-Being Index (WHO-10) scores highly correlated with tracer uptake to a great extent in the same regions in which rCBF differences between S and NS were found.

These findings support the involvement of posterior insular, cingulated, and parietal cortices (as well as the caudate) in the pathogenesis of PTSD and in the processing of related subjective well-being and distress. Our findings seem to provide a cross-validation for IES and WHO-10 scales by means of SPECT data, supporting their validity in the diagnosis of PTSD, and suggesting their use in future works.

Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail.

In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure.

Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity.

Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.

Kratom (Mitragyna speciosa) is an herb found in South East Asia belonging to the Rubiacea family, the active constituents being Mitragynine and 7-hydroxymitragynine. Sold as a dietary supplement in the form of a leaf, tablet, and powder, it has been gaining popularity as a natural supplement to alleviate pain, anxiety, depression, and manage opioid withdrawal symptoms. Our case report centers around a patient encountered with high-dose Kratom use who presented to our Psychiatric ER with psychosis.

The objectives of this case report are to raise awareness regarding the use of a newly popular substance easily available over-the-counter and the potential impacts it has on mental health.

PubMed was searched for the criteria Kratom AND Intellectual Disability, with a secodary search for Kratom AND Psychosis.

A 29-year-old male with a past psychiatric history of Schizoaffective Disorder, Borderline Intellectual Functioning, Polysubstance Use, ADHD, and six prior suicide attempts was brought to the Psychiatric ED by ambulance activated by his mother for severe psychiatric decompensation following ingestion of 270 pills of Kratom over the course of three days.

This case report further increases awareness of the dangers of Kratom use as well as brings to light the psychoactive properties of Kratom. This case report exposes areas where research can further expand understanding regarding the impacts Kratom can have on psychiatric populations.

No significant relationships.

While 1–Hz repetitive transcranial magnetic stimulation (rTMS) has been found to be effective in reducing auditory hallucinations (AH), its effects are transient. cTBS, a patterned-rTMS technique induces sustained long-term-depression-like effects. Here, we demonstrate efficacy of twice daily, bilateral-cTBS in a patient with treatment-resistant AH, reflex hallucinations and vision-touch synesthesia.

A 25-year-old male with 5 years history of treatment-resistant AH (2nd/3rd person), vision-touch synesthesia and reflex hallucinations. He was on a combination of 200 mg clozapine and 300 mg amisulpride for the last 6 months with no improvement. He received two-weeks of twice daily, bilateral-cTBS [40,1 s-trains (bursts of 3-pulses at 50 Hz every 200 ms) given continuously at 90% motor threshold] over the temporoparietal junctions located using the International 10/20 system. Amisulpride was stopped and clozapine was increased to 300 mg/day. Change in AH and synesthesiae were assessed using auditory hallucination rating scale (AHRS) and clinical interview.

AHRS scores reduced from 35/41 to 0/41 at the end of 2 weeks, with substantial improvement being noticed at the end of the fifth day. Synesthesiae and reflex hallucinations also showed similar trends in improvement. No serious adverse events.

Integration of auditory, visual and tactile perceptions is an important function of the temporoparietal junction. administering cTBS to this region bilaterally reduced our patient's perceptual abnormalities. Increasing dose of clozapine could be a confounding factor, however, the rapidity of treatment response enables us to attribute part of the improvement to cTBS.

The authors have not supplied their declaration of competing interest.

Schizophrenia (SCH) is one of the major and potentially severe mental illness that is characterized by both genetic and clinical heterogeneity. Thyroid hormone plays an important role in the development of the brain and nervous system both in the basic process of neurogenesis and of terminal brain differentiation. Type II deiodinase (DIO2) enzyme which has a critical role on thyroid hormone metabolism to convert pro-hormone thyroxine (T4) to the active hormone triiodothyronine (T3). Recently, DIO2 gene variations have been identified in association with mental disorders.

To investigate the potential genetic contribution of the DIO2 gene to SCH, we studied DIO2 Thr92Ala (rs225014) and ORFa-Gly3Asp (rs12885300) polymorphisms in a Turkish cohort of 290 unrelated SCH patients and 198 healthy controls. All subjects were genotyped by Taqman SNP genotyping assays.

Single marker analysis showed a positive association of SCH and rs225014. Particularly, Thr92Ala genotype frequency was significantly higher in patients with SCH than controls (p=0.045) and in male patients with SCH, both allele and genotype frequencies were significantly higher compared to male controls (p=0.03). Allele and genotype frequencies of ORFa- Gly3Asp polymorphism were no different within the study group.

These data show a potential role of DIO2 as a candidate gene for susceptibility to SCH and provide a strong evidence for a role of the DIO2 Thr92Ala allele and genotype in the etiopathogenesis of SCH with sexual difference.

Impairment of executive function is the fundamental feature of the cognitive dysfunction in schizophrenia has to be measured throughout the illness regularly. Computerized technologies for assessment of cognitive dysfunction are widely used. However, their applicability in hospitalized schizophrenic patients setting should be specially examined.

Executive function in schizophrenia.

To test the applicability of “CANTAB” neurocognitive battery for measurement of executive function in young hospitalized schizophrenic patients in Russian sample.

Fifteen inpatients diagnosed with schizophrenia according to ICD-10 (F 20.хх), 13 males and 2 females, aged 23.5(SD 3.2), disease duration is 5(SD 1.6) years and 16 healthy individuals, 7 males and 9 females, aged 21.3(SD 0.7). Spatial Working Memory (SWM) (Mnemonic Executive function), Stockings of Cambridge (OTS) (Planning Executive function), Intra/Extra-Dimensional Shift (IED) (Cognitive flexibility) were administered.

The majority of patients and controls easily understood the test instructions. Both groups did not have any difficulties with the touchpad. The “CANTAB” demonstrated sensitivity to the impairments of executive function. As a group, patients with schizophrenia performed significantly worse than controls on almost all tests: SWM–Between errors (P = 0.028), Total errors (P = 0.019), Strategy (P = 0.03), Mean time to last response (P = 0.001); OTS–Mean choices to correct (P = 0.044), Problems solved on first choice (P = 0.009), Probability of error given correct (P = 0.021); IED–Total errors (P = 0.015), Total trials (P = 0.002).

The “CANTAB” is an applicable instrument for assessment of the executive function in young hospitalized schizophrenic patients. It can be used both for experimental and clinical needs.

The authors have not supplied their declaration of competing interest.

Personality was shown to play an important role for well being under academic stress. The purpose of the present study was to evaluate how temperament and character traits predict academic burnout in Korean medical students.

One hundred and seventy-eight Korean medical students completed the Cloninger's temperament and character inventory (TCI) at the beginning of semester and Maslach burnout inventory-student survey (MBI-SS) was also measured around the final exam when academic stress and burnout is at the highest. The correlation between TCI and MBI-SS was examined and stepwise regression analysis was performed to measure how well personality traits predict academic burnout level.

The MBI-SS total burnout score was correlated positively with harm-avoidance (r = 0.247, P < 0.05) and negatively with self-directedness (r = -0.296, P < 0.001) and Cooperativeness (r = -0.169, P < 0.05) scores. The regression analysis showed that the harm-avoidance (β = 0.269, P < 0.001) accounted for exhaustion score and the self-directedness explained the Total burnout score (β = -0.296, P < 0.001) and Inefficacy score (β = -0.284, P < 0.001). The Cynicism score was accounted for high Novelty-Seeking (β = 0.150, P < 0.05) and low Cooperativeness (β = -0.182, P < 0.05).

This study showed that the Cloninger's temperament and character might explain the burnout level from the stressful medical education. The temperament of novelty-seeking and harm-avoidance could provide the susceptibility to the academic burnout and the character of self-directedness and cooperativeness might determine the resilience to the negative influence of academic stress.

The authors have not supplied their declaration of competing interest.

At resent 3desaides management of chronic mental disorders at psychiatric health association tobe high attention.

Determining effect of psychodrama on depression among women with chronic mental disorder.

This study was a quasi-experimental study that done in RAZI comprehensive psychiatric center. Community of this research consists of chronic mental patients bedridden at RAZI comprehensive psychiatric center that among them 30 women with chronic mental disease possess entrains criterions selected and with randomized permuted blokes’ allocation to two control and intervention groups. Then them depression examined with beck depression inventory (BDI). Then 12sessions hours long of psychodrama, 2ice per week, 6 weeks for intervention group enactment but control group received routine treatments. When the program ended depression of ills reexamined whit study instrument and analyzed with independent T test, paired T test kolmogroph smernophand Leven and covariance analyzes tests.

Main of depression before and after intervention at control group was not significant but at Intervention group was significant (P = 0.000).

At two groups after Intervention depression differences revolve significant (P = 0.000).

Comparison between main of depression after psychodrama even after modification of age and before intervention depression effect by covariance analyzes at two groups showed significant deferens.

Psychodrama leads to decrease of depression at intervention group.

The devastating effects of the current pandemic are profoundly affecting peoples’s physical and psychological health. Numerous studies on the effects of previous infectious outbreaks have been published. Similarly, an increasingly growing body of research on COVID-19 has been developed and released, reporting a substancial psychological impact of both the outbreak and the response, suggesting that the population may express high levels of psychological symptoms.

This presentation aims to synthesize existent literature that reports on the effects of COVID-19 on psychological outcomes of the general population, groups with higher vulnerability and its associated risk factors.

Bibliographic research was made through scientific databases such as PubMed and EMBASE. No time limit was used. Pertinent articles were carefully reviewed for additional relevant citations.

Generally, there is a higher prevalence of symptoms of adverse psychiatric outcomes among the public when compared to the prevalence before the pandemic. Psychological reactions to pandemics include maladaptive behaviours, emotional distress and symptoms of stress, anxiety, depression, and avoidance behaviors. The groups known to be at higher risk for mental health problems during the pandemic are: women, healthcare workers, people under 40 years old and with chronic diseases. Other risk factors are: frequent exposure to social media/news relating to COVID-19, poor economic status, lower education level, and unemployment.

The COVID-19 pandemic represents an unprecedented threat to mental health. In addition to flattening the curve of viral transmission, special attention needs to be paid to the challenges it poses to the mental health of the population at a global scale.

This double-blind (DB), relapse prevention, phase-3 study was designed to evaluate the efficacy and safety of paliperidone palmitate long-acting 3-monthly formulation (PP3M) versus placebo in delaying time-to-relapse of schizophrenia symptoms.

Adults (18-70 years old) with schizophrenia (DSM-IV-TR) were treated with PP (17-week, open-label [OL] transition phase: 50, 75, 100, or 150 mg eq, once-monthly, [PP1M]; 12-week OL maintenance phase: 3.5-fold PP1M stabilized dose, single injection), and then randomized (1:1) to PP3M fixed doses (175, 263, 350 or 525 mg eq.) or placebo.

305/506 patients enrolled were randomized (PP3M: n=160; placebo: n=145); majority were men (75%), white (59%), mean age 38.4 years. Interim analysis results favored PP3M vs. placebo (p = 0.0002, two-sided log-rank test; HR: 3.45, 95% CI: 1.73; 6.88); median time-to-relapse was 274 days in placebo and not estimable in PP3M group. Final results were consistent with interim analysis. Both PANSS total score and CGI-S score showed a significant effect over time in PP3M- vs. placebo-treated patients (p>0.001). 330/506 (65.2%) patients in OL phase and 183/305 (60.0%) in DB phase (PP3M: 61.9% vs. placebo: 57.9%) had ≥1 treatment-emergent adverse event (TEAE). The TEAEs noted more frequently in PP3M-vs. placebo (DB phase) were nasopharyngitis (5.6% vs. 1.4%), weight gain (8.8% vs. 3.4%), headache (8.8% vs.4.1%) and akathisia (4.4% vs. 0.7%).

Compared with placebo, PP3M significantly delayed time to first relapse in patients with schizophrenia, previously treated for 4 months with PP1M. PP3M was tolerable with a safety profile generally consistent with other marketed formulations of paliperidone.

Several reviews have reported the incidence of schizophrenia in patients with eating disorders (ED) to be between 3–10% and the incidence of transient psychotic episodes to be 10–15%. On the other hand, anorexia nervosa appears to affect 1 to 4% of schizophrenia patients. Reports of psychosis and ED occurring in the same patient have led to various views as to the nature of the relationship between the two.

Analysis of the literature illustrated by different clinical cases in which appears to be a relationship between ED and psychosis.

Critical reflection about the hypothesis that could underlie the comorbidity of psychotic illness and ED.

Non-systematic review of a literature search using the keywords: eating disorders; psychosis; comorbidity.

There is no consistent sequence in the co-occurrence of the two conditions – ED sometimes precede and sometimes follows the onset of psychosis. ED patients can develop psychotic symptoms, most frequently transient in the course of the disorder, while others are subsequently diagnosed with a chronic psychotic disorder. On the other hand, patients with a primary psychotic illness can develop an eating disorder. The connection between the two, however, remains speculative, considering the hypothesis that ED and psychosis can be entirely separate disorders that can, by chance, occur in the same person.

The area of comorbidity and overlapping symptoms in psychiatry requires more deep research. Despite evidence from case series, the comorbidity between ED and psychosis is poorly understood, and firm conclusions cannot be drawn from this analysis.

The authors have not supplied their declaration of competing interest.

To describe reasons for not seeking professional help at the age of 17-18 years, when a need for mental help is present.

In a person identifiable survey among 3278 Finnish adolescents 15-16 years old at baseline, reasons for not seeking professional help were studied among respondents of a two-year follow-up, who had reported a need for help for a mental health problem but had not sought professional help(n=128). The respondents were instructed to choose from the following list all alternatives describing their situation: thought that the symptoms will eventually alleviate anyway, unsure about who to turn to, felt too exhausted to get help, anxious of somebody finding out, negative experiences of dealing with health professionals, distrusted the effectiveness of professional help, turned to parents for help, parents estimated that there was no need for professional help, turned to friends for help,. friends estimated that there was no need for professional help.

The three most common reasons for not searching for professional help were, the notion that the symptoms would alleviate without help (71%), exhaustion (43%) and turning to friends for help (26%). Uncertainty about to whom to turn and exhaustion were more common among those with depression compared to those with no depression (33% vs 14%, p=0.025 and 55% vs 35%, p= 0.042).

Mental health literacy of late adolescents must be enhanced in order to make them take mental health problems seriously enough to get professional help.

Existential anxiety (EA) has been described as the anxiety about the meaning of life, death and the necessity to make choices (Tillich, 1953).Although recent research found EA to be associated with trauma and general psychological symptoms in community samples (Weems et al. 2004), to date, no study has investigated its relationship with trauma exposure and posttraumatic stress disorder (PTSD) symptoms in psychiatric outpatients.

To examine the association between EA and self-reported trauma history and PTSD symptoms in psychiatric outpatients.

Seventy-two stable psychiatric outpatients (mean(SD) age=46.1(14), 55% females) were assessed with the Existential Anxiety Questionnaire (EAQ; score ranging 0-39), the Trauma History Questionnaire which reports on criminal experiences, natural disasters, death exposure and questioning about physical and sexual experiences, and the PTSD Checklist (PCL; score ranging 17-85).

Mean(SD) EAQ and PCL scores were 20.0(7.8) and 40.0(15), respectively. A majority of participants (93%) reported at least one lifetime trauma exposure. Results revealed a positive correlation between existential anxiety and lifetime trauma exposure (r=.28, p< .05).Furthermore, in patients with lifetime trauma exposure, increased EA was associated with increased PCL total score (r=.57, p< .001) as well as with all PTSD symptom clusters: re-experiencing (r=0.45, p < 0.001), hyperarousal (r=.51, p< .001) and avoidance (r=.53, p < .01).

Our findings suggest that EA might be an interesting construct to examine further in the assessment and treatment of PTSD and paves the way for empirical investigations of existential therapies.

A new computerized cognitive behavioural therapy (CCBT) program was offered to consecutive referrals to the clinical psychology department where the referral letter had noted the presence of depression/low mood as a major problem. The exclusion criteria were age below 16 or above 65, current active suicidal intent, psychosis and an inability to read.

Seventy-eight consecutive referrals were offered an appointment for CCBT; 20 (26%) attended at least one session of CCBT and 14 (70% of starters) completed all six hour-long sessions. A clinically and statistically significant fall of over 11.07 points (SD 6.16) on the BDI-II occurred between baseline and 6 weeks, from a mean score of 30 (severe) to 18.93 (mild). The equivalent mean differences between the baseline and 6-week scores were 7.66 points for the BAI (SD 11.25), 2.93 points for the BHS (SD 5.54), and –3.93 points for the SASS (SD 8.35). Beck Depression Inventory scores (BDI-II) fell from a mean of 28.15 (SD 11.41) to 20.00 (SD 10.41) (p=.000) over the 6-week intervention period using an intention to treat analysis. The mean time with a self-help support nurse supporting their use of the CD Rom was 52 minutes in total.

Only a quarter of patients on this psychology waiting list chose to use a CBT CD-Rom. The package seems to lead to improved mood. A randomised controlled study is required and is in progress.