Dissociative Identity Disorder (DID), as defined in the DSM-5-TR, involves two or more distinct personality states within an individual, along with memory gaps for daily or traumatic events [1]. It is strongly associated with early trauma, such as childhood abuse, and linked to severe psychiatric comorbidities, including depression, anxiety, and self-harm, with an elevated risk of suicide attempts [2][3]. Stress-related neurobiological responses, particularly HPA axis hyperactivity, contribute to identity fragmentation in DID patients. Treatment, often through cognitive-behavioral therapy, aims to integrate dissociated states, reduce self-destructive behaviors, and improve quality of life [2][3].

In this case study, we present two compelling cases of dissociative identity disorder following a state of stress. We hope this case study will help reveal the possible association of the disorder with stress

This is a retrospective and descriptive case study aimed at exploring the manifestations and associated factors of dissociative identity disorder in patients who have experienced traumatic events.

Clinical Case Summary of Case 1 :

A 24-year-old student developed dissociative identity disorder after witnessing a fatal accident caused by a drunk driver. This trauma fragmented his personality into three identities: a child expressing needs through crying, a rebellious adolescent who smokes, and a feminine, seductive personality. These identities appear involuntarily, especially during periods of stress, causing him anxiety and memory loss regarding these episodes.

Clinical Case Summary of Case 2 :

A 23-year-old single, unemployed patient with a long psychiatric history was admitted following a suicide attempt by jumping. She experiences recurrent depressive episodes, suicidal thoughts, and engages in self-harm to manage her anxiety. Salma has dissociative identity disorder, with an alternate identity named “RUBY” that emerges under stress, driving her towards self-destructive behaviors and exacerbating her distress. Her history includes significant childhood trauma, such as sexual abuse and physical violence, contributing to her identity dissociation. She also exhibits alcohol abuse, consuming up to 1 liter daily to manage her anxiety.

Dissociative identity disorder is a complex condition, often linked to early trauma, characterized by the presence of multiple distinct identities within the same individual. This disorder causes significant distress and impacts patients’ daily functioning, especially in stressful situations. Treatment primarily involves therapeutic approaches aimed at integrating the different identities and reducing self-destructive behaviors. Understanding and managing this disorder require a personalized approach and long-term follow-up.

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War is the most powerful psychosocial stressor affecting all segments of modern Ukrainian society.

It was conducted a comprehensive examination of 176 patients of both sexes: Group I consisted of 101 military personnel; Group II - 97 volunteers; Group III - 95 IDPs in order to develop a system of personality-oriented treatment of stress-related disorders in persons affected by war.

Clinical and psychopathological examination, which included a structured interview and patient’s observation aimed at studying influence of socio-psychological and biological factors on development of post-stress disorders. Psychodiagnostic method include use: M-PTSD; HADS; HAM-A, HAM-D; Questionnaire of neuropsychological stress by T.A. Nemchin; State-Trait Anxiety Invertory; Methods of diagnosing coping behaviour in stressful situations; Impact of Event Scale-Revised; Clinical Administered PTSD Scale-CAPS; Traumatic Stress Questionnaire; Colombian Suicide Intentions Severity Scale; Methods for determining suicide risk and assessing self-awareness of death in patients with depressive disorder (Kozhyna H.M., Zelenska K.O., 2015); Methods for ‘Diagnosing the level of social frustration (Wasserman L.I., modified by Boyko V.V., 2002).

Clinical structure of stress-related disorders was presented by PTSD and adjustment disorders. Clinical structure of PTSD was represented by anxious, dysphoric, asthenic and somatoform syndromes. System of personality-oriented treatment was developed, including differentiated use of psychopharmacotherapy, psychotherapy and psychoeducation; creation of re-adaptive atmosphere; formation of health-centered lifestyle and based on a salutogenic approach. Pharmacotherapeutic component of developed program included differentiated, targeted use of SSRIs, SNRIs, antipsychotics, tranquilizers and anxiolytics. Psychotherapeutic program was based on identification of dominant resource channels for overcoming stress and finding inner stability using integrative model of psychological survival after severe stress, Basic Ph. Psychotherapeutic support included trauma-focused CBT for all patients, EMDR therapy with additional use of Pucelik Consulting Group’s PTSD Self-Management Program for servicemen patients in Group I; individual crisis therapy for patients in Group II; and interpersonal therapy for patients in Group III. For anxious depressive reactions, CBT and art therapy were used for all patients; with the additional use of problem-solving therapy for patients of Group I; Group II - individual crisis therapy; Group III - mindfulness techniques, relaxation training.

Effectiveness of developed system of personality-oriented treatment of stress-related disorders was proved, and positive dynamics of mental state, reduction of psychopathological symptoms, increased resistance, reduced levels of social and psychological frustration were established.

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In the Cognitive-Behavioral Conceptualization of Complicated Grief, avoidance strategies toward bereavement-related stimuli contribute to the development and maintenance of prolonged grief. Traumatic events, such as bereavement, often lead to intrusive negative thoughts and evoke painful emotions. For individuals experiencing prolonged grief, avoidant coping can deteriorate their symptoms. Deliberate rumination on the loss, as an active information-processing strategy to understand and find meaning in the traumatic experience, may promote adaptation to life after the loss.

This study aims to examine the impact of prolonged grief on approach-avoidance behaviors and to evaluate the effects of a deliberate rumination intervention.

Data were collected from 41 Korean adults aged 18 and above, who had experienced bereavement at least 12 months prior. Participants were randomly assigned to either a deliberate rumination intervention group (n=21) or a distraction intervention group (n=20). The Approach-Avoidance Task (AAT) was used to measure implicit approach-avoidance behaviors toward bereavement-related and neutral stimuli in each group, with assessments conducted both before and after the intervention.

The study results revealed no significant differences in approach-avoidance tendencies according to the level of prolonged grief for both bereavement-related and neutral stimuli. However, a significant interaction effect between group and time of measurement was observed for bereavement-related stimuli [F(1,39)=4.431, p<.05], but not for neutral stimuli [F(1,39)=.424, n.s.].

Although this study did not identify significant avoidance tendencies according to prolonged grief levels, it experimentally showed that deliberate rumination influences avoidance strategies among individuals experiencing prolonged grief. This finding implies significance in suggesting effective intervention approaches for those with pathological grief.

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Accumulating evidence identifies post-traumatic stress disorder (PTSD) as a significant risk factor for the development of dementia, with affected individuals demonstrating a twofold increase in dementia risk compared to the general population. Additionally, the development of dementia in these patients may exacerbate the clinical manifestations associated with PTSD, complicating proper management and treatment.

To describe a clinical case of a patient with a history of PTSD presenting with cognitive impairment, and to provide a brief review of the literature.

Case description and literature review.

A 65-year-old male patient, originally from Colombia, with a documented history of PTSD secondary to kidnapping and armed conflict, presented to psychiatric services in Spain for initial assessment and treatment. The family reports neglect of self-care, persistent hypervigilance, nightmares, and night screams, as well as multiple attentional failures, learning difficulties, and memory impairments. The patient was referred for a neurological consultation where the evaluation included a Mini-Mental State Examination (MMSE) scoring 16/30. Cranial MRI showed no abnormalities, and amyloid PET was negative. An FDG PET scan revealed discrete hypometabolism of the medial prefrontal cortex, which could be indicative of possible frontotemporal dementia.

The prevalence of dementia is rising globally. PTSD has been identified as a modifiable risk factor for developing dementia. Furthermore, studies show that the relationship between these conditions is bidirectional, with late-onset PTSD also potentially developing in patients with a diagnosis of dementia. The mechanisms underlying this relationship are poorly understood. It is hypothesized that both conditions share common pathophysiological pathways. PTSD manifestations in patients with dementia are often difficult to recognize, which is believed to result in an underdiagnosis of the condition. Additionally, these clinical manifestations can be confused with neuropsychiatric symptoms associated with dementia, further complicating diagnosis. The relationship between PTSD and dementia may be modifiable if patients with PTSD are provided with appropriate diagnosis and treatment, thereby improving their quality of life and prognosis.

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A human represents wholeness of biological, psychological and social nature and below impact of psychosocial stress preserves the homeostasis of the organism manifests a complete biopsychosocial response is therefore necessary in professional practice to be taken psychoneuroendocrine immunological approach in treating certain somatic and psychological.

Determining emotions, various types of aggression in people who have experienced a heart attack and is currently under the influence of chronic psychosocial stress of moderate intensity.

The examination was conducted on an outpatient basis on 14 subjects aged 51 to 72. age of male and female who experienced a heart attack. Applied: Azingerova aggression scale, PSQ stress test, Zung anxiety scale, Zung depression scale.

The respondents show a stress reaction at the level of moderate stress (30-60) with dominant feelings of: fatigue, tension, dissatisfaction, overload. Anxious symptoms are at the level of mild to moderate (45-59). Depressive symptoms are at the mild level (50-59). They have higher values on the aggression test. In both sexes (male and female) they have the highest values in self-aggression. Somewhat lower is verbal aggression while emotional aggression has average values. In the female gender, aggression is the lowest through physical force, while the use of aggression through physical force is occasional for men. Both sexes show little aggression towards objects around them.

In people with somatic diseases, in the case of a heart attack, emotions are high an important factor for their stability, especially the negative ones, and therefore it is necessarily needed an integrative approach to treatment, taking into account the mental state as a whole especially when they are in a state of psychosocial stress.

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Post-traumatic stress disorder (PTSD) is a chronic condition resulting from exposure to traumatic events. The utilization of stellate ganglion block (SGB) as a potential treatment for PTSD has garnered increased interest in recent years. SGB acts by blocking sympathetic outflow, offering promise in alleviating autonomic dysfunction associated with PTSD symptoms. However, the evidence supporting SGB’s efficacy compared to established recommendations remains limited.

To bridge this knowledge gap, a systematic review was conducted following PRISMA guidelines to assess the clinical applications and implications of stellate ganglion block (SGB) in the management of post-traumatic stress disorder (PTSD). The study aimed to identify pertinent literature, synthesize findings from diverse sources, evaluate outcomes of SGB therapy for PTSD, analyze factors such as anesthesia preferences and procedural methods, scrutinize symptom alleviation post-SGB sessions, explore reported side effects and symptom recurrence, and shed light on existing limitations within the current discourse on SGB’s utility in treating PTSD.

The systematic review involved the evaluation of 14 studies meeting predetermined inclusion criteria, incorporating a total of 550 participants. Notably, the majority of participants were military service members and veterans, with a median age of 36.9 years. The review focused on anesthetic practices, procedural techniques, timing of SGB administration, and symptom progression post-SGB therapy sessions.

Analysis of the selected studies highlighted the prevalent use of 0.5% ropivacaine as the preferred anesthetic for SGB, with the right-sided technique being the most commonly employed. Timing of the initial SGB session varied widely, with symptom improvement typically observed immediately or within the first week post-procedure. Positive outcomes often coincided with reductions in alcohol intake, medication use, and enhanced mood. Recurrence of symptoms was noted, necessitating additional SGB sessions, while reported side effects were predominantly mild and transient in nature.

While promising, caution is advised when interpreting the benefits of SGB due to challenges such as the absence of standardized clinical trial data, variabilities in reported outcomes, and potential reporting biases. Addressing these limitations through standardized assessment and reporting in future studies is crucial to enhance comprehension of SGB’s efficacy, safety, tolerability, and appropriate indications for treating PTSD. This endeavor is pivotal in advancing a more nuanced understanding of SGB’s role as a therapeutic modality in PTSD management.

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Diagnosing psychiatric disorders in individuals raised in orphanages is challenging due to symptom overlap. Trauma from institutional life can mimic symptoms of both Post-Traumatic Stress Disorder (PTSD) and paranoid schizophrenia (Hermenau et al. J Trauma Stress 2011; 24: 513-516). For example, PTSD symptoms like intrusive memories may resemble schizophrenia’s delusions when trauma affects threat perception. Additionally, PTSD-related attachment issues can exacerbate paranoia (Patel et al. J Trauma Dissociation 2016; 17: 123-136). Accurate diagnosis requires careful assessment of trauma history and symptom differentiation (Robinaugh et al. Depress Anxiety 2011; 28: 305-311).

Challenges of symptoms overlapping in schizophrenia, borderline personality disorder, and PTSD.

Effects of orphanage background and early trauma on psychiatric symptoms.

Diagnostic methods and evolving treatment plans.

Patient ZN, a 37-year-old female with paranoid schizophrenia and borderline personality disorder (BPD), has had 11 admissions over six years at our clinic. Despite treatment with DSM-5 criteria, PANSS, and BEST scales, using antipsychotics, mood stabilizers, and benzodiazepines, there was no significant improvement. This year, her hospitalizations increased, particularly after developing a strong attachment and maternal feelings toward a doctor who treated her three times consecutively. PTSD, relevant due to her orphanage background and initially unassessed, was later identified through screening. Data were recorded through clinical notes, informed consent was obtained, and the case study’s single-case design limits generalizability.

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Ongoing global conflicts have significant implications for the mental health of affected populations, with PTSD being one of the most prevalent disorders among those exposed to active violence.

To understand the importance of PTSD diagnosis and treatment in individuals exposed to active violence through the review of two clinical cases.

A clinical evaluation, diagnosis, treatment and follow-up of two patients (A and B) during their admission to our hospital and a literature review of diagnosis and treatment of PTSD.

We studied two patients from Armenia, a country currently engaged in armed conflict, who sustained injuries from a bomb explosion. Patient A had burns covering 18% of Total Body Surface Area (TBSA) and three fingers amputated, while B had burns in 50% of TBSA. Both were admitted to the Intensive Care Unit, where psychiatric evaluations were conducted, and then they were transferred to the plastic surgery unit for further care until discharge. During the first week of admission, symptoms such as flashbacks, nightmares, emotional numbness, feelings of fear, hopelessness, excessive guilt, insomnia, hypervigilance and episodes of depersonalization or derealization began to appear. Patient A exhibited an externalizing profile of symptoms (nocturnal agitation, crying and verbalization of guilt-related ruminations), while B presented an internalizing profile (affective numbness and dissociative episodes). Both cases were diagnosed with PTSD after more than a month of persistent symptoms. Psychopharmacological treatment was initiated after 20 days of hospitalization. Patient A was treated with quetiapine 200 mg/day for nocturnal agitation and sertraline 100 mg/day; while Patient B started sertraline 100mg/day and mirtazapine 15 mg/day. According to literature, first-line pharmacological treatment for PTSD includes SSRIs such as sertraline or fluoxetine. As a second-line we found mirtazapine, antipsychotics and prazosin. Benzodiazepines are not a choice and should be used cautiously (Schrader et al. MM 2021; 118 (6), 546-551). First-line treatment for PTSD is trauma-focused therapy and eye movement desensitization and reprocessing (EMDR) (Mann et al. TI 2023). In our case, such therapy was not possible to start due to language barriers and the severity of patients’ physical conditions. Notably, current clinical trials are exploring the use of psychedelics in therapy to improve PTSD symptoms (Krediet et al. IJNP 2020; 23 (6), 385-400).

PTSD is a relatively common mental disorder, affecting up to 11% of war victims. Early detection of symptoms is crucial to start an appropiate psychotherapeutic treatment. Although psychopharmacological interventions are recommended as a second-line treatment, they may sometimes be the only feasible option, as demonstrated in these two clinical cases.

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In addition to the typical risks associated with healthcare professions, being a midwife carries a significant psychological and emotional burden. This responsibility extends not only to the mother’s well-being but also to the newborn’s, making the role particularly vulnerable to psychosocial risks, often driven by high-stress situations.

To assess the post-traumatic stress disorder (PTSD) experienced by midwives.

We conducted a cross-sectional study using a self-administered questionnaire distributed to midwives in the Sfax region. The questionnaire consisted of a first part relating to socio-demographic and professional data and a second part relating to the evaluation of the PTSD in midwives using the Impact of Event Scale (IES).

Our population comprised 74 midwives with an average age of 45.6 ± 10.3 years. Only 21.6% reported engaging in regular physical activity. The midwives worked in both public and private health facilities, with a mean of job tenure of 20.3 ± 10.6 years. A stressful event in their professional life was reported by 68.8% of midwives. The PTSD was detected in 30 midwives (40.5% of the midwifery population surveyed), 8 of whom had severe symptoms. The traumatic events reported by the midwives were related to injury to the newborn, injury to the parturient or working conditions.

We found that the factors related to the PTSD were the number of dependent parents, a history of anxiety, depression or hypothyroidism, and working fixed hours. Physical activity was a protective factor against post-traumatic stress. A statistically significant link was found between severe forms of PTSD and taking leave in the last three months. Binary logistic regression confirmed that while physical activity was protective, anxiety, depression, and hypothyroidism were independent risk factors for PTSD.

PTSD is a common issue among midwives. It should be studied and identified early in at-risk populations to prevent lasting consequences.

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South African adolescents are exposed to significant levels of trauma exposure, resulting in high levels post-traumatic stress disorder (PTSD). Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD.

The current study aimed to determine the feasibility and preliminary efficacy of the SAASI on PTSD symptom severity and sleep disturbance when delivered in group format to South African adolescents with PTSD.

Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned to either one individual and four group sessions of the sleep intervention (SAASI) or a control group. At baseline, post- and 1-month follow-up participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).

There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect. Interaction between groups on the CPSS-5 was also not significant. Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment and at the 1-month follow-up suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention and control groups. Reasons provided for dropout were mostly school commitments or travel related.

Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.

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Background: The United Nations defines Human Trafficking as “the recruitment, transportation, transfer, harbouring, or receipt of people through force, fraud or deception, with the aim of exploiting them for profit,” and says it is practiced everywhere in the world. Studies show that women who have been trafficked for sex have higher levels of fear, are more isolated, greater trauma and mental health needs than other victims of crime, high rates of physical and sexual violence, memory loss, sexually transmitted diseases, and traumatic brain injuries. The present study attends to explore the mental health profile of a cohort of trafficked women from Egypt.

Studies show that women who have been trafficked for sex have higher levels of fear, are more isolated, greater trauma and mental health needs than other victims of crime, high rates of physical and sexual violence, memory loss, sexually transmitted diseases, and traumatic brain injuries.The present study attends to explore the mental health profile of a cohort of trafficked women from Egypt.

This study included detailed mental health assessments of 42 trafficked women in and around Cairo in Egypt. Data was collected by social workers. Assessments, Diagnosis and interventions were done by the author with the help of two clinical psychologists.

This snapshot study shows very convincingly that there’s a high burden of mental ill health among the trafficked women.Suitable therapeutic interventions may provide effective management and prevention of further deterioration of mental health issues of these vulnerable trafficked women.

This snapshot study shows very convincingly that there’s a high burden of mental ill health among the trafficked women.Suitable therapeutic interventions may provide effective management and prevention of further deterioration of mental health issues of these vulnerable trafficked women.

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Previous research has demonstrated a relationship between work-related stigma during the COVID-19 pandemic and posttraumatic stress disorder (PTSD). Whilst it is possible that shared social characteristics explain the link between stigma and PTSD, this article hypothesizes that work-related stigma is itself associated with symptoms of PTSD.

This study examined whether work-related stigma was associated with PTSD symptoms one year after the onset of the COVID-19 pandemic in a sample of French healthcare workers (HCWs).

Data were based on an online survey that recruited HCWs working during the first wave of the COVID-19 pandemic. The presence of PTSD symptoms was assessed using the Posttraumatic Stress Disorder Checklist (PCL-5) with a cut-off score of ≥33. Work-related stigma was defined as the perception of having been treated differently and unfairly because of one’s profession.The relationship between work-related stigma and PTSD symptoms was tested using propensity scores including all relevant confounding factors: financial and social support, and work-related,or pandemic-related factors.

Among the 655 respondents, 71.6% were physicians, 11.1% were nurses, and 17.3% had other occupations. A total of 53 participants (8.7%) presented symptoms of PTSD. We found an association between work-related stigma and PTSD symptoms (OR 2.13, 95% CI [1.04;4.35]) one year after the onset of the COVID-19 pandemic adjusted for propensity scores including relevant confounding factors.

Our findings suggest that work-related stigma is associated with PTSD symptoms among HCWs. This association was independent of social characteristics known to influence both stigma and PTSD. Work-related stigma may be a propitious occupational risk factor to target in order to improve HCWs work conditions and mental health.

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Firefighters face routine occupational risks and high-stress environments. Accordingly, 96.4% are exposed to a potentially traumatizing event throughout their career (Nazari et al. Work 2020; 67(1):215-222). This is accompanied by high rates of trauma-related mental illnesses (TRMI) such as PTSD. First-line treatments of TRMI remain limited. A novel treatment that has emerged, Ketamine-Assisted Therapy (KAT) has shown meaningful improvements in PTSD treatment (Ragnhildstveit et al.Ther Adv Psychopharmacol 2023; 6:13).

The primary objective was to synthesize prevalent themes among participants, shedding light on their journeys to accessing KAT as well as highlighting internal motivations and societal barriers that exist.

In this study, there are six working firefighters, diagnosed with TRMI. They have enrolled in but not begun the 12-week Roots to Thrive (RTT) KAT program. Interviews were conducted individually and transcribed for further analysis. Data from the interview responses was analyzed by two independent reviewers and coded to create main themes of focus. The inconsistencies were managed by the third senior reviewer.

The major themes prevalent among participants include social stigma, self-advocacy/education, logistical barriers and feeling stuck with previous treatments.Throughout the interviews, participants indicated that the use of ketamine and their mental illness diagnosis were stigmatized. Some kept their treatment a secret from family members while others reported telling very few colleagues about their PTSD. In response to traumatic events at work, one participant explained that the prevalent attitude was “Suck it up. Move on.” The lack of administrative support prompted several participants to teach themselves about psychedelics and mental health in order learn about treatment possibilities. Logistical barriers included barriers to physically commuting, paying for and having time away for the KAT sessions. They pointed out that aside from the price of the treatment itself, paying for cabs and ferries adds to the costs. Each of the participants detailed their journey with trauma and mental illness before KAT. A common sentiment expressed was that they couldn’t cope anymore with symptoms like night terrors and extreme anxiety. Participants discussed a gradual build-up and burnout, as one explained, “You continually are always going to other trauma calls, so it kind of builds up layer, layer, layer after layer.” A reoccuring theme in their experiences was trying different treatment modalities (EMT, EMDR and CBT) with little permanent success.

Greater funding, awareness and administrative support is needed for firefighters diagnosed with PTSD to successfully receive and undergo treatment.

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There is consistent evidence that increased self-compassion (SC) is associated with less posttraumatic stress disorder (PTSD) symptoms. However, knowledge about the contribution of SC to military-related posttraumatic sequelae among women combat veterans is sparse. Moreover, the underlying mechanism for the beneficial effect of SC remains to be determined.

The present study aims to examine the contribution of SC to PTSD and complex PTSD symptoms among female veterans as well as the mediating roles of coping strategies in these possible associations.

In a cross-sectional study, a volunteer community sample of Israeli women combat veterans (n = 885) and non-combat veterans (n = 728) responded to online self-report questionnaires.

Combat veterans reported higher levels of PTSD symptoms but not complex PTSD symptoms, SC, or coping strategies, as compared to non-combat veterans. Moreover, among combat and noncombat veterans, SC was associated with lower levels of PTSD and complex PTSD symptoms beyond adverse childhood experiences and combat exposure. Notably, SC was inversely and indirectly associated with higher levels of PTSD and complex PTSD symptoms through maladaptive coping strategies for both combat and noncombat veterans.

Reports of higher SC among female veterans are associated with less severe PTSD and complex PTSD symptoms. Moreover, maladaptive coping strategies might serve as mechanisms that link SC to military-related posttraumatic consequences.

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Digital phenotyping offers a valuable method for predicting and preventing nonsuicidal self-injury (NSSI) in daily life by providing objective, ecologically valid measurements at multiple time points. This approach quantifies an individual’s phenotype by capturing self-injury-related markers such as mood, step counts, and heart rate.

The aim of this study is to identify real-time predictors and to elucidate the dynamic trajectory of NSSI in individuals.

This study targets individuals in their 20s residing in South Korea who engaged NSSI on five or more days during the past year, and a total of 56 participants were included in the current study. Once participants were enrolled, active (e.g., ecological momentary assessment) and passive (e.g., heart rate, step count) data were collected via a smartphone app and wrist-worn wearables for 14 days. Initially, a random forest algorithm was employed to assess the relative importance of passive and active data in predicting NSSI thoughts. Subsequently, a multilevel logistic regression model was used to capture variability at both the within-person and between-person levels.

After inputting passive data into the random forest algorithm, the model demonstrated an accuracy of 0.619. Among the variables, walking stride had the highest importance score at 0.28, followed by heart rate (0.18) and heart rate variability (0.17). Subsequently, when analyzing the random forest algorithm with active variables, the model’s accuracy was found to be 0.666. In this case, anger toward others had the highest importance score at 0.26, followed by depression (0.22) and anger toward oneself (0.19). In a separate analysis using multilevel logistic regression models for each passive variable, none of the variables produced significant results in either the fixed or random effects analyses. However, when active variables were entered into separate multilevel logistic regression models, all emotional variables yielded significant results in the fixed effects analysis: depression (0.746, p < .001), anxiety (0.521, p < .001), anger toward oneself (0.475, p < .001), anger toward others (0.403, p < .001), loneliness (0.329, p < .001), and shame (0.557, p < .05). In contrast, none of the variables showed significant results in the random effects analysis.

The findings from this study could offer insights into novel mechanisms underlying the occurrence of self-injurious thoughts and their prediction in daily life. Additionally, this advanced approach may help identify optimal strategies for NSSI prevention and enable the delivery of personalized, real-time interventions.

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Clozapine remains one of the most effective antipsychotic medications for treatment-resistant schizophrenia. However, its use is limited by significant metabolic and rare neurological side effects. The variability in patients’ susceptibility to these adverse effects suggests an unidentified genetic predisposition, which is critical to personalizing treatment.

This review aims to systematically investigate the genetic variants involved in the development of metabolic and neurological side effects in patients treated with clozapine. Specifically, it seeks to elucidate the pathways participating in the occurrence of these adverse reactions and identify genetic markers for personalized therapeutic approaches.

A literature search was conducted across multiple databases for studies published in recent years. Data were extracted from cohort studies and case-control studies based on predefined criteria, using keywords such as “clozapine”, “metabolic side effects”, “neurological side effects”, “pharmacogenetics”.

Preliminary results identified that variants in the FTO gene, known for its role in adipogenesis and energy homeostasis, were linked to enhanced adiposity and altered leptin signaling, contributing to the metabolic syndrome. Similarly, APOE gene was strongly correlated with increased risk of severe weight gain, dyslipidemia, and insulin resistance due to association with impaired lipid transport and metabolism.

In the context of neurological side effects, SNPs within the DRD2 Taq1A polymorphism, which affects dopamine receptor density and signaling, were associated with a higher incidence of extrapyramidal symptoms and tardive dyskinesia in patients on clozapine. The COMT Val158Met polymorphism, known to modulate prefrontal catecholamine degradation, was linked to cognitive impairments and clozapine-induced sedation.

Next-generation sequencing (NGS) enlightens rare SNPs, copy number variations (CNVs) and novel variants in genes related to drug metabolism, such as CYP1A2 and CYP2D6, allowing for the identification of complex genetic interactions. Furthermore, patients with high polygenic risk scores (PRS) exhibited a markedly increased likelihood of developing severe metabolic and neurological side effects, underscoring the utility of PRS in stratifying patient risk.

In summary, our findings demonstrate that genetic factors are key contributors to the development of clozapine-induced metabolic and neurological side effects. Variations in genes related to drug metabolism, neurotransmitter regulation, and metabolic pathways significantly influence individual susceptibility to these adverse effects. A deeper understanding of pharmacogenetic approaches could offer the potential for more personalized and precise treatment strategies, reducing adverse effects and improving drug tolerance.

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Transcranial magnetic stimulation (TMS) is an established treatment for difficult-to-treat depression (DTD), demonstrating moderate efficacy. In comparison to other non-invasive treatments in psychiatry, TMS can be relatively accurately directed at specific cortical subregions. TMS is typically targeted at the dorsolateral prefrontal cortex (DLPFC) based on scalp measurements. However, the DLPFC is a large and functionally heterogeneous region, with inter-individual variability in the localisation of target functions. The functional connectivity of the stimulation target with other brain areas has been shown to correlate with treatment outcomes. Nonetheless, the clinical benefits of connectivity-based individualised targeting remain to be demonstrated in randomised clinical trials, and the connections to be considered in such targeting are still inadequately understood.

To test whether individualised network connectivity-based localisation improves outcomes, and to further investigate the relationship between clinical results and the stimulated connections

In this ongoing study, we acquire functional and structural MRIs from adult volunteers with DTD, referred to clinical TMS. We focus on brain regions associated with depression and emotion regulation to target the core affective symptoms of depression. We compute the individual connectivity distribution of these regions within the DLPFC. We then employ a realistic individual head conductor model to determine the coil position that aligns the distribution of TMS-induced electrical effects with the individual connectivity distribution. These coil positions, along with standard scalp-measure-based coil positions, are entered into the neuronavigation system, and patients are randomised 1:1 for the targeting used to receive intermittent theta burst stimulation over 20-25 sessions. Patients and outcome assessors remain blind to the targeting method, with the primary outcome being the change in the Montgomery-Åsberg Depression Rating Scale from before to after treatment.

Interim analysis conducted by independent evaluators, based on results from the first 20 patients per group, suggested over 80% power to detect group differences at an alpha level of 0.048, with 40 patients in each group.

To our knowledge, these would be the first results from a randomised prospective trial indicating the superiority of functional targeting over standard scalp measure-based targeting. While these targeting methods require further refinement, clinical applications will depend on the balance between effectiveness and cost compared to standard targeting. Related studies exploring the relationship between targeted brain connections and clinical outcomes may illuminate the brain-level mechanisms underlying recovery from depression.

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Theoretical analysis of the problem of anticipatory competence in adolescents with mental disorders highlights its insufficient study as an integral ability that contributes to their adaptation in society and the prevention of deviant behavior.

To identify and study the relationship between anticipatory consistency and deviations in adolescents with mental disorders.

The study involved 25 adolescents aged 12-14 (6A00.0, ICD-11) attending an educational institution for children with disabilities. The following methods were used: the “Test of Anticipatory Solvency” by V.D. Mendelevich, the “Test of Propensity for Deviant Behavior” by E.V. Leusa and A.G. Solovieva, and the “Study of Anticipatory Solvency in Adolescents” by A.I. Akhmetzyanova and T.V. Artemyeva.

Adolescents with mental disabilities exhibit varying degrees of motor clumsiness and difficulty judging distance in visual space. They struggle to predict the consequences of their actions and are not always able to foresee conflict situations in social settings, nor respond adequately in such interactions, which often leads to the development of antisocial behavior. The majority of adolescents with mental disorders (56% of the subjects) exhibit a situational predisposition to delinquent behavior, indicating a tendency to put their own norms and values in conflict with those of the group. Correlation analysis revealed a statistically significant relationship between personal-situational anticipatory consistency and the scale of delinquent behavior (r=0.416).

The findings of this study can be useful to practitioners working with adolescents with mental disorders, helping them to plan and organize corrective interventions that consider the development of this essential skill. Anticipatory competence is one of the factors necessary for successful socialization and the prevention of deviant behavior in adolescents.

This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program (PRIORITY-2030).

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Bore-out affects three times as many employees as burn-out. It results from a lack of activity during work, and the healthcare sector, due to its monotony, promotes the emergence of these disorders

Study the predisposition of hospital nurses to boredom, and investigate a possible relationship between this predisposition and their anxiety-depression profile.

This is a cross-sectional descriptive study conducted in April 2022 involving all nurses at the Sahloul University Hospital in Sousse. We used a pre-established questionnaire that included two validated tools: the Boredom Proneness Scale (BP) and the Hospital Anxiety and Depression Scale (HAD).

A total of 65 nurses took part in this study. The mean age was 36.62 ± 4.82 years and the sex ratio was 0.38. According to the BP Scale, 13 nurses were inclined towards boredom (20%). A predisposition to boredom has been observed among staff with less than 8 years of seniority (p= 0.001), those with no extracurricular activities (p= 0.020), those with a moderate or severe workload (p= 0.008), and those whose profession had no impact on their relationships with others (p= 0.012).The depression score on the HAD scale was moderate (32%), average (20%), and severe (12%). The HAD scale revealed that 29% of people had mild anxiety, 23% had moderate anxiety, and 12% had severe anxiety. No statistically significant relationship was found between the boredom disposition scale and the HAD scale.

Bore-out can worsen anxiety and depressive disorders by causing boredom and frustration. It is crucial to promote an engaging and varied work environment to protect employees’ mental health.

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Poverty’s impact on mental health and quality of life is well documented. Studies have shown that the high stress levels associated with poverty increase the risk of mental illness. Moreover, cognitive abilities seem to be influenced by a low socioeconomic level. Conversely, individuals who benefit from a better socioeconomic situation since childhood and throughout adulthood are more likely to succeed academically and professionally.

This paper examines the relationship between socioeconomic status and executive functioning in healthy Tunisian adults. It aims to determine if socioeconomic differences influence executive processes.

We conducted an experimental study with 95 Tunisian adults (ages 20-55) from the city of Tunis, divided into 4 socioeconomic groups (low, lower middle, higher middle, and high). We used objective and subjective socioeconomic measures and assessed cognitive and behavioral executive functioning through various tests, including the Stroop and Hayling tests, verbal fluency tasks, and the BRIEF questionnaire.

ANOVA analyses didn’t show global differences between groups, but Fisher Post Hoc tests revealed that participants from the highest socioeconomic group (group 4) performed better on several tasks. Group 4 showed faster processing times on Stroop tasks, better scores on the Digit Span Task, verbal fluency tasks, and the Modified Card Sorting Test, indicating a better processing speed and stronger cognitive flexibility and working memory. Behavioral executive measures also favored group 4 in areas such as working memory and task control.

This study highlights the clear advantage of higher socioeconomic status in executive functioning. Further research could develop strategies to improve cognitive functioning and quality of life for individuals with a lower socioeconomic level.

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