Pyromania is an impulse control disorder where repeatedly setting up intentional fires provides instant gratification after failing to control the urge. Within the psychiatric population, 6% of the individuals meet the lifetime criteria of pyromania, making it a rare diagnosis of high medico-legal significance. We aimed to estimate the prevalence of pyromania, identify psychiatric comorbidities, substance use, and related sociodemographic factors in patients with a history of pyromania within a psychiatric center in South Bronx. We hypothesize that individuals with fire-setting behavior are more likely to have antisocial tendencies, substance use disorders, and psychiatric comorbidities, leading to increased mental health service use.

The objective of this study is to estimate the prevalence of pyromania and fire-setting behavior in a psychiatric center in South Bronx, and to examine the associated psychiatric comorbidities, substance use disorders, and sociodemographic factors. By analyzing these relationships, we aim to provide insights into the characteristics and mental health service utilization patterns of individuals with pyromania or fire-setting behavior, thereby informing future treatment strategies and interventions in urban mental health settings.

We searched for patients aged 12 and older, including all genders, who were evaluated or admitted through a psychiatric center within the South Bronx between December 2013 and December 2023 for a retrospective observational study. After applying inclusion/exclusion criteria, we included 11 patients diagnosed with pyromania or fire-setting behavior (ICD-10-CM code F63.1 or ICD-9-CM code 312.33), based on evaluation notes. We extracted and analyzed the data for demographics, substance use, comorbid psychiatric, and medical diagnosis.

We found that pyromania diagnosis was found in individual’s age range of 12 to 59 years (Mean Age-33.36 ± 14.72 years). All individuals were single, 82% were unemployed, 72.73% were US-born, and 91% were male. Psychotic disorders, primarily schizophrenia, were diagnosed in 73%, while 64% had a substance use disorder. The group comprised 45% Hispanic and 55% African American individuals.

Our study, conducted over ten years in the Bronx, revealed a strong association between firesetting behavior and psychiatric comorbidities, particularly psychotic disorders and substance use. Contrary to our initial hypothesis, we found no significant link between firesetting and antisocial tendencies. These findings emphasize the need for targeted interventions addressing both psychiatric and sociodemographic factors, especially in urban mental health settings like the Bronx.

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Antipsychotic medications, initially designed for severe mental illnesses like schizophrenia and bipolar disorder, have witnessed a significant rise in off-label prescribing for a diverse range of conditions and at times these medications remain unchanged over long periods of time and poses a potential risk due to their side effect profile. There are different types of risks associated and depends on the dose of medication, age and comorbid physical health conditions of the patient.

To evaluate the outcomes of tapering and discontinuing off-label low-dose antipsychotic medications in patients without psychiatric disorders, focusing on the effectiveness of the deprescribing process and any associated withdrawal symptoms or adverse effects.

The authors decided to review their caseload and identify patients who are prescribed off label use of antipsychotic medication for example for sleep issues, Axis 2 mental illness as per DSM-4 classification and on doses where there was no indication of antipsychotic medication. It was planned to have detailed discussion with patients about the impact of having off label antipsychotic prescription and agreed to slowly tapper off and discontinue this medication. There were 18 patients identified with off label use of antipsychotic medication. In this quasi-experimental study design, we selected eighteen patients by convenience sampling method from the caseload who were identified to be on off label prescription of antipsychotic medications. These patients were explained to the purpose of the study and the course of intervention, and all agreed to participate in the intervention.

Out of 40 patients prescribed off-label antipsychotic medications, 18 were identified for review, all had been receiving mental health services for over six months and had been on antipsychotics for more than eight weeks. The most prescribed medication was quetiapine (n=11), followed by olanzapine (n=4), risperidone (n=2), and haloperidol (n=1). These medications were prescribed for issues like sleep disturbance, anxiety, and agitation, not for mood stabilization in bipolar disorder or augmentation in depression or OCD. Patients were gradually tapered off antipsychotic medications, with quetiapine doses typically reduced by 50% over two months and halved again over the next two months. Olanzapine and risperidone were discontinued over 3-6 months. Those successfully deprescribed reported improved energy, reduced fatigue, and no long-term adverse effects like tremors or extrapyramidal symptoms.

Antispcyhtic deprescribing is an important part of clinical care that reduce the risk to patients and gradual tapering of low-dose off-label antipsychotic medications, including quetiapine, olanzapine, and risperidone, was largely successful in this study, with most patients experiencing improved energy and reduced sedation.

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The limited research conducted so far suggests that kickboxing and other martial arts can positively impact psychological well-being in a psychotherapeutic setting. The study by de Vries et al. (de Vries, et al.), which focuses on the application of kickboxing with psychotic patients, suggests improvements in self-esteem, social behavior, and aggression regulation through structured, body-oriented therapy. Physical activity that is intense and structured, such as kickboxing, helps reduce stress and anxiety by increasing endorphin production, which improves mood and reduces tension.

The aim of our study is to analyze the impact of kickboxing on non-psychotic disorders in relation to anxiety, depression, and stress levels, as well as its effect on self-esteem and the overall quality and satisfaction. To our knowledge, this research is the first of its kind in Croatia.

This study involved 11 participants who were receiving treatment at the Day Hospital for Non-Psychotic Disorders, which treats patients suffering from a wide range of anxiety disorders, mood disorders, reactions to severe stress, and adjustment disorders. The participants were a mixed group of 6 men and 5 women, aged 28 to 58, with varying levels of education and living standards. Kickboxing training has been conducted once a week for 60 minutes during consecutive 6 months. The training is conducted in a group with an individualized approach depending on the patient’s condition. The assessment was conducted at two time points: the first data collection occurred before the start of therapy, and the second took place 6 months after regular kickboxing training. The comparison was made using the Wilcoxon signed-rank test.

The results of this preliminary study indicate statistically significant positive changes. Compared to the results of the first assessment, participants were significantly more satisfied with their lives in the second assessment and perceived their quality of life as significantly improved in terms of physical and mental health as well as social relationships. Depression, anxiety, and stress levels were rated as significantly less pronounced, while self-liking and self-competence did not change significantly.

Kickboxing offers a new, innovative approach to improving mental health in the therapeutic environment of a day hospital, especially for patients suffering from anxiety and depression.

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Children and adolescents are a fairly vulnerable population for diabetes.

Caregivers of children and adolescents with diabetes were most involved in their care.

Measuring the burden endured by caregivers is a good indicator of the negative repercussions on caregivers when caring for their loved ones.

• - Determine the level of burden among family caregivers of children and adolescents with diabetes.

• - Identify factors associated with a high level of burden.

The study was conducted at the University Hospital of Gabès, in the pediatrics and internal medicine departments, as well as in outpatient clinics with caregivers of children and adolescents during the period from March 2024 to May 2024.

We collected sociodemographic and clinical data for each caregiver and child or adolescent followed for diabetes.

We used :

Burden scale (Zarit): explores the psychological, physical and social impact of patient care on the caregiver. The higher the score, the greater the burden. A score above 61 means a severe burden.

The study included 32 caregivers. The mean age was 35.55 years with extremes of 22 and 55 years and the sex ratio (M/F) was 0.6.

Workload was shared equally by 66% of caregivers (65.7%; n=21). The majority of the sample (62.5%) did not seem to have experienced family conflicts related to the caregiver’s role.

Among the participants, the majority, 78.1% (n=25), presented symptoms of psychological distress. A high level of stress was perceived by 43.7% of caregivers and satisfaction was noted by 34.4%.

A mean burden score was 35.59 (SD =15.37) with extremes from 8 to 59. We reported that 40.6% of caregivers presented a moderate to severe burden and 34.4% presented a light to moderate burden.

According to our results, heavy burden was statistically more common among caregivers with unequal workload sharing (p=0.006) and family conflict (p=0.01).

We found a statistically significant correlation between burden and symptoms of psychological distress (p=0.001), daily stress level (p=0.001) and overall satisfaction (p=0.001).

Our study shows that the burden endured by caregivers of diabetic children and adolescents represents a real issue in the care of these patients.

Several factors seem to be inherent to the disease, the caregiver and the social context.

For this reason, it is imperative to develop specific support programs for family caregivers of diabetic children and adolescents. These programs should include interventions to reduce burden.

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Diabetes is a real public health problem. Some people seem to be more vulnerable to this pathology, especially children and teenagers. To ensure their loved one’s well-being, caregivers can also develop coping strategies.

• - Assessing caregivers’ resilience of children and adolescents with diabetes.

• - Identify factors associated with a high level of resilience.

The study was conducted at the University Hospital of Gabès, in the pediatrics and internal medicine departments, as well as in outpatient clinics with caregivers of children and adolescents during the period from March 2024 to May 2024.

The sociodemographic and clinical characteristics of caregivers of children and adolescents have been collected using a pre-established form.

We used :

The resilience scale (CD-RISC) is designed to measure resilience, defined as the ability to cope with traumatic events. The higher the score, the greater the resilience.

Our sample included 32 caregivers. The mean age was 35.55 years with extremes of 22 and 55 years and the sex ratio (M/F) was 0.6.

Among the participants, the majority, 78.1% (n=25), presented symptoms of psychological distress. A high level of stress was perceived by 43.7% of caregivers and satisfaction was noted by 34.4%.

The mean resilience score was 59.06 (SD =10.45) with extremes of 39 and 81.

We found a significant correlation between a high level of resilience and symptoms of psychological distress (p=0.003), the level of daily stress (p=0.03) and the level of overall satisfaction (p=0.043).

Our study showed that a high level of resilience is linked to several factors.

Interventions targeting stress related to social events should be integrated to increase the caregivers’resilience.

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In the dynamic setting of psychiatric care, patient satisfaction and shared decision-making are crucial for optimal, personalized treatment. This approach is particularly vital in the context of a psychiatric ward, where engaging patients in treatment decisions could enhance their satisfaction and the overall therapeutic outcomes.

This study evaluated the impact of shared decision-making on patient satisfaction from services among patients treated in a psychiatric ward. Additionally, it examined whether there are differences in satisfaction between psychotic and non-psychotic patients.

53 patients (30 women and 23 men) who were hospitalized in the 4th Inpatient Department of the Psychiatric Hospital of Attica were assessed using the Client Satisfaction Questionnaire (CSQ-8) and the 9-Item Shared Decision-Making Questionnaire (SDM-Q-9). Diagnoses were based on the Mini International Neuropsychiatric Interview (M.I.N.I.). A multiple linear regression analysis was conducted to evaluate the effect of the SDM-Q-9 total score and of the presence of psychotic symptoms on the CSQ-8 total score. The relationship of separate SDM-Q-9 and CSQ-8 items, controlling for the presence of psychosis was further analyzed through partial correlation analyses. The Bonferroni method was employed in order to adjust for multiple comparisons.

The mean age of the participants was 47.49 years (SD=13,65), and the mean duration of the disease was 15 years (SD=12,36). Thirty-two patients were diagnosed with psychotic disorders (psychotic disorder=28, bipolar disorder=1, mood disorder with psychotic features=3), while twenty-one were diagnosed with non-psychotic disorders (including Major Depressive Disorder, Obsessive Compulsive Disorder, Bipolar Disorder and Substance Use disorders). Increasing SDM-Q-9 total score significantly correlated with increasing CSQ-8 total score (B=0,276, 95% CI=,177, 0.374, t=5,627, p<0.001). Partial correlation analyses showed that separate SDM-Q-9 items significantly correlated with separate CSQ-8 items, while many correlations survived the stringent bonferonni correction. The presence of psychotic symptoms was not associated with client satisfaction.

Our findings suggest that shared decision-making correlates positively with patient’s satisfaction from services during their hospitalization in a psychiatric ward and this was independent of the presence of psychosis. In the ongoing effort to find real-world solutions in mental health, integrating shared decision-making practices into psychiatric care can be a fundamental strategy to empower and satisfy patients suffering from mental disorders.

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The work of original research on opioid and heroin depedence is of great interest as it has a serious medical and social impact on society.

Self Compassion and forgiveness are important factors in helping psychosocial support and improving mental health that contributes to the development of person’s character.

The purpose of this study is to explore the relationship between self compassion and forgiveness in people who are receiving treatment for opiod depedence.

An incidental sample of 153 opioid users has been selected for the study.

Data were collected using:

• - The Self Compassion Scale.

• - the Heartland Forgiveness Scale.

Demographic and social background information was also gathered to complement the primary data.

It has been established that there is a positive relationship between self compassion and the ability to forgive oneshelf or others among people with opiate addiction.

Participants reported appropriate levels of self compassion and forgiveness. Some of the important finding include:

• - There is a notable relationship age of first use illicit drugs and the level of forgiveness afforded to others.

• - In substance dependency, an inverse relatioship is noted between the level of triazolobenzodiazepine abuse and self forgiveness and self compassion.

There is a chance of improving self kindness and forgiveness even among opioid addicts if these factors may be effective in combating the addictions.

Suggestions for future investigation includes:

• - Further evaluation of the age in which a person engages in illicit substances and the level of forgiveness extended to these individuals.

Assessing if the use of benzodiazepine that are not prescribed affects self forgiveness and self compassion.

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Tunisia is considered one of the countries where women occupy an important place in the working society. Given the fundamental role played by women in the family, they would have to balance their family responsibilities with professional duties, especially after returning from maternity leave. In many cases, the return to work can be particularly difficult which could affect their physical and mental health and even the relationship with their child.

Assessing the effects of returning to work on the perceotion of stress after maternity leave among Tunisian women.

A cross-sectional study was conducted over a two-month period, from February to April 2024, in the department B of gynaecology and obstetrics in Charles Nicoles hospital (Tunis). Women who were in labor before delivery, who had fully responded to the questionnaire before and after returning to work and willing to take part in the study were included. A questionnaire including socio-demographic, pregnancy and delivery and labor characteristics was filled in by the participants. The effects of returning to work on the perception of stress after maternity leave were assessed using the Perceived Stress Scale (PSS-10). Women were assessed one month and three months after the delivery corresponding to one month after the return to work (maternity leave in Tunisia lasts two months).

A total of 62 women were included. The mean age was 32.45 ± 6.41. Pregnancy was planned in 56.4 % of cases, well supervised in 83.8 % of cases, and complicated by gestational diabetes in 24.1 % of participants. Most deliveries were at full term (92 %) and vaginal (66.1 %). Complications were post-partum hemorrhage (11.2 %), eclampsia (3.2 %) and puerperal infections (3.2 %). Most women worked in the public sector (69.3 %) with a salary between 500 and 1000 Tunisian dinars (42%). The mean PSS-10 before returning to work was 12.36 ± 4.79 and 19.41 ± 4.31 after. After returning to work, the PSS-10 was significantly higher among women with more than two children, whose deliveries were with complications and working in the private sector.

Several factors have been found to involved in the increase of stress after post-maternity leave return. Focus on the psychological aspect and on supporting young mothers throughout the perinatal period seem highly needed.

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Current political recommendations on mental health aim to keep people with mental illness in the community, emphasizing the need to develop a natural social support network, which includes families, giving rise to the role of the family caregiver.

The aims of the study were: a) to identify sociodemographic variables that influence the anxiety, depression and stress of the caregiver of people with mental disorders; b) to analyze the relationship between social support and caregiver burden with anxiety, depression and caregiver stress.

We carried out a cross-sectional, descriptive-correlational study, with 274 portuguese caregivers who were recruited using a convenience sampling technique. The instruments used were the Satisfaction with Social Support Scale (ESSS); Zarit Burden Interview Scale and Depression Anxiety Stress Scales (DASS-21). Descriptive statistics and nonparametric tests were used as required. Data were analyzed using SPSS-22.0. The protocol was approved by local ethical committee.

Most of participants were female (67.0%) and aged between 26 and 85 years old, with an average of 66.13 (SD=5.61) years old. Female caregivers have higher rates (p<0.05) of anxiety, depression and stress. Caregivers who lived in rural areas have higher levels of depression (p=0.036) and stress (p=0.029). On the other hand, the greater the perceived overload, the higher the levels of anxiety (p<0.001), depression and stress (p<0.001).

The results suggest the need to invest in local and community intervention strategies to promote mental health and prevent mental illnesses. In this vein, health institutions must support educational and monitoring measures that screen mental illness situations early.

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Effective discharge management is essential for psychiatric inpatient care, significantly impacting patient outcomes during and after the transition from inpatient to outpatient settings. A well-coordinated discharge process ensures continuity of care, reduces readmission risks, and supports long-term recovery. However, there is a notable lack of comprehensive data on discharge practices across European countries, impeding the evaluation of their effectiveness and the development of informed improvements.

The present study has two primary objectives: first, to systematically review current practices, challenges, and outcomes related to psychiatric discharge management across European countries. Second, to evaluate and compare existing discharge guidelines, protocols, and toolkits. By synthesizing these findings, we aim to identify best practices, highlight gaps, and offer recommendations for optimizing discharge procedures. Additionally, we will briefly present a current mixed-method research project from Germany, titled “Evaluation of Discharge Management in Psychiatric Care,” which aims to assess discharge management practices for psychiatric inpatients. These insights will supplement the broader European review by offering a focused perspective on the practical considerations and challenges of discharge management practices within a specific national context.

We will conduct a systematic search and review by exploring multiple electronic databases (MEDLINE, Embase, Cochrane Library and PsycINFO) and grey literature sources (Google and Google Scholar) for both quantitative (observational studies, reports) and qualitative (clinical guidelines, protocols, interviews, focus groups) data related to psychiatric discharge management. Additionally, we will hand-search the references of key papers, including existing systematic reviews and included articles. The search will include documents published from 2000 to December 31, 2024.

The presentation will provide an overview of the current research and literature on psychiatric discharge management practices in Europe. The review is expected to provide critical insights into advancing psychiatric care standards. Additionally, the presentation aims to engage researchers and clinical practitioners attending EPA25 by providing a platform for knowledge exchange on psychiatric discharge management, facilitating networking opportunities and fostering potential collaborations for future research in this vital field.

Discharge management is a critical aspect of psychiatric care that requires meticulous planning and coordination. The insights gained from this review will contribute to the development of evidence-based discharge protocols that are adaptable to diverse patient populations and healthcare settings, ultimately leading to more effective and cohesive care strategies across Europe.

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The social skills of the chronic schizophrenia is an important factor in assessing the prognosis of patients with schizophrenia.

The object of this study was to investigate the effects of group integrative arts therapy based on social skill training on communication, social adaptive function, and subjective well-being in inpatients with chronic schizophrenia.

Among the 125 patients who had been hospitalized in the mental hospital after being diagnosed with schizophrenia by psychiatrists according to DSM-5, 72 patients were selected by inclusion criteria and 48 patients were randomly assigned into an experimental group(n=16), comparative group(n=16), and control group(n=16). During this study, 4 patients from each groups dropped out. The final subjects of each groups were 12 patients. The experimental group followed a 60 minutes long social skill training based on group integrative arts therapy program for twice a week and 20 times in total. The Comparative group followed a social skill training program only for 60 minutes twice a week for 20 times in total. The control group received no treatment. To assess the social adaptive function, empowerment, subjective well-being of the subjects, Communication Competence Scale(CCS), Empowerment Scale(ES) and Korean Modification of Subjective Well-Being Scale(KmSWN) were used as subjective measuring. Assertiveness Observation Evaluation Scale(AOES), Social Adaptive Functioning Scale(SAFS), and Nurses’ Observation Scale of Inpatient Evaluation-30(NOSIE-30) were also used as objective measuring that were rated by nurses or social workers at the mental hospital.

There was no statistically significant difference except non-verbal communication of CCS among three groups in homogeneity test of sociodemographic and clinical variables. The group integrative arts therapy based on social skill training was found to significantly increase the communication, assertiveness, social adaptive functioning and empowerment of experimental group more than comparative group, and that of comparative group more than the control group. The group integrative arts therapy based on social skill training was found to significantly increase the NOSIE-30 of the experimental group and the comparative group more than control group. NOSIE-positive and irritability of NOSIE-30 in the comparative group was increased more than those of the experimental and the control groups.

The group integrative arts therapy based on social skill training is found to significantly enhance the social adaptive function and empowerment of inpatients with chronic schizophrenia than social skill training. These results suggest that group integrative arts therapy could be utilized as effective mental rehabilitation intervention program for inpatients with chronic schizophrenia.

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Diet-related support is urgently needed for people with serious mental illness underlying the role of nutrition in a biopsychosocial approach. Integrating healthy lifestyle practices such as a balanced diet and physical exercise could supplement and amplify the effects of existing pharmacotherapies and psychotherapies. Despite its considerable role, nutritional literacy of mental health professionals appears scarce. Specific nutrition training courses for mental health professionals are needed in order to increase awareness on nutrition as a well-being contributing factor in the biopsychosocial model.

The aim of this study is to investigate insight and attitudes on nutrition in mental health among a sample of psychiatrists and psychologists resident in Italy.

The survey was conducted from May to June 2024 and the questionnaire was anonymous and self-rated, accessible via Google forms. The sample comprised 110 Italian mental health professionals (adult and child psychiatrists, psychologists) who voluntarily completed the on‑line questionnaire.

110 participants (61 psychologists, 46 adult psychiatrists and 3 child psychiatrists) agreed to participate to our survey. 89.2 % (n= 91) of them worked in southern Italy.The majority of participants were female (77.98%) and reported working in a Mental Health Centre (n= 41, 37,27%), followed by psychiatric residential facilities (n=22, 20%), private practice (n= 19, 17.27%), hospital (n= 14, 12.73%), university research centre (n=4. 3.64%), other non specified institute (n=10; 9.09%). The numer of years of working as mental health professional was 19.27 ± 11.27 years. Adopting “sometimes” nutritional approach for the treatment of the patients was the answer mostly reported (n= 56, 51.4%) followed by “most of the time” (n= 28, 25.69%), “always” (n=11; 10.09%), “never” (n= 7, 6.42%), “almost never “(n= 7, 6.42%).

Despite the scientific evidence and some treatment guidelines in support of this relationship, the implementation of nutritional psychiatry into routine clinical practice remains limited. Integrating nutrition into the clinical practice of psychologists and psychiatrists and providing evidence-based nutritional advice represent an interesting mental health challenge to address in the coming years.

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There is a greater inequality in employment and underemployment among adults with Autism Spectrum Disorder (ASD) compared to their peers. Aspects such as sustained eye contact, interpreting non-verbal cues, understanding non-literal language, exhibiting cognitive inflexibility, and limitations in interpreting others’ perspectives impact their communication. Due to these difficulties, they are often subject to social embarrassment, isolation, and insecurity when initiating conversations. Considering that contemporary interactions have intensified through social media, these networks can be a facilitator of social inclusion, especially as they are digital environments—structured, free from unexpected stimuli, offering additional processing time, and without the need to interpret prosody and intonation. In this context, to understand its impact in the workplace for this population, one of the factors to consider is the self-esteem of these individuals within the workplace, given that self-esteem is a fundamental indicator of self-worth and self-acceptance, impacting mental health.

To verify the correlation between social media use and self-esteem in adults with ASD in their workplace.

This is a prospective, qualitative-quantitative study based on the Ethics Committee for Research number 65890317.9.0000.0065. Data were collected via an electronic form. Questionnaires: personal/social questions prepared by the authors; adapted protocols: Rosenberg Self-Esteem Scale and Facebook Intensity Scale.

A total of 132 adults with self-reported ASD, 68% of whom had ASD with comorbidities. Regarding gender and sexual orientation, 66% were cisgender and heterosexual women, and 62% were cisgender and heterosexual men. Concerning remuneration and education, 44.7% had completed higher education, earning between two to three thousand reais per month. Additionally, 61.4% reported not having inclusive strategies in their workplace. The overall correlation between self-esteem and social media use at work showed that 65.9% use social media moderately, of which 12.9%, 18.9%, and 34.1% have low, high, and medium self-esteem, respectively. Correlating personal/social questions with self-esteem, 34.8% never feel comfortable with group conversations, of which 11.4% have low self-esteem (p-value 0.008), 48.5% feel distressed at work (p-value 0.06), 62.9% are excessively concerned about work (p-value 0.02), and 49.2% find it difficult to assert themselves at work (p-value 0.02). (Image 1)

Image 1:

This study did not statistically demonstrate a correlation between social media use and self-esteem in the workplace. However, the challenges encountered in the workplace, such as the lack of inclusive strategies, social difficulties that generate fear, distress, and worry, corroborate the literature regarding the vulnerability this population is exposed to.

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Understanding resilience becomes important given that adversity is an unavoidable fact of human life. Over 70% of respondents in a sample of 68,894 people reported at least one traumatic event in their lifetime. The neurotoxic effects of these experiences range from compromised neurocompetence, psychopathology including PTSD and depression, to adverse physical effects.

To determine if we could reliably agree on ratings of resilience on a five point scale to aid future studies of the role of resilience in recovery and relapse.

To assess resilience we developed a five point scale with 1 being the least and 5 behind the most resilient pattern. We found a water metaphor useful to conceptualize these five levels of resilience. Resilience in an ever-changing world can be likened to navigating in a body of water. Adversity tosses us into the water. Here are our levels:

We used kappa statistics to assess our level of agreement among ourselves (three raters) after studying and discussing prototypical stories for each rating level.

Practicing with training videos, we found we could achieve 84% agreement on the five ratings with 3 raters.

Percent overall agreement = 84.00% Free-marginal kappa = 0.80

95% CI for free-marginal kappa [0.66, 0.94]; Fixed-marginal kappa = 0.78; 95% CI for fixed-marginal kappa [0.62, 0.93]

When we added AI, we got Percent overall agreement = 71.33% Free-marginal kappa = 0.64; 95% CI for free-marginal kappa [0.50, 0.79]

Fixed-marginal kappa = 0.61; 95% CI for fixed-marginal kappa [0.51, 0.71]

The individuals who fit into the pattern of low resilience tended to have a high amount of childhood adverse experiences as shown through the ACE survey. The accumulation of these events in combination with external variables shape resilience. Factors including intelligence/education level, drug/alcohol use, positive role models, exposures to nature/art/spirituality, and community/family norms steer a person down a set of patterned thinking and actions which ultimately depict their overall life story.

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An opportunity arose to compare the outcomes of patients of one psychiatrist in two different clinical settings – a community mental health center CMHC) in which the psychiatrist saw people on average for 15 minutes every 6 weeks (range 4 to 12 weeks) and a community clinic setting (CCS) in which the psychiatrist controlled the time allotted per patients and the frequency of visits. We assumed that the psychiatrist’s beliefs, attitudes, and style of practice did not change between the two settings except as influenced by time constraints. Psychotherapy was provided by social workers in both settings, with an average of 45 minutes every 3 weeks in the CMHC and 40 minutes every week in the CCS. Three optional groups existed in the CCS compared to one in the CMHC. New patients received a 30 minute evaluation in the CMHC and a 60 minute evaluation in the CCS.

To compare the dominant style of practice in the United States with an older style of practice in which psychiatrists spent more time with clients.

The psychiatrist administered the MYMOP2 (My Medical Outcome Profile, version 2) and the Brief Psychiatric Rating Scale (BPRS) to all patients at baseline in both settings. The MYMOP2 was repeated monthly (or at the next visit in the CMHC) and the BPRS at intervals of every three months. The study lasted two years and the average length of follow-up was 31 weeks in the CMHC and 49 weeks in the CCS, which was statistically significant.

No statistically significant differences appeared in demographic variables. Percent funded by Medicaid, Medicare, other insurance, gender, and age distribution were the same in both settings. Clinical improvement was not observed among patients on average on both measures in the CMHC. Clinical improvement was observed on both measures in the CCS (MYMOP-2; p < 0.01 on worst symptom; BPRS, p < 0.01). The CMHC showed higher profits than the CCS. Time spent per patient was statistically significantly greater in the CCS (p < 0.01).

Increased opportunity for contact and relationship with the psychiatrist may play a greater role than assumed by the biomedical model. A public health question arises in relation to models for provision of care that are more profitable but less health effective.

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Public sector mental health services in Australia typically do not provide Adult ADHD assessment or treatment, creating a significant reliance on private sector care. Consequently, the demand for private ADHD services has surged, resulting in extended wait times for assessment and treatment.

This study aimed primarily to evaluate the wait times for Adult ADHD assessments for patients referred by GPs to a private clinic. A secondary aim was to analyze the relationship between sociodemographic and clinical variables, including illness characteristics and timing of diagnosis.

Data were collected through retrospective file reviews of consecutive patients referred to the authors’ private clinics for Adult ADHD assessment between January 2023 and October 2024. Patients included in the study met the criteria of an eventual clinical diagnosis of Adult ADHD. Data collected included sociodemographic details, ADHD subtype, psychiatric comorbidities, and wait times for initial psychiatric consultations. Total sample was 68.

Wait times ranged from 10 days to 305 days, with a mean wait time of approximately 4 months (112 days). Almost 30 % of the patients referred had wait time of more than 4 months. The sample comprised nearly equal numbers of male and female patients (33 vs. 35), with ages ranging from 17 to 56 years (mean age: 28.35 years). The majority (68%) were diagnosed with Adult ADHD - Combined Presentation, while 32% had the Predominantly Inattentive Presentation. Nearly all patients received their ADHD diagnosis in adulthood, with less than 5% having a childhood ADHD diagnosis.

There are significant delays in acessing appropriate care for people with Adult ADHD in Australia. Improvement in mental health policy and service delivery with regard to ADHD services is essential if this barrier to access appropriate care has to be overcome.

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Mental health is indispensable to quality of life and social well-being, influencing economic stability, human rights and sustainable development. Despite growing awareness, the public often conflates mental health with mental illness, which means that stigma remains prevalent. Nursing professionals, who interact closely with patients, are uniquely positioned to provide psychological support. Therefore, understanding public perceptions of mental health and the role of nurses is crucial for developing effective care strategies and improving health outcomes.

With our research we aimed to examine public attitudes towards mental health and assess how the general population perceives nurses’ roles in psychological support. The study also sought to identify demographic influences on these attitudes and highlight potential improvements in nursing education.

The study utilized a cross-sectional survey design to collect quantitative data on public perceptions of mental health and the roles of nursing professionals. An anonymous online questionnaire was distributed, reaching a diverse sample of 270 participants from various demographic backgrounds. The survey included items assessing demographic information (gender, age, educational level, and residential location), as well as specific questions on mental health perceptions, experiences with psychological challenges, and also attitudes toward nursing empathy and support. Descriptive and inferential statistics - including Mann-Whitney U tests and chi-square tests - were used to analyze responses. Significance was set at p<0.05.

Of the respondents, 73% were female, 63.3% resided in urban areas, and 54% had completed secondary education. The majority (65%) were over 35 years old. Regarding self-assessed mental health, 48.9% rated it as “good,” and 48.5% reported occasional mental health challenges. Significant gender differences were observed in perceptions of empathy among nursing professionals, with female respondents reporting more positive views compared to male respondents (U=83.37, p=0.01). The study also revealed that 53% of participants believed nurses “sometimes” showed empathy toward patients’ mental health needs. A significant association was found between educational level and the perception that nurses need additional training to support mental health challenges (U=147.00, p=0.01).

This study highlights the vital role of nurses in mental health support and suggests that additional training on psychological support could enhance care quality, especially in the eyes of well-educated patients. While many respondents see nursing professionals as empathetic, there is room to further improve nurses’ mental health literacy and communication skills to reduce stigma and improve patient outcomes.

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Resilience, the ability to adapt and thrive amid adversity, is particularly prominent in Tunisian women, who are recognized for their strength and adaptability despite societal pressures. Their resilience appears closely linked to cultural heritage, indicating a significant connection between resilience and cultural values. This study explores how cultural values shape the psychological resilience of Tunisian women.

To examine the influence of cultural values on resilience among Tunisian women.

A cross-sectional survey was conducted Tunisian women aged 18 and above, from June to August 2024. Sociodemographic data were gathered, while cultural values were assessed using the Individual Cultural Values Scale (CVScale) and the Centrality of Religion Scale (CRS-5). Resilience was measured with the 25-item Connor-Davidson Resilience Scale (CD-RISC 25).

We collected 695 responses in our survey. Participants had a mean age of 36.72 ± 12.23 years, with 90.9% holding university degrees, 56.5% employed, 49.2% married, and 50.6% with children. The mean resilience score was 68.26 ± 14.09, with 26.3% showing low resilience. Average scores for cultural values were “power distance” (9.13 ± 3.46), “uncertainty avoidance” (20.84 ± 2.95), “masculinity” (9.55 ± 3.99), “collectivism” (21.64 ± 5.07), “long-term orientation” (25.89 ± 2.94), and “centrality of religion” (3.95 ± 0.77).

Resilience correlated positively with “uncertainty avoidance” (p < 10⁻³, r = 0.145), “collectivism” (p < 10⁻³, r = 0.208), “long-term orientation” (p < 10⁻³, r = 0.267), and “centrality of religion” (p < 10⁻³, r = 0.186). Conversely, resilience was negatively correlated with “power distance” (p < 10⁻³, r = -0.104), and no significant correlation was observed with masculinity.

The findings reveal that cultural values significantly shape resilience in Tunisian women. Higher resilience was associated with uncertainty avoidance, collectivism, long-term orientation, and religious centrality, while power distance negatively impacted resilience. This emphasizes the need to incorporate cultural dimensions when designing initiatives to support resilience among women in Tunisia.

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Self-esteem, defined as an individual’s overall sense of self-worth and confidence, plays a crucial role in shaping how people interact with their environment. It has been strongly linked in the literature to both mental health and resilience. Tunisian women, known for their achievements despite numerous challenges, provide a compelling population for exploring the dynamics between self-esteem and resilience.

To assess the impact of self-esteem on resilience among Tunisian women.

This cross-sectional study surveyed Tunisian women aged 18 and above, between June and August 2024, using an online questionnaire. General health information was gathered through a structured survey. Self-esteem levels were evaluated using the Rosenberg Self-Esteem Scale, while resilience was measured with the 25-item Connor-Davidson Resilience Scale (CD-RISC 25).

Data were collected from 695 Tunisian women, with participants having a mean age of 36.72 ± 12.23 years. Of the respondents, 22.3% reported using psychoactive substances: 20.4% smoked, 9.4% consumed alcohol, and 2.5% used cannabis. Additionally, 22.2% had somatic conditions, 24.5% reported a personal psychiatric illness, 28.2% had a family psychiatric history, 39.3% had seen a psychiatrist at least once, and 15% were using psychotropic medications. The average resilience score was 68.26 ± 14.09, with 26.3% of participants displaying low resilience. The mean self-esteem score was 29.38 ± 5.64, with 55.8% of participants exhibiting low self-esteem. No significant correlation was found between resilience and substance use. However, resilience was significantly associated with personal psychiatric illness (p < 10⁻³), family psychiatric history (p < 10⁻³), psychotropic medication use (p < 10⁻³), and psychiatrist visits (p < 10⁻³). In contrast, there was no correlation between resilience and somatic conditions. A strong association was found between resilience and self-esteem: only 6.8% of participants with normal to high self-esteem exhibited low resilience, compared to 41.8% of those with low self-esteem showing low resilience.

This study demonstrates a significant relationship between self-esteem and resilience among Tunisian women, indicating that higher self-esteem is linked to greater resilience. These findings suggest that interventions aimed at enhancing self-esteem could improve resilience, particularly for women facing psychological difficulties. Future research could explore targeted strategies to boost self-esteem as a pathway to strengthen resilience and overall mental well-being in this population.

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Personality encompasses stable traits, behaviors, thoughts, and emotions that shape how individuals interact with their environment. It stands to reason that personality can influence how a person responds to life’s challenges, essentially defining their level of resilience. Tunisian women, who frequently face a range of daily struggles, represent a significant group for exploring the dynamics of resilience. Understanding how their personality traits impact their ability to adapt and thrive amidst adversity provides valuable insights, making this an important area of study.

To examine the relationship between personality traits and resilience among Tunisian women.

This cross-sectional study surveyed Tunisian women aged 18 and above using an online questionnaire between June and August 2024. Personality traits were assessed using the 10-item Big Five Inventory (BFI-10), while psychological resilience was measured using the 25-item Connor-Davidson Resilience Scale (CD-RISC 25).

Data were collected from 695 Tunisian women, with a mean age of 36.72 ± 12.23 years. Among participants, 24.7% were students, 56.5% were employed, 49.2% were married, and 50.6% had children. Regarding sexual orientation, 93.4% identified as heterosexual, 0.4% as homosexual, 3.3% as bisexual, and 2.9% as undefined. The average resilience score was 68.26 ± 14.09, with 26.3% of participants exhibiting low resilience. Mean scores for personality traits were as follows: agreeableness: 6.8 ± 1.86, extraversion: 6.1 ± 1.79, neuroticism: 6.33 ± 2.01, conscientiousness: 7.16 ± 1.94, and openness to experience: 8.03 ± 1.71. Resilience was positively associated with age (p < 10⁻³, r = 0.143), marital status (p = 0.022), sexual orientation (p = 0.001), and education level (p < 10⁻³), with 80% of those with only primary education showing low resilience compared to 24.2% of those with a university education. Personality traits showed significant correlations with resilience: agreeableness (p < 10⁻³, r = 0.165), extraversion (p < 10⁻³, r = 0.207), conscientiousness (p < 10⁻³, r = 0.367), and openness to experience (p < 10⁻³, r = 0.278) were positively correlated, while neuroticism was negatively correlated (p < 10⁻³, r = -0.482).

Personality traits are significant determinants of resilience in Tunisian women. Positive traits like agreeableness, openness, extraversion, and conscientiousness enhance resilience, while neuroticism has the opposite effect. Considering that personality is influenced by factors such as early childhood experiences and parenting styles, future interventions could focus on fostering these positive traits to strengthen resilience.

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