It is suggested that parenting intervention programs can play a core component in early child development. Given the limited healthcare resources in developing countries, a group design intervention might be cost-effective.

Our objective was to assess the effect of parenting interventions in a cost-effective setting through group sessions CCD interventions on children’s development and behaviors in a non-Western, low/middle income country.

This randomized controlled trial was conducted in a public Pediatrics clinic in Isfahan, Iran. We included 210 pregnant women in their third trimester, and then followed their children for 18 months. The intervention group underwent 5 educational group sessions. The main outcomes were the children’s development and behaviors based on Bayley Scales of Infant and Toddler Development-III (BSCID-III) at 12 months and Children Behavior Checklist (CBCL) at 18-month of age.

Data of 181 children were analyzed (80 in the intervention group and 101 controls. The adjusted median differences were significantly lower in the intervention group than in controls for attention problems (-3.38; SE=1.59; P=0.035), anxiety problems (-2.28; SE=1.03; P=0.007) and pervasive developmental problems (-5; SE= 1.16; P<0.001) based on CBCL results. However, the difference of proportions was not significant in none of the BSCID-III domains in the intervention and control groups.Table 1-Results of BSID-III in intervention and control groups at 12 months of age a

We found that parenting interventions through CCD group sessions were significantly effective on several child’s behavior domains, but not on children’s development. Future longitudinal studies are necessary in this field.

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Growing evidence supports a possible link between gut microbiota and attention-deficit/hyperactivity disorder (ADHD) via the gut-brain axis. Short-chain fatty acids (SCFAs), the major metabolites produced by gut microbiota through anaerobic fermentation, may influence gut-brain communication.

To determine the alterations of gut microbiota and fecal SCFAs in children diagnosed with ADHD compared to healthy subjects.

Fecal samples were collected from children with ADHD (n=10), and age- and sex-matched healthy controls (n=10) for gut microbiota and SCFAs analysis.

There were no significant differences in the abundance of any bacterial phyla in feces between groups. However, fecal concentrations of acetic acid, propionic acid, and butyric acid were significantly lower in children with ADHD compared to those of controls (Figure1). Interestingly, acetic acid and propionic acid levels were negatively correlated with ADHD symptoms (Table 1). Macronutrient and fiber intake, determined from food frequency questionnaires, did not differ between groups.Table 1.The regression analyses predicting ADHD symptoms scores from fecal short-chain fatty acids level.

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Our findings suggested that gut dysbiosis was possibly developed in children with ADHD, as indicated by a significant decrease in fecal SCFAs. In fact, fecal acetic acid, propionic acid, and butyric acid may potentially be the early detector for ADHD. In addition, fecal acetic acid and propionic acid could be potential biomarkers for the severity of ADHD.

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Another pandemic besides COVID-19 stalks the land. This one takes a heavy toll on the young.

Suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 years old globally.

The objective of this review is to highlight for another tragic pandemic, with main emphasis on the preventable character.

Data was obtained through an internet-based literature review, using the research platform Pubmed and the World Health Organization website. Seven articles from the last two years were included.

Improved surveillance and monitoring of suicide attempts and self-harm is a core element of suicide prevention and desirable worldwide.

A public health surveillance system based on medical records would provide and disseminate data that would guide and prioritize the best interventions in each context and contribute to an effective overall suicide prevention strategy.

Close to 800 000 people die due to suicide every year, which is one person every 40 seconds.

According to current data, for each adult who died by suicide there may have been more than 20 others attempting suicide.

Effective and evidence-based interventions can be implemented to prevent suicide and suicide attempts.

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Suicide is a complex problem in which individual, family social factors are interrelated. The 1997 Asian financial crisis caused a major economic crisis in Korea, and Korea received bailout support from the International Monetary Funds(IMF) from December 23, 1997 to August 23, 1997.

This study aimed to investigate the relationship between the suicide rate of children and adolescents who grew up during this economic crisis in Korea.

Suicide rates are calculated according to gender, region, and age of 5 years (10-14 years old, 15-19 years old, 20-24 years old) using suicide death data from the Korea National Statistical Office from 2000 to 2017. The cohort of interest in the study is the group that was in childhood and early adolescence between 1997-2000 and corresponds to 1986-1995 in terms of birth year. Cohorts are divided into 1986-1989 (G1), 1990-1992 (G2), and 1993-1995 (G3) according to birth year. These groups were 8-14 years old for G1 and 5-10 years old for G2, 2-7 years old for G3 during 1997-2000, during the economic crisis. The Age-Period-Cohort analysis and linear mixed-effects regression models are used and the moderating effect on region and age is also analyzed.

The 10-24 year-old suicide rate was higher in males than females, in older age groups, earlier in birth years in the birth cohort, and in rural than urban areas. Suicide rates between the ages of 20-24 years were particularly high among men living in rural areas. During the national economic crisis, the suicide rate was higher among adolescents than preschoolers (G3 < G1) (p<0.001), and this trend was observed for both men and women. However, the main effect of the cohort was not observed at a statistically significant level.

The national economic crisis has a negative impact on the mental health of children and adolescents, and it is more negative for adolescents than for children, which can increase the suicide rate between the ages of 20-24.

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This umbrella review is the frst to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions.

This review aimed to be the frst to evaluate whether psychological trauma fulflilled criteria as a transdiagnostic risk factor cutting across various diagnostic categories and spectra. Transdiagnosticity will be assessed against the framework of the TRANSD criteria (Fusar-Poli, World Psychiatry 2019; 18 361-362). The paper additionally aimed to analyse the association of psychopathology with specifc trauma type.

We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classifed the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-efects p value, the 95% conf- dence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study efect, and excess significance bias. Additional outcomes were the association between specifc trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines.

Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across diferent diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR=2.92) and between childhood trauma and any mental disorder

(OR=2.90). Regarding specifc trauma types, convincing evidence linked physical abuse (OR=2.36) and highly suggestive evidence linked sexual abuse (OR=3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR=3.05); there were no data for emotional abuse with other disorders.

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These fndings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.

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Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia are among the most frequent developmental disorders in school-aged students, and both often cause an impact on scholar reading performance. Therefore, it is fundamental to trace the differential profile in reading performance in such diagnoses. Competent reading occurs through the interaction of several cognitive processes, such as decoding, fluency, and oral and reading comprehension, that should be assessed in an evaluation.

The study aimed to characterize the performance of students with ADHD and dyslexia.

We assessed 25 adolescents, aged between 11 and 14 years old, from 6th to 9th year of middle school of public and private schools in Brazil, divided into two groups: the group with ADHD (16 students) and the group with dyslexia (9 students). The diagnoses were established by a multidisciplinary center and there were no comorbidities for any case. The instruments used were: Comprehension Test of Words and Pseudowords II (TCLPP II) to assess decoding (indicate if the word is correct or incorrect); Reading Fluency Test (TFL) to assess fluency in single words and in text reading; Cloze Reading Comprehension Test (TCCL) to measure reading comprehension; and the WISC vocabulary subtest to assess auditory comprehension.

Non-parametric analyzes revealed statistically significant differences in measures of textual comprehension, especially in the tasks that involved decoding and fluency processes, evidencing superior performance of the group with ADHD in these tests. Participants with dyslexia had a significantly higher performance in relation to the number of word omissions, that is, they had lower omission errors. There was no significant difference between groups in auditory comprehension.

A differential profile was found in reading performance, consistent with the cognitive deficits classically pointed out in the literature for each diagnosis: phonological deficits in dyslexia, with problems in decoding and fluency; and attentional deficits in ADHD, with omission errors. In the comprehension measures, dyslexic group had significant lower performance than ADHD in the Cloze Reading Comprehension Test, but there was no difference in the Vocabulary subtest-WISC. An explanatory hypothesis is that, to understand the text, it is necessary to recognize the words previously, whereas, in the WISC, it is not necessary to read, since the questions are oral. These results corroborate the hypothesis that deficits in reading comprehension in dyslexia are more related to difficulties in word recognition and fluency skills than in general listening comprehension.

Financial support: CAPES Proex [grant 0426/2021, no. 23038.006837/2021-73]; CNPq [grant 310845/2021-1]

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Around 2010, the number of hikikomori cases increased rapidly. Hikikomori is a global problem that characterizes the current era, and has become an increasingly deep-rooted social issue that affects the younger generation, especially during the coronavirus disease-2019 (COVID-19) pandemic. In our previous comparative study of adolescent hikikomori between Japan and France (Hamasaki et al. BMC Psychiatry 2022; 22, 477), we investigated its psychopathology, including potential cultural influencing factors. The study showed no difference in terms of psycho-behavioral characteristics of hikikomori between Japan and France. However, the sociocultural factors that make hikikomori more severe differed between the two countries, i.e., in Japan: lack of communication between parents, in France: lack of communication between the family and the community.

Since these differences in sociocultural factors are closely related to the social context in which the mothers were placed, the factors in terms of maternal gender issues were examined, along with reviewing previous studies.

Statistical data from the “Global Gender Gap Report 2022” of the World Economic Forum, the “Towards real gender equality 2021” of the Ministry of Gender Equality, Diversity, and Equal Opportunities of France, the “Women and Men in Japan 2020” of the Gender Equality Bureau, Cabinet Office, Government of Japan, and other sources were evaluated. Further, previous literature on the family environmental factors of hikikomori were reviewed.

An absent father, a subsequent mother-child closeness and over-interference, and the inhibition of children’s independence, have been repeatedly mentioned in studies as factors leading to hikikomori. The time spent on housework and childcare by Japanese men is at the lowest level globally (Japan’s gender gap index ranks 116th out of 146 countries, the lowest among the seven major G7 nations). In Japan, where generally little cooperation exists between parents, particularly in those families where communication between parents is self-rated as relatively poor, the above factors may surpass the threshold for triggering hikikomori. In France (ranked 15th in gender gap index), the isolation of mothers and children from society is an important factor associated with hikikomori. Adequate social participation of the mother may be a protective factor against hikikomori.

Gender gap-related issues among mothers may be involved in the root of the hikikomori problem. Hikikomori has emerged from various socio-familial factors. Further studies are warranted to determine the causal relationships of these factors with the onset and severity of hikikomori.

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We introduce and present a psychotherapic technique initiated by Wilhelm Reich (1897-1957) in the 1920’s and thereafter expanded and refined with essential contributions by Elsworth Baker among others. We outline its theory and technical foundations and also provide an epistemologic interpretation of its peculiar body-mind representation based on character- and muscular armoring as a reaction to suffering; armoring of the ocular segment in the etiology of Bleuler’s schizophrenic splitting; and finally the consequences of armoring on the energetic functions as the logical development of Freud’s theory of libido, with significant theoretic, therapeutic and nosologic consequences.

The goal of my presentation is to avoid extinction of a valuable technique for future psychiatrists; moreover, to catch the interest of young collegues to a technique that integrates Bleuler’s psychiatric discovery with Freud’s psychoanalytic contribution and demonstrates that the old nosology and theoretical achievements in the psychic field were not as obsolete as today many think.

Research, book summaries, practical experience

Poster presentation

Poster presentation

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Manic and depressive mood states in bipolar disorder (BD) may emerge from the non-linear relations between constantly changing mood symptoms exhibited as a complex dynamic system. Dynamic Time Warp (DTW) is an algorithm that may capture symptom interactions from panel data with sparse observations over time.

The current study is the first to analyze a time series of depression and manic symptoms using DTW analyses in patients with BD. We studied interactions and relative changes in symptom severity within and between participants.

The Young Mania Rating Scale and Quick Inventory of Depressive Symptomatology were repeatedly assessed in 141 patients with BD, with on average 5.5 assessments per patient every 3 to 6 months. DTW calculated the distance between each of the 27*27 pairs of standardized symptom scores. The changing profile of standardized symptom scores of BD patients was analyzed in individual patients, yielding symptom dimensions in aggregated group-level analyses. Using an asymmetric time-window, symptom changes that preceded other symptom changes (i.e., Granger causality) yielded a directed network.

The mean age of the patients was 40.1 (SD 13.5) years old, and 60% were female. Idiographic symptom networks were highly variable between patients. Yet, nomothetic analyses showed five symptom dimensions: core (hypo)mania (6 items), dysphoric mania (5 items), lethargy (7 items), somatic/suicidality (6 items), and sleep (3 items). Symptoms of the ‘Lethargy’ dimension showed the highest out-strength, and its changes preceded those of ‘somatic/suicidality’, while changes in ‘core (hypo)mania’ preceded those of ‘dysphoric mania’.

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DTW may help to capture meaningful BD symptom interactions from panel data with sparse observations. It may increase insight into the temporal dynamics of symptoms, as those with high out-strength (rather than high in-strength) could be promising targets for intervention.

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Sadness, nostalgia, deep discomfort, guilt and feelings of loss, hopelessness are just some of the emotions that overwhelm people who are experiencing the death of a loved one (Franza et al. Psychiatr Danub 2022; 34 (8) 60-63). The unusual mourning process in the time of COVID-19 challenges the usual process of coping with loss. The absence of the funeral rite and coping in time of COVID-19 affects the grieving process. The consequences of “bodiless” bereavement in survivors of people who died during the COVID-19 pandemic may be similar to Post Traumatic Stress Disorder (PTSD) (Spurio. Psychiatr Danub 2021; 33 (Suppl 9) 102-107).

To evaluate the effects of the absence of the funeral rite on anxiety, depression, PTSD and hope in family members of people who have died from COVID-19.

In our observational study, 23 family members (12 females; 11 males; mean age: 48.56 yrs) who experienced a bereavement of a loved one without participation in funeral rites due to COVID-19 restrictions were recruited. They had turned to mental health professionals (psychiatrists and psychologists) as suffering from anxiety and depressive disorders. The subjects interviewed between the months of May 2020 and July 2020 (T0) were administered the following evaluation scales: Beck Hopelessness Scale (BHS), Beck Depression Inventory -2 (BDI-II); Anxiety Zung, and PTSD Checklist for DSM-5 (PCL-5).

The same scales were administered after 1 year (T1) and after two years (T2).

All the relevant data were analysed using EZAnalyze Version 3.0, Microsoft Excel Add-ln. Repeated Measures ANOVA Variables used for analyzing scales scores.

The main results are shown in Table 1. High values of hopelessness, anxiety and depressive symptoms were observed in T0. The score was reduced in the following times. In BHS the ANOVA results indicate that at least two of the repeated measures differed significantly (P – Unadjusted: T0 and T2: .003, T1 and T2: .009; P – Bonferroni: T0 and T1: .009, T1 and T2: 0.28). Similar results were highlighted in the Zung and DBI-II scales. These results indicate high levels of anxiety and depression at the beginning of the observation period (T0). The results for the assessment of PTSD indicate statistically significant differences (P. .000, Eta Squared: .378).

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Our little study evaluated some psychological factors in the emotional process of “normal” and complicated mourning. The loss of a loved one is inevitably an extremely painful event and is accompanied by a series of highly emotional experiential pathways. In the first months after death, family members have high levels of anxiety, depression, and hopelessness. There is a need to deepen the study with a higher number of participants and with a comparison with “normal” bereavement

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Mixed results have been reported on the association between prenatal cannabis exposure and preterm birth.

This systematic review and meta-analysis aimed to examine the magnitude and consistency of associations reported between prenatal cannabis exposure and preterm birth.

This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We performed a comprehensive search of the literature on the following electronic databases: PubMed, EMBASE, SCOPUS, Psych-INFO, and Web of Science. The revised version of the Newcastle-Ottawa Scale (NOS) was used to appraise the methodological quality of the studies included in this review. Inverse variance weighted random effects cumulative meta-analysis was undertaken to pool adjusted odds ratios (AOR) after sequential inclusion of each newly published study over time. The odds ratio and 95% confidence interval (CI) limits required for a new study to move the cumulative odds ratio to the null were also computed.

A total of 27 observational studies published between 1986 and 2022 were included in the final cumulative meta-analysis. The sample size of the studies ranged from 304 to 4.83 million births. Prenatal cannabis exposure was associated with an increased risk of preterm birth [pooled Adjusted Odds Ratio (AOR) = 1.35, 95% CI: 1.24-1.48]. The stability threshold was 0.74 (95%CI limit 0.81) by the end of 2022.

Offspring exposed to maternal prenatal cannabis use was associated with higher risk of preterm birth and it is strongly unlikely that any new epidemiological studies will change this conclusion. It is also plausible that avoiding cannabis intake during the prenatal period can reduce the risk of preterm birth.

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The sudden and large-scale Russian invasion of Ukraine has caused significant stress not only in Ukrainians but also in citizens of countries which have received the largest numbers of refugees.

The aim of the current study was to identify stress, resilience, and self-efficacy levels, as well as to examine the relationships between these variables, in a sample of women from Ukraine, Poland, Slovakia, and Romania during the third month of Russian aggression on Ukraine.

The study involved measuring a sample of Ukrainian (N = 82), Polish (N = 102), Slovak (N = 79), and Romanian (N = 42) women using the Perception of Stress Questionnaire, the Brief Resilience Scale, and the Generalized Self-Efficacy Scale in May 2022.

The results showed that during the third month of Russian aggression on Ukraine, stress levels and its components (emotional tension, external stress, and intrapsychic stress) were the highest among Ukrainian women and the lowest among Polish women. The sense of self-efficacy was the lowest among Ukrainian women and highest among Polish women, while resilience was the lowest among Ukrainian women and the highest among Slovak women.

Women from Ukraine reported being in the worst mental state compared to the rest of the sample. Moreover, a path analysis of the measured variables points to a multifaceted relationship between stress, resilience, and self-efficacy among women from Ukraine, Poland, Slovakia, and Romania during the third month of the Russian invasion.

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Psychotic experiences (PE) are strongly associated with non-suicidal self-harm (NSA). NSA are present throughout life, but are more frequent during adolescence and young adulthood. Early psychotic episodes (PEP) are a particularly vulnerable group compared to later phases of psychosis psychosis.

Analyze risk factors for suicide attempts and NSA, in order to improve early detection and prevention of suicides in adolescents and young adults with PD

Review in the literature of the different risk factors associated with parasuicidal behaviors in early psychosis

• • Presence of positive psychotic symptoms: auditory hallucinations, Delusional ideation.

• • Social isolation

• • Longer duration of untreated psychosis.

• • Comorbid symptoms: irritability, depression, anxiety, psychotic distress, insomnia.

• • Traumatic events in childhood

• • Difficulty in regulating emotional, impulsivity and sensitivity to reward.

• • Consumption of substances.

• • Psychosocial stress.

We consider essential the inclusion of early intervention programs aimed at the prevention of suicide and NSA, evaluating all risk factors for suicide and NSA among individuals with a PEP and high-risk mental states.

Initial assessment and ongoing assessments of suicide risk and parasuicidal behaviors, positive psychotic symptoms, depression, and the other related risk factors mentioned are required. Integrating trauma management into PEP care is critical.

Bibliography:

1.- Honings S, et al. Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis. Psychol Med. 2016;46(02):237–51. doi: 10.1017/S0033291715001841

2.- Honings S, et al. Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology. Psychiatry Res. 2016;245:267–75. doi: 10.1016/j.psychres.2016.08.002

3.- Nishida A, et al. Risk for suicidal problems in poor-help-seeking adolescents with psychotic-like experiences: Findings from a cross-sectional survey of 16,131 adolescents. Schizphr Res. 2014;159(2–3):257–62. doi: 10.1016/j.schres.2014.09.030 39.

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Numerous preclinical and clinical studies established the contribution of childhood adversity to acute stress vulnerability at adulthood. Several different physiological, psychological and behavioral factors have been suggested as putative mediators of this association. Sleep, and more specifically sleep disruption, has emerged as one such promising candidate. First, adverse childhood experiences have been repeatedly associated with adult sleep disorders. Second, individuals that suffer from stress-related psychopathology at adulthood often exhibit sleep disturbances, to the extent that sleep difficulties are diagnostic criteria for many of these disorders. Third, inefficient sleep pre and post exposure to acute stress was shown to increase the likelihood for maladaptive outcome, potently by impairing critical processes that occur during sleep as arousal regulation and memory consolidation.

To date, very few studies integrated these independent lines of research. Also, previous studies mostly assessed sleep via self-reported diary or a single night measurement at laboratory settings. The current study aimed to provide a more ecological and continuous account for sleep patterns, and their putative associations with childhood adversity on the one hand and vulnerability to acute stress at adulthood on the other hand.

Ninety-six healthy adult female participants completed the well-established childhood trauma questionnaire (CTQ) before wearing a wearable sensor for seven consecutive days and nights while maintaining their regular life routine. Following that, participants all underwent an acute laboratory stress induction procedure while their psychological and endocrine responses were recorded at multiple time points throughout.

Sleep patterns fully mediated the association between childhood adversity and psychological response to acute stress at adulthood (Figure 1). Specifically, elevated levels of childhood trauma were associated with more variation in sleep duration across the recording period, which in turn was associated with higher stress-induced negative affect. Interestingly, this association did not emerge with respect to mean sleep time nor with stress-induced cortisol release.

Results imply that childhood trauma may lead to irregular sleep patterns which in turn contribute to exaggerated emotional response to acute stress at adulthood. These findings support the mediating role of sleep in the link between childhood adversity and acute stress vulnerability at adulthood, and highlight sleep as a viable target for early or even preventive intervention.

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Evidence from contemporary research has highlighted abnormal subjective pre-psychotic experiences as an expression of schizotropic vulnerability, for which trajectories up to First Rank Symptoms have been described. Embodiment is crucial to the conceptualisation of these experiences as the distinctive feature of schizophrenic phenomena. In fact, these are embedded in precise experiential frameworks such as Diminished Self-Affection and Hyperreflexivity, which constitute in nuce the experience of Dis-Embodiment. The latter responds poorly to conventional therapies, thereby affecting considerably the prognosis quoad valetudinem of Schizophrenia.

This study is intended to explore the use of specific psychomotor therapy protocols aimed at fostering Embodiment in patients with Schizophrenia, especially by investigating its efficacy and specificity on self-perceived body disorders, on characteristic motor abnormalities and on psychopathological dimensions.

The study involves the participation of 20 patients throughout 10 weekly 90-minute meetings of Embodied Psychomotor Therapy (EPT) in groups of approximately 5 participants. Despite being partially inspired by current approaches, EPT is conceived as a specific activity intended for patients with schizophrenia: each meeting combines intersubjective coordination activities (complex motor sequences, harmonious control of voluntary movement and movement in space, body-awareness), intra-subjective coordination (mirroring, demarcation and identification of one’s own boundaries, single-group dynamics), and exercises aimed at developing motor skills (proprioception, balance, posture, rhythm and speed). At the beginning of the activity (T0) and after 10 meetings (T1) participants will carry out self-administered and externally administered assessments, for the evaluation of motor (BMS, LOFOPT, BBS, AIMS, SRRS), psychopathological (PANSS, FBF, ABP), social functioning (SOFAS) and daily physical activity level (IPAQ) dimensions.

The study is still ongoing, due to limitations dictated by the Sars-CoV-2 pandemic. Preliminary results at T0 indicate a positive correlation between low levels of daily physical activity (IPAQ) and poor functioning (SOFAS). Significantly higher motor impairment with respect to the general population is also confirmed in all motor scales used. Moreover, a positive correlation between low levels of motor coordination (BMS_MC) and balance (BSS_TOT) was found together with basic symptoms related to loss of control or self-agency (FCQ_KO). Furthermore, the first results suggest an overall improvement in motor performance at T1.

The longitudinal analysis will enable the extent of the impact of EPT on functioning, motor and psychopathological dimensions of the patients to be determined, providing useful elements for planning specific rehabilitation interventions for schizophrenia.

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Autism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental disorder, with both contribution of genetic and non-genetic factors. A collaboration of de novo mutations and prenatal with postnatal environmental factors are likely to play a role. ASD can be syndromic or non-syndromic. The etiology of non-syndromic ASD is still relatively undefined due to its genetic heterogeneity. Contrary to non-syndromic ASD, syndromic ASD is often associated with chromosomal abnormalities or monogenic alterations. Familial cases of ASD support the strong genetic component of ASD.

To collect clinical arguments supporting a genetic cause of autism spectrum disorder.

We present a clinical study of familial cases of ASD. The families were recruited as part of a collaborative project between the department of Medical Genetic and the department of Child Psychiatry in Hedi Chaker Hospital, Sfax, Tunisia. The clinical and paraclinical data were collected retrospectively.

Our study included 11 unrelated families from southern Tunisia, each with two ASD children, among them four couples of twins. Most families (80%) are consanguineous belonging to a middle socioeconomic class. None of the parents suffered from psychiatric disorder and a familial history of autism was reported in one family. Perinatal history, including advanced maternal or paternal age, fetal suffering and/or gestational problems, was found in 35% of cases.

The average age was 9.89 ± 3.787 (3 to 17 years) with a balanced sex-ratio.

ASD was syndromic in seven out of 11 families: facial dysmorphism in half of cases (6/11 families) and/or another comorbidity in 25% of cases (celiac disease, congenital heart disease or idiopathic hydrocephaly). ASD was associated with other(s) neurodevelopmental disorder(s) in all children. Most of cases (14/22) had delayed psychomotor development and all of them had intellectual disability with various degrees. Epilepsy was identified in three cases belonging to unrelated families. Other behavioral problem was identified in 65% of cases.

When the autism spectrum disorder is syndromic and/or associated with other(s) neurodevelopmental(s) disorder(s), this points more towards a genetic origin.

Our study highlights the interest of clinical investigations to determine genetic risk factors of ASD. The identification of a genetic cause in familial cases would contribute not only to better understand the pathological processes of ASD but also to provide an appropriate genetic counseling.

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The COVID-19 pandemic has had an unprecedented detrimental impact on mental health in people around the world. It is therefore important to examine factors that may buffer or heighten the risk of mental health problems in this context.

The current study explores the buffering effects of different flows of compassion (for self, for others, from others) and the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on indicators of mental health and psychosocial wellbeing.

4057 adult participants collected from the general community population across 21 countries from Europe, Middle East, North America, South America, Asia and Oceania, completed self-report measures of perceived threat of COVID-19, compassion, fears of compassion, social safeness, loneliness, depression, anxiety, stress, posttraumatic stress and growth.

Self-compassion moderated the impact of perceived threat of COVID-19 on depression, anxiety and stress, whereas compassion from others moderated the effects of fears of COVID-19 on social safeness. Fears of compassion moderated the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of fears of COVID-19 on social safeness. Furthermore, social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. The effects were consistent across countries.

Our findings highlight the universal protective role of compassion and social connection in promoting resilience and buffering against the harmful effects of the COVID-19 pandemic on mental health and psychosocial wellbeing. Furthermore, our results reveal that fears of compassion have a magnifying effect on the damaging impact of the COVID-19 pandemic on mental health.

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Alcohol Use Disorder (AUD) is one of the most significant public health problems in Europe, being highly associated with several medical and psychiatric comorbidities. Sleep disturbances are in this interface and may include insomnia, alterations of sleep architecture and circadian rhythm abnormalities, breathing-related sleep disorders, and sleep-related movement disorders. Also, considering the three stages of the addiction cycle (binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation) and since these domains are reflected in key regions of the brain, it is possible to map these nearly ubiquitous sleep disturbances.

This review aims to summarize the current literature related to the association between sleep disorders and AUD, with a focus on its clinical aspects and neurobiology.

Non-systematic research was made recurring to the PubMed database, with the keywords “alcohol use disorder”, “sleep”, “sleep disorder”. The most relevant articles were selected, focusing on articles published in the last decade.

In patients with AUD, the prevalence of insomnia ranges from 36-91%. A possible mechanism underlies in a mismatch involving maintained activity in wake-promoting structures during non-rapid eye movement sleep (NREM) and a blunted homeostatic drive. On the other hand, alcohol consumption also affects the normal sleep-wake cycle, due to a disruption in the underlying circadian rhythms, a mechanism compassed by the suprachiasmatic nucleus and by photic and non-photic cues. Considering this, it seems highly likely that insomnia and circadian abnormalities may coexist in some individuals. Moreover, AUD is implicated in initiation or worsening of breathing-related events in sleep, especially when having a history of snoring or sleep apnoea syndrome and in period limb movement disorder.

Simultaneously, sleep disorders in AUD can be incorporated into the three-stage addiction cycle. In the binge/intoxication stage, excessive alcohol intake leads to a faster sleep onset but poor sleep quality, explained by the effects on GABAergic systems. During the withdrawal/negative affect stage, there is a decrease in slow-wave sleep and limited rapid eye movement (REM) sleep recovery, which can be explained by the alcohol-positive allosteric modulation of GABAA receptor and other mechanisms. Lastly, during the preoccupation/anticipation stage, the glutamatergic system dysregulation contributes to persistent sleep disturbances, including insomnia, decrease in slow-wave sleep, and an increase in REM sleep.

The knowledge of sleep disturbances associated with AUD has grown and has suggested a bidirectional process that appears to play an essential role in the addiction process. Further studies investigating this association are warranted.

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As one of the most basic social institutions, the family plays an important role in different periods of people’s lives. One of these periods, which are usually associated with a crisis and change in the physical and mental conditions of women, is menopause, which requires the provision of suitable conditions for transition, especially in the family.

the purpose of this research is to study the role of interactions within the family in the psychological well-being of postmenopausal women.

To achieve this goal, qualitative content analysis method has been used. The main question of this research is how do family interactions play a role in the life of postmenopausal women? The participants of this research were 15 menopausal women aged 45 to 60 years old in Shiraz (Iran) who were selected using the purposeful sampling method. Data were collected, coded and analyzed using in-depth and semi-structured interviews. In order to achieve the accuracy and reliability of the data, Guba and Lincoln reliability criteria have been used.

The analysis of the interviews of the participants in this research led to the extraction of 6 subcategories included, “mental rumination in sexual relations”, “changes in marital intimacy”, “insufficient interactions in the family”, “resistant normative femininity and motherhood”, “fear of aging”, “female shame and taboo”, and the two main categories included “lack of awareness as a relationship parasite” and “destructive resistance”.

The findings of the research indicate that the family members’ lack of knowledge about this period and the prevailing culture of female shame and the taboo of women’s bodies make the family unable to provide the necessary support to menopausal women. On the other hand, keeping menopause a secret and emphasizing on maintaining pre-menopausal conditions by women is a destructive resistance that ultimately leads to psychological damage to them. Therefore, it is suggested that in addition to holding training programs for women in order to enter and face this period properly, trainings should also be considered for other family members and especially husbands (men). It seems that family members can play an effective role in various stages of menopause, including preparation and psychological adaptation of women by receiving correct training.

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There is a high prevalence of stress, anxiety, depression, and substance use disorders in college students globally. Financial stressors, course workload, peer pressure and other personal, family, and societal stressors contribute to the high incidence of mental disorders among college students. Despite the high prevalence of mental disorders in college students, barriers such as lack of mental health literacy, stigma of mental health, inadequate numbers of mental health counsellors and clinical psychologists supporting students in colleges in both low- and high-income countries, financial and geographical barriers often hinder college students from accessing the needed mental supports.

In this article, we provide a perspective on the ResilienceNHope program, an evidence-based text and email messaging innovation to close the psychological treatment gap and improve the mental health literacy of university and college students.

Review of literature. There is increasing evidence on the effectiveness and feasibility of mobile technology in health promotion and closing psychological treatment gaps. College students are well adapted to the use of mobile technology, particularly text and email messaging daily, which presents a unique opportunity for an innovative way to offer support for their mental health.

There’s evidence to support the findings that ResilienceNHope program, which involves the use of text and email messaging is an innovative tool which can be adopted to close the psychological treatment gap and improve the mental health literacy of university and college students

Supportive text messaging can be adopted to help support and improve the mental health of university and college students.

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