Referral is not a necessity for a patient who wants to get psychiatrist consultation in Latvia. The good thing about it is the availability and the possibility to consult with highest educated mental health specialist for any person in society without barriers. On the other hand, there is an overwhelming work load for psychiatrists.

To explore the prevalence of self-referred patients in out-patient care and the adherence to psychiatrist recommendations.

The medical documentation of all consecutive first-time out-patient center “Pardaugava” psychiatrist patients over the period of 01.01.2020. to 30.04.2020. with one year follow-up was analyzed.

236 patients were included in the study, 31.2% of them were men. The average age was 49 (SD ± 22.65) years. Patients with Affective (F3X) and Neurotic (F4X) disorders were self-referred more often compared to Organic mental (F0X) disorder or other spectrum patients (83.3% and 77.5% vs 33.3% or 56.0%, p<0.001). Median appointment count was 4, higher in F4X (6) and lower in F3X patients (2). Majority of F4X patients (61,6%) did not follow the recommendations or stopped seeing psychiatrist, while only 13,7% were persistent. Сonversely, 48,4% of F3X patients followed the recommendations and only 43,5% stopped. In comparison, other spectrum patients followed recommendations in 32.0% of cases and ignored - in 56.6%.

Patients were actively self-referring themselves to psychiatrist. Highest adherence to psychiatrist recommendations was found in patients with affective disorders compared to other spectrum patients. In contrast, adherence was the lowest in patients with neurotic disorders.

No significant relationships.

Analytical-cathartic therapy (ACTA), a modern model of psychotherapy, the theoretical basis of which is the psychology of relations of V.N. Myasishchev. ACTA is intended for the treatment of emotional disorders; the study of the dynamics of clinical and pathopsychological characteristics has not been previously conducted.

To assess the dynamics of the clinical and pathological characteristics of patients with neurotic disorders, in whose clinical picture anxiety syndrome predominated, in the process of an individual ACTA.

A specially designed semi-structured interview, HARS, and the CGI (CGI-S - disease severity, CGI-I - improvement dynamics). The study group (N = 90) included patients with neurotic disorders, whose clinical picture was dominated by anxiety syndrome

AKTA course 12 sessions 3 times a week for 60 minutes. Psychopharmacotherapy during the period of psychotherapeutic treatment in patients was not carried out.

The study of ACTA was carried out before, after treatment and in the follow-up.

The overall decrease in the HARS score was 73.8% - the high success of the therapy in relation to the reduction of anxiety.

On the CGI-I scale - improvement from minimal to significant. On the CGI-S scale, no more than mild disease severity (p <0.01). The change in the CGI scale also indicates the success of the therapy.

As a result of the study, clinical indicators were determined, on the basis of changes in which in dynamics the success of the treatment can be assessed. ACTA allows to clearly reduce anxiety and improve the general condition of patients with neurotic disorders.

No significant relationships.

Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship.

Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3–42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life.

Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29–1.61], other psychotic disorders (HR 1.41, 95% CI 1.27–1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37–1.54). Relationships persisted in models that included illness in brothers.

Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.