Mental health literacy (MHL) is crucial for undergraduate students as it empowers them to recognize, understand, and address mental health challenges. This knowledge contributes to improved happiness by reducing stigma, fostering resilience, and promoting positive coping strategies. Enhanced emotional well-being results from effective stress management and the ability to seek help when needed. Ultimately, mental health literacy positively influences academic life satisfaction by creating a supportive environment, reducing the impact of stressors, and fostering a holistic approach to well-being in the challenging context of higher education.

To assess the association between MHL and satisfaction with academic life, happiness, psychological well-being and psychiatric symptoms in undergraduate students. It also aimed to analyse the relationship between MHL and sociodemographic and clinical characteristics of these students.

Under the ongoing prospective project called “SMILE”, this preliminary study integrated a sample of undergraduate students from a private higher education institution in northern of Portugal. The research protocol included a semi-structured interview (sociodemographic and clinical data) and the Mental Health Literacy Questionnaire (MHLq-SVa), Satisfaction with Academic Life Scale (SALS), Subjective Happiness Scale (SHS), Psychological Well-Being Scale (PWBS) and Depression Anxiety Stress Scale (DASS). Non-parametric statistical tests were used, as the data did not follow a normal distribution.

Twenty-four students were evaluated (75% female, 92% single; mean age=25.5y y.o.). Around 67% were nursing students and 42% in their 4th year. Regarding support needs for mental health problems, 74% had support at some point in their lives and about 17% were currently receiving support. (22% were taking psychotropic medications). Also, 57% had a family history of mental disorders. Women had a greater knowledge of mental health problems (MHI domain), compared to men (median=28vs.25; p=0.025). This MHL domain was negatively correlated with satisfaction with the academic environment (rs= -0,571). Higher scores in MHL total and in its self-help strategies domain were identified among students with previous mental health support needs (median=72vs69.5, p=0.20; median=19vs18, p=0.44, respectively). Lower level of erroneous beliefs/stereotypes (MHI domain) were more evident in students with family mental health history (median=15vs13.5, p=0.007). No relations were found between MHL and other assessed variables.

These findings are important for designing interventions to promote mental health in academic contexts, aimed at positive and healthy changes in the academic environment, particularly in line with their expectations and needs, with the aim of reducing levels of psychological distress.

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Job satisfaction and psychological distress are pivotal elements in the overall well-being of healthcare professionals, whose work environment is inherently challenging and stressful. High levels of job satisfaction are essential for the health, motivation, and performance of the workforce, and for ensuring high-quality patient care and the effective functioning of the healthcare organization. Conversely, psychological distress among healthcare workers can result in burnout, a reduction in the quality of care provided, and an increase in turnover rates. This study examines the complex factors influencing job satisfaction and psychological distress, with the aim of providing a comprehensive understanding that can inform the development of interventions and policy changes within healthcare settings.

The purpose of this study is to explore the factors that contribute to job satisfaction and psychological distress among medical and nursing staff. By identifying conditions that lead to increased satisfaction or distress, the research seeks to propose actionable strategies to improve the working environment and reduce psychological strain among healthcare workers.

This research employed a quantitative approach utilizing a specifically designed questionnaire that incorporated the DASS21 (Depression, Anxiety, and Stress Scale) and the K6+ scale for measuring psychological distress. The sample consisted of 132 healthcare professionals, selected through the snowball sampling method. The questionnaire was based on a comprehensive review of the literature and included measures to assess job satisfaction, anxiety, stress, and psychological distress.

The findings indicate that the majority of healthcare workers perceive limited opportunities for job advancement and salary increases. Furthermore, communication within organizations is perceived as moderate, and employees report that their efforts are not adequately recognized or rewarded. These factors are associated with both job dissatisfaction and increased psychological distress, as measured by the DASS21 and K6+ scales.

The findings of this study highlight the imperative for systemic reforms within healthcare organizations to enhance job satisfaction and mitigate psychological distress among healthcare personnel. It is recommended that strategies include the creation of more transparent pathways for career advancement, the fostering of a supportive and communicative work environment, and the implementation of recognition programs that validate and reward employee contributions. It would be beneficial for future research to investigate the long-term impact of such interventions in order to ascertain their efficacy in maintaining positive changes within healthcare settings.

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Burnout is defined by the WHO as “a feeling of intense fatigue, loss of control and inability to achieve concrete results at work”. Among the most affected populations, are medical and paramedical teams, particularly those exposed not only to a sustained work rhythm but also to frequent confrontations with suffering and death, such as emergency staff.

Evaluate the frequency of burnout among medical and paramedical staff and determine the factors associated with it.

A 1-month cross-sectional study (November to December 2023) was conducted in the emergency department of Charles Nicolle’s hospital, Tunis. We included all medical and paramedical staff. Data were collected using an anonymous online questionnaire on Google Forms. We used the Maslach Burnout Inventory (MBI) as a rating scale.

Forty-five forms were completed. The average age was 29 ±2 years, with a male predominance (69%). Twenty-four percent were already being treated for a psychiatric condition. The average length of service in the emergency department was 8 ± 2 years.

The prevalence of burnout was 98%. Burnout was high in 43% of study participants. Fifty-two percent had a high level of burnout, 63% had a high level of depersonalization and 88% had a low level of sense of personal accomplishment. High burnout was more common among women (79% vs. 21%). Of the participants with high burnout: 31.6% were family doctors, 21% were nurses; 15.7% were emergency physicians (residents or seniors in emergency medicine) and 15.7% were emergency technicians.

Burnout risk factors were divided schematically into 3 categories: among organizational risk factors, 98% complained of work overload with insufficient human and material resources, 44% reported the absence of listening and support from hierarchy, and 31% experienced the feeling that their missions were imprecise. Among the professional risk factors, 78% reported an incompatibility between salary and workload, 67% did not receive any words of recognition from the patient or his family, and 53% did not have any specific training in stress management. Not being able to take time off as they wished was the most reported personal risk factor (76%).

A desire to improve working conditions was present in 80% of participants.

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A very high prevalence of burnout has been found within the emergency care team, which could explain their despair of the healthcare system and the increasing exodus rate leading to a potential medical and paramedical desert in Tunisia. It would therefore be urgent to improve working conditions and provide more facilities for young doctors and nurses, particularly in emergency departments.

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Ayurveda is Indian traditional medicine that has a considerable presence in Europe. Incidentally the definition of health developed by the WHO since 1946 has striking similarities with the ones found in Ayurveda texts dating back few millenia ago. The encouragement Ayurveda provides in the pursuit of a flourishing life resonates with the principles and philosophy of Positive psychiatry. So this begs the question did Ayurveda have concepts resembling positive psychiatry and if so, what were the tenets. To this aim we review an Ayurveda text dating back to 3000 BC called Charaka Samhita.

To explore concepts related to positive psychiatry and psychology in Charaka Samhita.

Relevant chapters and sections in Charaka Samhita were screened for descriptions or recommendations for mental health and a meaningful life.

Similarities between Positive Psychiatry and Ayurveda Psychiatry were present. As a part of psychotherapy Ayurveda recommends cultivation of spiritual awareness, wisdom fortitude/resileance and practice meditation. It further encourages the pursuit of ethically reasonable desires, material prosperity and righteous- religious conduct. For the healthy individuals, it recommends maintaining robust physical and mental health, actively accumulating wealth ethically and attain spiritual liberation.

We conclude Ayurveda had its own version of Positive Psychiatry and delineates ways to achieve it.

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The emotional bond a person forms with their parents during childhood is a crucial factor that influences the choices they make and the parenting style they adopt when they become parents themselves. Conversely, the parenting approach one chooses and the decisions made in raising their children will impact their future relationship with their child.

To explore (a) the type of emotional bond that the participants had developed with their own parents during their childhood, (b) their attitudes towards breastfeeding, and (c) their parenting style.

A cross-sectional study was conducted using self-administered questionnaires completed by 862 parents—both mothers and fathers—who had received support from a private maternity and breastfeeding support center in Athens.

Participants who received higher levels of care from their parents during childhood were negatively associated with exclusive breastfeeding (p = 0.041), shorter durations of breastfeeding (p < 0.001), and a positive attitude toward breastfeeding beyond 12 months (p = 0.002). Mothers who received high care from their parents tended to adopt a more supportive parenting style (p < 0.001), in contrast to those who experienced high levels of control (p = 0.001). A supportive maternal style was positively associated with natural weaning (p = 0.018). In contrast, a more authoritarian maternal style was positively associated with non-exclusive breastfeeding (p = 0.012), abrupt weaning (p = 0.021), introducing solid foods as the first food (p = 0.001), parents and children not sharing the same room (p < 0.001), and the implementation of sleep training (p < 0.001). Maternal permissiveness was positively associated with not breastfeeding (p = 0.011), non-exclusive breastfeeding (p = 0.002), pacifier use (p < 0.001), introducing pureed foods as the first foods (p = 0.001), and the use of sleep training (p = 0.001). For fathers, a shorter duration of room-sharing with the child was significantly associated with a stricter parenting style (p = 0.023). The more children a mother had, the more likely she was to adopt an authoritarian or permissive parenting style (p < 0.001), and the same was true for fathers (p < 0.001). Additionally, older paternal age was positively associated with a more authoritarian parenting style (p = 0.001). An overall positive breastfeeding experience was associated with being less authoritarian, strict, or permissive (p = 0.003; p = 0.005; p < 0.001, respectively).

Breastfeeding may act as a catalyst for parents to adopt a more supportive parenting style toward their children, regardless of the type of bond they developed with their own parents. This study could serve as a foundation for more extensive research on breastfeeding, early parental choices, attachment bonds, and parenting practices.

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Parenting style plays a crucial role in shaping a child’s development and behavior. Supportive parenting has been associated with positive child outcomes, while authoritarian or permissive styles may lead to less desirable behaviors. Breastfeeding, known for its numerous benefits to both mother and child, may also interact with parenting approaches to influence a child’s emotional and social development.

To explore (a) the parenting style of the participants, (b) their attitudes towards breastfeeding, and (c) the behavioral characteristics of their children.

A cross-sectional study was conducted using self-administered questionnaires completed by 862 parents—both mothers and fathers—who had received support from a private maternity and breastfeeding support center in Athens.

Mothers who adopted a more supportive parenting style had a more positive perception of their children’s behavior compared to more authoritarian, strict, or permissive mothers. Specifically, these supportive mothers viewed their children as less anxious (p = 0.015), more willing to share (p = 0.001), less irritable (p = 0.006), more affectionate (p = 0.009), more expressive of their emotions (p < 0.001), generally obedient (p < 0.001), better at maintaining attention (p < 0.001), less nervous in new situations (p = 0.019), and less easily frightened (p = 0.028). Fathers with a more supportive parenting style also perceived their children as sharing more readily (p < 0.001). Additionally, a longer duration of breastfeeding was associated with children who expressed their emotions more easily (p = 0.042) but were less obedient (p = 0.021). Finally, a more positive overall evaluation of the breastfeeding experience correlated with less agreement that the child is hyperactive (p = 0.020), irritable (p = 0.004), unreceptive to affection (p = 0.034), easily distracted (p = 0.004), and easily scared (p = 0.002).

These findings highlight the importance of supportive parenting and positive breastfeeding attitudes in promoting favorable behavioral outcomes in children. Health professionals can use this information to encourage parenting practices that foster healthy child development.

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The benefits of breastfeeding for mothers, infants, and society as a whole are well documented. These benefits appear to be linked to the duration of breastfeeding for both mother and child. Despite this knowledge, the rates of exclusive breastfeeding and continued breastfeeding at 6 and 12 months in Greece are exceptionally low.

To explore Greek parents’ attitudes towards breastfeeding according to their sociodemographic characteristics.

A cross-sectional study was conducted using self-administered questionnaires completed by 862 parents—both mothers and fathers—who had received support from a private maternity and breastfeeding support center in Athens.

The choice of breastfeeding was positively correlated with parents’ higher educational level (p<0.001), normal delivery (p<0.001), residence in Athens or another urban area ((p=0.017), positive attitude towards breastfeeding during pregnancy (p<0.001) and for breastfeeding after 12 months (p<0.001), previous breastfeeding experience (p<0.001), not using a pacifier (p<0.001), introducing whole foods at 6 months ( p<0.001), co-sleeping with their baby (p<0.001) and not implementing sleep training (p<0.001). Accordingly, the duration of breastfeeding was positively associated with living in another urban area (p<0.001), and unemployment (p=0.009). Longer duration of breastfeeding showed children who were exclusively breastfed (p<0.001), who weaned naturally (p<0.001), who were born naturally (p<0.001), who did not take a pacifier (p<0.001), who started with whole foods ( p<0.001), who stayed longer in their parents’ room (p<0.001), who did not receive sleep training (p<0.001) and those whose parents were informed about breastfeeding (p<0.001).

This study could serve as a foundation for more extensive research on breastfeeding. Findings can be utilized by health professionals to enhance their awareness, empathy, and effectiveness regarding issues related to breastfeeding.

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The COVID-19 pandemic has emphasized the crucial need to understand the lasting mental health effects on individuals.

This study aims to investigate the occurrence and connections of post-COVID-19 mental health disorders among adults treated at a community mental health center in Tirana. By closing existing knowledge gaps, it seeks to lay the groundwork for tailored interventions.

Employing a historical cohort study design, data will be collected from Tirana residents diagnosed with COVID-19. Comprehensive clinical and laboratory assessments will focus on mental health outcomes post-infection. Demographic, socio-economic, psychiatric, and biomarker data will be analyzed to provide a thorough understanding of post-COVID-19 mental health disorders in the study cohort.

Preliminary findings are expected to provide valuable insights into the occurrence and connections of post-COVID-19 mental health disorders among Tirana’s adult population. Statistical analyses will identify potential risk factors, informing the development of interventions. Robust data presentation will enhance the credibility and applicability of the study outcomes.

This study promises to elucidate the public health implications of post-COVID-19 mental health disorders in Tirana, guiding targeted interventions. Recommendations based on study findings aim to strengthen mental health services and implement tailored interventions, addressing the unique needs of the community.

Main Messages:

Assessing post-COVID-19 mental health disorders in Tirana informs targeted interventions.

Study findings guide public health actions to enhance mental health services in the community.

Key words: Post-COVID-19 mental health disorders; Tirana; community mental health center

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The mental health of medical students is a critical concern, as their well-being directly influences academic performance and the overall success of educational institutions. The high academic demands, heavy workload, and emotional stress encountered by medical students can lead to significant mental strain, potentially resulting in mental disorders. Understanding these factors is essential for developing effective support mechanisms.

This study aimed to investigate the mental well-being of medical students across the Visegrad Four countries (Hungary, Czech Republic, Poland, Slovakia) by identifying key predictors of well-being and categorizing students into well-being clusters based on psychological and physical health indicators.

A cross-sectional exploratory study was conducted using an anonymous, English-language online questionnaire. The survey gathered general demographic data, health-related information, and academic attitudes. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), coping strategies were evaluated with the Brief COPE inventory, and somatic symptoms were measured using the Patient Health Questionnaire-15 (PHQ-15). Regression analysis was performed to identify predictors of mental well-being, and a two-step cluster analysis was employed to classify students into distinct well-being groups.

A total of 1,703 medical students (467 males) participated in the study. Regression analysis identified adaptive problem-focused and emotion-focused coping, social support, satisfaction with the university experience, healthy eating habits, and a sense of control over personal health as positive predictors of mental well-being. In contrast, maladaptive coping strategies (avoidant and passive) and frequent somatic symptoms were negative predictors. The cluster analysis revealed three distinct groups: (1) a stable group with high well-being and satisfaction, low somatic symptom frequency, and low incidence of mental disorders; (2) a risk group with moderate well-being, low satisfaction, higher somatic symptom frequency, and increased incidence of mental disorders; and (3) a problematic group characterized by low well-being, low satisfaction, high somatic symptom frequency, and frequent mental disorders.

The findings suggest that enhancing adaptive coping strategies, the sense of control, and perceived social support may significantly improve mental well-being of medical students. Furthermore, identifying risk and problematic groups can support the development of targeted interventions. These insights not only contribute to a better understanding of medical students’ mental well-being but also offer practical implications for designing preventive and supportive programs to address mental disorders.

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An increasing number of studies have investigated the role of inflammation in mood disorders, like an altered C-reactive protein (CRP) hematic level. Some studies have also shown an association between suicidal behavior and increased CRP levels.

The objective of this study was to evaluate the association between specific clinical features and high sensitivity CRP (hsCRP) levels with suicidal risk in mood disorders inpatients.

A naturalistic, observational, cross-sectional study was carried out by retrospectively recruiting 353 adult inpatients affected by severe mental illness (SMI), excluding patients affected by inflammatory pathology, alcohol/substances use disorders or treaded by anti-inflammatory/immunosuppressive therapy. In this sample 241 patients suffering from mood disorders were selected. HsCRP levels were measured at the ward admission. All patients were assessed with subscale 5 of the Mini International Neuropsychiatric Interview (MINI-5-s), TEMPS-M, BPRS, HAM-D21, YMRS, CGI-S, CGI-I, MOCA, MDQ, MSRS.

A logistic regression analysis was performed to ascertain the effects of hsCRP and personality trait on the likelihood of suicidality risk. The logistic regression model was statistically significant, χ2(2) = 32.868, p < 0.001. The model explained 18.7% (Nagelkerke R2) of the variance in subjects with a suicidality risk and correctly classified 76.8% of cases. According to the logistic regression model, suicidality risk is negatively predicted by the total score of the YMRS (exp(B)=0.969, IC95%=0.947-0.993, p=0.01) and hostility subscale of the BPRS (exp(B)=0.905, IC95%=0.819-1.000, p=0.05) while it is positively predicted by the cyclothymic temperament subscale of the TEMPS-M (exp(B)=1.066, IC95%=1.017-1.118, p=0.008) and hsCRP (exp(B)=1.090, IC95%=1.012-1.174, p=0.024).

The study suggests the potential transdiagnostic association between low grade inflammation, temperament and suicidal risk in patients affected by mood disorders. Our preliminary findings could support a routine introduction of hsCRP hematic measurement, due to its relatively low cost, for its possible utility as an early trans-diagnostically biomarker for suicidal risk. The findings could also lead to developing a model to identify subjects who may benefit from a combined anti-inflammatory and psychopharmacological treatment strategy during the acute illness phase. A neuroinflammatory approach could further help stage and subtype mood disorder patients in more homogenous samples and investigate short- and long-term treatment implications, clinical course, and prognosis. Further research studies should consider all illness phases and how specific temperament and chronotype may influence treatment response, illness course, and outcomes.

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Obesity represents a heterogeneous group of clinical conditions, underpinned by a multifactorial pathogenesis. People affected by severe obesity could be eligible for Bariatric Surgery (BS). Generally, researchers agree on the complex interplay between a variety of biochemical and neuroendocrine factors in determining body weight regulation, as well as on the quite common co-exhibition of severe obesity and psychopathological symptoms. Both obesity and mood disorders resulted as chronic low grade pro-inflammatory states and it has been stressed the relevance of traumatic life events in overweight conditions, but few is known about underlining trajectories and neurobiological correlates. BS candidates have high rates of lifetime psychiatric disorders, supporting a comprehensive assessment of psychopathological and peripheral biomarkers in this population.

Aim of this cross-sectional survey was the investigation of possible relationships between hematochemical parameters and specific psychopathological features in a sample of BS candidates.

Seventy-seven subjects with severe obesity undergoing the BS preoperative multidisciplinary evaluation at the University Hospital of Pisa were investigated. Psychopathological data were obtained by self-report instruments exploring a series of full-blown and sub-threshold symptoms of mood and post-traumatic-stress disorders, as well as for emotional eating features: the Mood spectrum-self report (MOODS-SR) lifetime; the Trauma and Loss Spectrum self-report (TALS-SR) lifetime; the Emotional Eating Scale (EES). As concerns the biochemical assessment, we considered morning cortisol plasma levels and blood cell counts. Non-parametric Spearman correlations were applied. The statistical threshold was set up at P ≤ .05.

We found significant negative correlations between cortisol plasma levels measured in the morning and sleep (P=.001) or appetite disturbances (P=.04), as well as total altered mood scores (P=.001). Significant positive correlations emerged between Platelet count and total depression scores (P=.042), appetite disturbances (P=.027), TALS-SR domain 3 score (P=.0069), as well as the anger (P=.006), the anxiety (P=.025) and the total components (P=.015) in the EES. Interestingly, there were significant positive correlations also between Platelets-to-Lymphocytes Ratio and the domains 3 (P=.015) and 4 (P=.025) of TALS-SR questionnaire.

These preliminary correlations suggest that in severe obesity (or, almost, in a subgroup of patients), post-traumatic stress features, mood, sleep and appetite disturbances could be related to a lower basal hypothalamic-pituitary-adrenal axis activity and higher inflammatory parameters, especially those linked to platelet status.

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VEXAS syndrome is a newly recognized multisystem inflammatory disorder characterized by recurrent fevers, skin manifestations, and systemic symptoms, often leading to significant morbidity. While the physical aspects of this syndrome are increasingly documented, the psychiatric implications, particularly depressive symptoms, are less explored. This case study aims to elucidate depressive symptoms in a patient diagnosed with VEXAS syndrome, examine how these symptoms relate to prolonged diagnostic uncertainty, and assess the impact of receiving a definitive diagnosis on the patient’s mental health.

To evaluate the presence and severity of depressive symptoms in a patient with VEXAS syndrome. To analyze the psychological impact of prolonged diagnostic uncertainty on the patient’s mood. To investigate the effect of receiving a definitive diagnosis and a comprehensive treatment plan on the patient’s emotional well-being.

This case report describes a 61-year-old male patient with VEXAS syndrome, admitted for further evaluation of his condition. He presented to the psychiatry service with complaints of low mood and morning asthenia. A thorough psychiatric assessment revealed a history of psychiatric hospitalization 30 years prior and ongoing treatment for an adjustment disorder since 2007. The assessment utilized standardized scales to measure depressive symptoms and documented the patient’s emotional state and coping mechanisms throughout his medical journey.

The patient experienced persistent low mood episodes since the onset of organic symptoms in 2019, exacerbated by multiple misdiagnoses and inadequate treatments. After receiving a diagnosis of VEXAS syndrome in July 2023, he reported significant improvements in mood and a reduction in suicidal ideation. He attributed these changes primarily to the clarity provided by the diagnosis and the development of a new treatment plan, rather than solely to adjustments in his antidepressant medication (sertraline, 100 mg). Although he tolerated the medication well, he emphasized that the sense of being understood significantly enhanced his motivation. Additionally, the patient reported vivid nightmares over the last two weeks but denied current suicidal thoughts.

This case highlights the complex relationship between prolonged diagnostic uncertainty and depressive symptoms in chronic inflammatory diseases like VEXAS syndrome. The findings suggest that a definitive diagnosis and clear treatment strategy are crucial for improving mental health and overall well-being. This underscores the importance of a multidisciplinary approach that prioritizes both physical and psychological needs, enhancing the quality of care for patients navigating such complex conditions.

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There is a need to search for new treatment options not only for depression but also its concomitant diseases. Particularly, depression and metabolic-health abnormalities often coexist, while inflammation and microbiota imbalance, may play a part in their pathophysiological overlap. Thus, the trials of interventions on the microbiota may result in establishing a safe adjunctive treatment option.

The primary aim of this seconadry analysis was to assess the effect of probiotic formulation on inflammatory parameters in adult patients with depressive disorders. The secondary aim was to assess some possible pretreatment determinants of probiotics action towards inflammation, e.g., dietary habits, inflammatory or metabolic status, severity and dimensions of psychiatric symptoms, medications used.

The parent trial was a two-arm, 60-day, prospective, randomized, double-blind, controlled design. The probiotic formulation contained Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175. The change in inflammatory parameters (e.g., C-reactive protein, complete blood count-derived markers, tumor necrosis factor-alpha) after intervention alone and in the context of basal lifestyle, psychometric, metabolic, and inflammatory parameters was assessed.

Probiotics significantly decreased CRP levels compared with placebo by 21.3 % (p = .047) with nearly moderate effect size as measured with Cliff’s delta (∆ = .249). Rates of CRP-responders (a minimum 50% decrease in CRP level) were non-significantly higher in the probiotic than placebo group (18.0 % vs. 5.26 %, respectively; χ2(1) = 3.20, p = .074); but the effect size was shown to be clinically meaningful (OR = 3.95; NNT = 7.85). In two-way ANOVA with interaction analysis, probiotics anti-inflammatory action was shown to be favoured by antidepressant use, and higher basal alanine aminotransferase. But, pretreatment chronic low-grade inflammation status counteracted probiotics anti-inflammatory properties.

There were no significant differences in complete blood count-derived parameters, nor in TNF-α levels.

We have found an anti-inflammatory action of probiotics in patients with depression, as shown in the assessment of CRP levels. Additionally, probiotics were revealed to be more effective for inflammation measured by CRP levels when used by subjects with certain pretreatment features. Further studies should be performed to replicate these results.

ClinicalTrials.gov identifier: NCT04756544.

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Vitamin D is a fat-soluble vitamin that together with parathyroid hormone (PTH) regulates blood calcium and phosphorus levels. Vitamin D also has anti-inflammatory, antioxidant, and neurotrophic properties. It acts through the vitamin D receptor (VDR), which has been found throughout the body, including the nervous system. Its deficiency is associated with various diseases, including depression and schizophrenia. It is estimated that approximately 1 billion people worldwide have vitamin D deficiency, while 50% of people worldwide (4 billion people) are thought to have insufficient levels of vitamin D.

The retrospective study aimed to determine whether routine laboratory tests in a psychiatric office/outpatient clinic can find a connection between vitamin D levels and inflammatory parameters such as CRP, leukocytes, and the neutrophil-to-lymphocyte ratio (NLR).

Data was collected from a psychiatric office/outpatient clinic between the years 2020 and 2023. We included the patients (and their basic data, such as gender, age, diagnosis during treatment) whose laboratory results had vitamin D levels as well as a complete blood count (leukocytes, neutrophils, and lymphocytes) and c-reactive protein (CRP). We calculated the ratio of neutrophils to lymphocytes (NLR) and performed Spearman’s correlation, where a p-value of <0.05 indicated a statistically significant change.

Between 2020 and 2023, 88 laboratory tests were conducted in the outpatient office, that included vitamin D levels, of these, 67 had all the necessary data. Vitamin D deficiency was present in 65% of patients. We found that CRP was not sensitive enough for our study, as 83% of CRP values were below 8 mg/L. After performing a correlation between vitamin D levels and leukocytes and NLR, we did not find a statistically significant connection.

We did not find statistically significant corelation between the level of vitamin D and NLR and leucocytes. We would recommend further research that uses a larger sample of patients and conduct measurements during acute illness or exacerbation to obtain more reliable conclusions.

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Suicidality is a critical concern in individuals with affective disorders, and environmental and biological factors may influence its risk. In recent years, seasonal variations and systemic inflammation, as indicated by high-sensitivity C-reactive protein (hsCRP), have garnered interest as potential contributors.

To assess the risk of suicidality in affective disorders among seasonality correlated with hsCRP.

A naturalistic, observational, cross-sectional study was carried out by retrospectively recruiting 353 adult inpatients affected by severe mental illness (SMI) consecutively hospitalized in the Psychiatry Clinic of the Ospedali Riuniti of Ancona, Italy. Patients affected by inflammatory pathology, alcohol/substance use disorders or treated by anti-inflammatory/immunosuppressive therapy were excluded. Only patients suffering from mood disorders were considered for this analysis (n=246). We administered a checklist for socio-demographic and clinical features (diagnosis, age of onset, disease duration, number of episodes, number of episodes per year, suicidal attempts and comorbidities). Subscale 5 of the Mini International Neuropsychiatric Interview (MINI-5-s) was administered to all the patients involved to assess suicidality risk. To normalize hs-CRP, a logarithmic transformation was performed (log-hsCRP). At the same time, season were codified as dummy variables. T-test for independent groups and multivariate linear regression were conducted.

47.2% (n=116) of the sample were male. The mean value of hsCRP was 5.7mg/L (SD=15.8). The mean score of MINI-5-s total score was 13.3 (SD=11.6). Patients admitted to our psychiatric ward in meteorological (p=0.013) and astronomical (p=0.049) autumn had a lower log-hsCRP compared to other seasons. A multivariate linear regression was observed between MINI-5-s total score (R² =0.74, F=9.639, Durbin-Watson=1.915, p<0.001) and hsCRP (B=0.94, p=0.041) and the meteorological autumn (B=-7.436; p<0.001).

This study highlights a significant association between seasonality, systemic inflammation (as measured by hsCRP), and suicidality risk in patients with mood disorders. Our results focus on the importance of considering biological and environmental factors in assessing and managing suicidality risk in affective disorders. Further studies are essential to link seasonal and inflammatory mechanisms.

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It is well known that alcohol has a variety of pathologic effects on hematopoiesis. Long term alcohol abuse result in a significant suppression of both the production of blood cells and structural changes in precursors, namely the suppression of their maturation, up to pancytopenia. We first demonstrated the immunomodulatory properties of a synthetic GABAA-R ligand, meta-chlorobenzhydrylurea (m-CBU). We also showed that splenic lymphocytes modulated in vitro by m-CBU after intravenous administration to syngeneic long-term alcoholized recipients have a positive effect, manifested in the editing of behavior characteristic of alcoholism against the background of stimulation neuroplasticity and reduction of neuroinflammation.

The purpose of this work was to study bone marrow hematopoiesis and peripheral blood parameters in long-term alcoholized recipients after transplantation of syngeneic lymphocytes modulated in vitro by m-CBU.

Male (CBAxC57Bl/6)F1 mice with 6-month 10% ethanol exposure were undergoing the transplantation of syngeneic long-term alcoholized mice lymphocytes, pretreated in vitro with m-CBU. The number of bone marrow hematopoietic progenitors and cellular composition of the blood were assessed in the recipients.

Long-term alcoholization in mice led to a decrease in the colony-forming activity of hematopoietic precursors, mainly erythroid; in the peripheral blood of mice, a significant decrease in the number of erythrocytes, leukocytes, lymphocytes and platelets was recorded, while the population of segmented neutrophils significantly increased. Lymphocytes, precultured with m-CBU, in syngeneic long-term alcoholized recipients had a corrective effect on a number of hematopoietic parameters (colony-forming activity of erythroid precursors in the bone marrow, the number of erythrocytes, segmented neutrophils and lymphocytes in the peripheral blood) to indicators comparable to those in intact mice of the corresponding with tendency to increase the number of platelets in the peripheral blood.

The data obtained may indicate the effectiveness of m-CBU -modulated lymphocytes transplantation in correcting a number of changes in hematopoiesis provoked by long-term alcohol abuse.

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Negative consequences of acute and chronic stress caused by information overload, environmental problems, natural disasters, man-made disasters, military clashes, and acts of terrorism have become increasingly evident in recent decades. They can lead to a painful “breakdown” of socio-biological adaptation mechanisms, a decrease in adequacy in assessing the environment, and, as a consequence, the formation of disturbances in the psycho-emotional sphere, manifested in the development of behavioral disorders (aggression and depression). Therapy for behavioral disorders does not provide a complete cure, apparently due to the formation of a “vicious circle” that can only be broken by normalizing the regulatory relationship between the central nervous system and the immune system. One way to solve this problem is to develop new methods of therapy based on immunological approaches. The method of choice may obviously be immunotherapy with autologous immune cells with a certain, including in vitro modulated, functional activity.

The aim of the study was to investigate the possibility of obtaining a positive psychoneuroimmunomodulatory effect in aggressive and depressive-like animals by transplanting immune cells, the functional activity of which was in vitro modulated by a psychoactive substance (PAS).

Male (CBAxC57Bl/6)F1 mice aged, in which aggressive or depressive-like states were formed under the influence of long-term social stress, were used as donors and recipients in the experiments. Immune cells for transplantation were obtained from a suspension of donor’s splenocytes, cultured in vitro with PAS (chlorpromazine or caffeine, respectively) and then intravenously administered to syngeneic recipients. In the control group of animals, cell preparation and transplantation were carried out under similar conditions, except that the latter were cultured without the presence of PAS. In recipients the parameters of the nervous and immune systems functional activity were recorded.

Transplantation of in vitro PAS-modulated splenocytes to recipients with stress-induced behavior patterns resulted in targeted changes in their motor and exploratory activity in the Open field test, motor activity in the Porsolt test, and decreased anhedonia in recipients with a depressive-like phenotype, recorded against the background of changes in the content of a number of pro- and anti-inflammatory cytokines IL-1β, IL-2, IL-4, IL-6, IL-10, IFNγ, TNFα in pathogenetically significant brain structures. In recipients, a positive change in the parameters of the immune system functional activity were also revealed.

The possibility of immunoediting stress-induced forms of behavior by transplanting in vitro PAS-modulated immune cells, which have a positive psychoneuroimmunomodulatory effect in the body of syngeneic recipients, has been demonstrated.

None Declared

Assessing psychiatric and neurological symptoms in emergency settings is crucial for accurate differential diagnosis. Psychosis, seizures, and cognitive impairment often overlap with various medical and psychiatric conditions, making early and precise identification essential for differentiating between potential causes, guiding appropriate treatment, and improving patient outcomes.

This report presents a clinical case with initial suspicion of psychotic symptoms accompanied by convulsive features to emphasize the importance of differential diagnosis in neuropsychiatric manifestations.

This report details a clinical case involving a 26-year-old woman with no prior psychiatric or neurological history, who presented to the emergency department with headaches, insomnia, and unusual behaviors. Three weeks earlier, she had a right parietal focal epileptic seizure and was being treated with lacosamide 100 mg every 12 hours. Post-seizure, she exhibited symptoms such as disorientation, memory lapses, thought blocking, soliloquies, disorganized thinking, and insomnia. Due to suspected psychotic symptoms, the emergency department consulted psychiatry. Both psychiatry and neurology were involved in her evaluation due to the neuropsychiatric nature of her symptoms. The differential diagnosis considered was a first psychotic episode, postictal psychosis, or encephalitis. She was initially prescribed anxiolytics and antipsychotics, including olanzapine 2.5 mg and clonazepam 0.5 mg. Complementary tests, including an EEG, showed right parietal epileptiform discharges and diffuse encephalopathy, but no evidence of status epilepticus. These findings, combined with convulsive symptoms, suggested a neurological origin, leading to her admission to the neurology department.

Further investigation revealed right temporoparietal cortical thickening on brain MRI, indicative of encephalitis, and lumbar puncture results were positive for anti-NMDA receptor antibodies. The patient was then treated with high-dose corticosteroids, later replaced by plasmapheresis every two days. A gynecological consultation was performed to exclude ovarian pathology, and a body CT scan was ordered to rule out tumor-related conditions. Although her condition has stabilized, it is still early to fully assess the effectiveness of the treatment.

This case emphasizes the critical importance of neuropsychiatric differential diagnosis. The overlapping symptoms of psychosis and cognitive impairment can mimic various conditions, making accurate diagnosis challenging. The collaboration between psychiatry and neurology was essential in distinguishing between psychiatric disorders and anti-NMDA receptor encephalitis. Timely and precise diagnosis enabled targeted treatment, demonstrating the need for a multidisciplinary approach in managing complex neuropsychiatric cases.

None Declared

Previous studies have shown that neuroinflammation can play a significant role in the pathogenesis of schizophrenia. The search for inflammatory markers in late-onset schizophrenia are very important for diagnostics.

Determination of inflammatory markers in the peripheral blood plasma of patients with late-onset schizophrenia in relation to the clinical characteristics of patients.

The study included 46 patients with schizophrenia aged 61 [56; 69] years (2 men and 44 women); the age of disease onset was 51 [45; 60] years. The severity of mental disorders was assessed using the PANSS scale, and cognitive impairment was assessed using the MMSE and MoCA scales. The control group consisted of 77 people comparable in age with the patients (p=0.16). A spectrophotometric method was used to determine inflammatory markers (enzymatic activity of leukocyte elastase (LE), functional activity of α1-proteinase inhibitor (α1-PI)). The protease inhibitory index (PII) was calculated - the ratio of LE and α1-PI activity, indicating the direction of the inflammatory process. Comparative data analysis was performed using the Statistica 10.

The 1st cluster (22 patients (47.8%)) was characterized by a significantly increased α1-PI activity (p=0.000), decreased LE activity (p=0.000) compared to the control values, and, accordingly, a low PII value (p=0.000), which is an unfavorable prognostic factor for further development of the disease and response to therapy. A 28-day course of therapy with 1st and 2nd generation neuroleptics didn’t change the immunological parameters in patients of this cluster. In this cluster, a positive correlation was found between LE activity and scores on the MMSE (r=0.512, p<0.05) and MoCA (r=507, p<0.05) scales at the start of treatment, i.e. the lower score on the cognitive functioning scales and the more severe the disease correlate with lower the LE activity.

The 2nd cluster (24 patients (52.2%)) was characterized by a significant increase in inflammatory markers, LE and α1-PI activity (p=0.000, p=0.000, respectively) in relation to the control parameters, while the PII value didn’t differ from the control. In this group, paranoid and schizotypal personality were significantly less common in the premorbid period (41.6% of cases), and formal thinking disorders were expressed to a lesser extent. No clinical and immunological relationships were revealed. A 28-day course of therapy influenced the change in immunological parameters towards their relative normalization.

The obtained results confirm the involvement of the inflammatory link in the development of late-onset schizophrenia, as well as the heterogeneity of the patient group in terms of clinical and immunological parameters. Evaluation of the spectrum of inflammatory markers allows us to identify patients with an unfavorable course of the disease and resistance to therapy.

None Declared

Immune checkpoint inhibitors are being used in patients with advanced malignancies. Although it can effectively treat tumors, 30–60% of patients could experience immune-related adverse events such as encephalitis with antibodies against the NMDA receptor.

We present a case of a 57-years-old man with no prior mental health history who was diagnosed of kidney cancer and received treatment with checkpoint inhibitors. He developed incoherent speech, visual hallucinations, delusional megalomania, disorientation, sleepiness and a low-grade fever of 37.7ºC. He was admitted in Neurology unit and diagnosed of autoimmune limbic encephalitis in a patient treated with checkpoint inhibitors.

To describe a case of a psychotic episode associated with autoimmune limbic encephalitis in a patient treated with checkpoint inhibitors.

Clinical assesment and bibliographic review of pertinent literature.

During his admission in Neurology ward, the patient was suspicious, inattentive, aggressive with healthcare staff and he developed incoherent speech with visual hallucinations.

MRI suggested bilateral limbic encephalitis and the antibody test in cerebrospinal fluid were positive for NMDA receptor.

The psychotic episode was treated with olanzapine up to 20 milligrams and the limbic encephalitis with rituximab with a good response.

The case presented is consistent with other reports of psychotic symptoms and development of encephalitis associated with antibodies against the NMDA receptor.

The diagnosis of anti-NMDAR encephalitis is usually delayed.

The differential diagnosis should be established with primary psychiatric disorders.

None Declared