Sarcopenia is a syndrome described as generalized and progressive loss of muscle mass, strength and function, leading to an increased risk of falls, fractures, disability and mortality. Recent studies have shown that sarcopenia is more common in patients with long-standing psychiatric illnesses compared to the general population, particularly in those with depression and dementia. There have also been reports of higher prevalence in patients with schizophrenia and bipolar disorder.

Our study aims to determine the prevalence of sarcopenia and the factors associated with the syndrome among the geriatric psychiatric population diagnosed with Alzheimer’s disease, depression, bipolar disorder, or schizophrenia in the central Slovenian region.

A single-centre cross-sectional study will be conducted over 3 months at the Department of Geriatric Psychiatry of the University Psychiatric Clinic Ljubljana. Admitted patients aged 65 years or older with a diagnosis of Alzheimer’s, depression, bipolar disorder, or schizophrenia will be eligible (50 patients per each diagnosis). The SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls) and the MSRA (Mini Sarcopenia Risk Assessment) questionnaires will be used as screening tools to identify sarcopenic patients. Additionally, calf circumference and handgrip strength will be measured. The patients’ cognitive functioning will be assessed using the Mini‐Mental State Evaluation (MMSE).

We expect to detect higher rates of sarcopenia among inpatients with mental illness. Subgroups will be analyzed according to different demographic and disease parameters.

This study is the first to evaluate sarcopenia among elderly Slovenian inpatients with a mental health illness. We believe that sarcopenia is an important yet underdiagnosed parameter of functional health in the elderly struggling with a chronic mental health illness and should be regularly screened for. Further research is required to identify sarcopenia in this vulnerable population, especially at an early stage, to counteract the progression of the disease.

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Research has shown that staff working in clinical environments caring for frail, elderly or dying patients often must deal with high levels of emotional distress and psychological pain. Psychological defences are necessary and are part of our normal coping mechanism to deal with grief and losses but if they are not understood and recognized, may impact on staff and organizations in unhelpful and destructive ways. In resilient caregiving organizations, emotions are respected and attending to these emotions allow staff to create relationships which will help them cope with their work better.

Through interprofessional education with a reflective group, it was hoped that the improved understanding of emotions and experiences of staff and patients could directly influence clinical practice.

Participants were invited to monthly meetings of 60 minutes for 12 months. A psychodynamic perspective addressed the unconscious processes in clinical encounters. Participants were encouraged to describe how they felt and the meanings of their behaviour rather than just focusing on what happened. Group size was capped at 12 with 2 psychodynamically-oriented facilitators. Semi-structured interviews were conducted and a qualitative approach with content analysis of the transcribed interviews was adopted.

Interdisciplinary staff included nurses, psychologists, social workers, junior and senior clinicians. Our findings showed that staff in dementia care encountered significant levels of emotional distress. The major themes emerged included:

1. 1. Universality of emotions

2. 2. Psychologically safe space

3. 3. Enhancement of reflective capacity

4. 4. Sense-making in the clinical environment

The experiential group discussions allowed staff to better understand and recognize their vulnerability by providing a safe space for directed catharsis. The enhancement of reflective capacity through mirroring and universality in groups allowed members to create relationships which helped them cope with their work better. Through critical inquiry and dialogue, there was better awareness of the social, cultural, economic and political forces at work as staff were encouraged to think and respond honestly to day to day clinical and organizational pressures.

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Previous research suggests that individuals with lower socioeconomic status are frequently exposed to more health risks and emotionally stressful conditions compared to those with higher status. There is a clear link between income and poor quality of life, with disadvantaged older adults lacking key resources. This study explores the relationship between the economic profile of older individuals and their psychosomatic health within the Greek population. It continues a previous investigation on the impact of socioeconomic status on health, offering a deeper understanding of long-term effects.

This study investigates how socioeconomic status affects the physical and mental health of older adults in Greece, focusing on income levels’ influence on health quality and disparities in health outcomes.

This cross-sectional study was conducted among 516 Greek participants (214 men, 302 women, average age 73.47 ± 7.72). The participants’ average monthly income was €796.72 ± 621.82 (p=0.002). Psychosomatic health was evaluated using the Other As Shamer Scale (OAS), Experience of Shame Scale (ESS), and Cardiac Anxiety Questionnaire (CAQ). A one-way MANOVA analyzed the impact of income on health quality, focusing on both physical and mental health using the 36-Item Short Form Health Survey (SF-36).

Our findings revealed that individuals with a monthly income above €1,500 reported significantly higher quality of life scores. In contrast, those with lower economic profiles exhibited increased levels of shame (measured by OAS and ESS), anxiety about their heart health (measured by CAQ), and a tendency to somatize stress. The analysis indicated that for every additional €100 of monthly income, physical health quality increased by 4.4 points on the SF-36 Physical Health Scale, and mental health quality improved by 2.9 points on the SF-36 Mental Health Scale. These results underscore the statistically significant impact of monthly income on overall physical and mental health scores.

The study highlights a strong link between lower economic status and poorer physical and mental health among older Greek adults. Addressing these effects requires political and societal efforts, with mental health policies that focus on economically vulnerable populations to mitigate the health impacts of low income and improve overall well-being.

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Artificial Intelligence (AI) is increasingly recognized as a powerful tool for customizing learning experiences, fundamentally transforming traditional teaching methods.

This systematic review aims to evaluate and synthesize current research on AI learning tools and their role in enhancing educational experiences for older adults, as well as in promoting intergenerational learning and engagement.

Following PRISMA guidelines, a comprehensive review of both quantitative and qualitative data was conducted. Electronic databases such as PubMed, Scopus, and ERIC were searched up to October 20, 2024. The reference lists of included studies and relevant review articles were also thoroughly examined. The quality of the eligible studies was assessed using the Mixed Methods Appraisal Tool (MMAT).

Nine studies met the inclusion criteria. Findings indicate that personalized education for older adults can be delivered through various approaches, including interactive, user-friendly learning environments, training via virtual conversation agents and digital assistants, and automatic adjustments of pace and content to meet user needs (Figure 1). These approaches also facilitate and promote intergenerational learning (Figure 2).

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Image 2:

Personalized education through artificial intelligence can significantly enhance older adults’ quality of life by promoting autonomy, expanding knowledge, supporting psychosocial well-being, and fostering intergenerational connections.

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Loneliness is widely recognized as a significant risk factor for psychosomatic issues in older adults, potentially impacting various aspects of health, including oral health.

This study aims to investigate the relationship between loneliness and oral health in older adults.

This cross-sectional study was conducted with a sample of 84 older adults (41 females and 42 males), aged between 65 and 94 years (mean age: 74.1 years, SD = 8.1). Participants completed a sociodemographic questionnaire, the 12-item Geriatric Oral Health Assessment Index (GOHAI), and the Emotional and Social Loneliness Scale. Multivariate analysis was used to assess the impact of loneliness on oral health outcomes.

The analysis revealed that emotional and social loneliness had a significant negative impact on oral health. Furthermore, the overall loneliness score was strongly associated with poorer oral health quality, independent of marital status or the presence of children. In other words, the relationship between loneliness and oral health was not moderated by these demographic factors.

As loneliness increases in older adults, their susceptibility to poor oral health rises, which can have significant implications for their psychological well-being. This study underscores the need to consider oral health as an integral component of overall well-being, particularly in the context of mental health in older populations.

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Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia and is clinically characterised by progressive behavioural changes, executive dysfunction and language difficulties. FTD is often confused with Alzheimer’s disease and other psychiatric disorders. Clinical features of FTD include personality changes, agitation, loss of inhibition, apathy, social withdrawal and impulsivity. In some cases, the disease is accompanied by mood or psychotic symptoms, resulting in the diagnosis of an additional psychiatric disorder. (Gliebus G.(2014). SAGE open medical case reports,2, 2050313X13519977.). This article presents the case of a middle-aged woman who was diagnosed with an anxiety spectrum disorder before developing and being diagnosed with FTD.

A 57-years-old right handed female with previous history of anxiety disorder admitted to psychiatry clinic with restlessness, decreased sleep, and complain of constant non-purpose walking. Physical examination revealed bradymimia and grabellar reflex. Additionally in her psychiatric evaluation she had short-term memory impairment, disinhibition and verbal perseverations. She had been given multiple combinations of medications by outpatient providers and her restlessness only increased. At the time of admission she was taking mirtazapine,olanzapine and clonazepam. The initial impression was that she had akathisia, and her medications were tapered. She was then started on propanolol and lorazepam. After several days her symptoms had not changed.

In routine biochemical and hematological tests, electroencephalogram (EEG) were within normal limits. 18F-FDG PET/MRI revealed hypometabolism in the bilateral temporal-frontoparietal region, more pronounced in the frontal region which is consistent with FTD.

Trazodone was started to control behavioural symptoms and the dose was gradually increased to 150 mg/day. The dose of propranolol was increased to 80 mg/day, and lorazepam was tapered and discontinued. During the follow up with this treatment, there was an improvement in her restlessness and anxiety symptoms, but her memory problems were persistent.

Frontotemporal dementia may overlap and be confused with other psychiatric disorders. Therefore, a comprehensive history, physical and neurological examination are required to differentiate each clinical entity (Khan I, De Jesus O. (2023).Frontotemporal Lobe Dementia. In: StatPearls ). Additionally, the use of functional neuroimaging, such as 18F-FDG PET/MRI, enables the different distribution of pathology in dementing disorders to be highlighted, as can be seen in our case. This case report highlights the importance of re-evaluating patients with psychiatric diseases, especially when symptoms are resistant to treatment.

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Lyme borreliosis is one of the most common vector diseases transmitted by tick bites; it is caused by Borrelia burgdorferi. Mostly it manifests on the skin, in the nervous system or joints. It involves the nervous system in 10-15% of cases, of which 2-4 % affect the central nervous system. The most common manifestation is encephalitis, which has a diverse clinical picture.

We aim to describe a rare case and discuss the diagnostic challenges of a rapidly progressive disease.

A detailed description of the patient based on our interview and clinical findings, including blood work, imaging, microbiological testing, lumbar puncture, and treatment.

A 67-year old female patient came to the psychiatric emergency room in March 2024, because of persistent anxiety and unexplained somatic disorders, including weight loss, tremor and unstable gait, which began a few months ago. She had some somatic diagnostic procedures done, with no abnormal findings. 2 weeks before being admitted she was sent to the emergency neurological unit because of fatigue and tremor. They excluded focal neurological signs and concluded that she had an adjustment disorder and suggested psychiatric treatment. In March 2024 she was admitted to the geriatric psychiatry ward, where at first our main differential diagnosis was pseudodementia. In the next few days her condition worsened. She appeared psychotic, with ideas of persecution and reference. On the psychological exam she had moderate cognitive decline with a focus on impaired attention, memory and executive systems, misinterpretations of past and current events, misidentifications of people and possible complex visual hallucinations. At that time we suspected she might have prolonged delirium. Because of an uncommon clinical picture, we pursued further diagnostics. The lumbar puncture showed cerebral spinal fluid (CSF) pleocytosis, which confirmed the diagnosis of encephalitis. Blood tested for multiple infectious causes was positive for Lyme borreliosis. The brain CT scan showed an inflammatory or infiltrative process in both cerebral hemispheres. We then transferred her to the infectious disease clinic where she had a brain MRI with contrast and her CSF was tested for Borrelia and other possible causes. On the MRI they suspected she had rhombencephalitis with leptomeningitis. After the diagnosis of neuroborreliosis was confirmed, she received a 4-week parenteral treatment with ceftriaxone. Two months after completing the treatment she has fully recovered.

When faced with a patient with rapidly progressive dementia a wider range of possible diagnoses has to be considered. We have to be aware of the importance of recognising the cause of the disease sooner, as the patient may have a treatable condition.

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Discriminatory and abusive behaviors may strongly affect older LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more) adults, and poorer health is linked to discriminating practices. Shame is associated with ageism and sexual orientation-based discrimination and may be a significant impediment to aging well by undermining older adults’ sense of agency, health, and well-being. However, little is still known about older LGBTQIA+ adults who encounter double stigmatization.

This study aims to explore the dimensions of shame and double stigmatization of older LGBTQIA+ adults.

The significant psychological challenges and relevant themes experienced by older LGBTQIA+ adults, as related to shame and double stigmatization, were illustrated by semi-structured interviews with 329 older adults in a qualitative study through content analysis.

The results highlight four themes of shame and double stigmatization among older LGBTQIA+ adults, encompassing (1) ageism (86.5%), (2) sexual orientation-based discrimination (81.1%), (3) stereotyping (76.8%), and (4) social exclusion (72.3%).

The study reveals the profound negative effects of shame and double stigmatization on older LGBTQIA+ adults, emphasizing the need for inclusive policies and interventions to address multiple forms of discrimination and promote equitable treatment in aging populations.

Keywords: Shame; Ageism; double stigmatization; LGBTQIA+; multiple discrimination; older adults.

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Pet companionship plays a pivotal role in the lives of older couples, significantly influencing their intimate relationships, by fostering deeper connections and enhancing mental well-being.

This study has two aims: (1) to explore the impact of pet companionship on the intimacy of older couples; and (2) to examine its influence on their mental health.

This study included 223 older couples aged between 65 and 94 years. To explore the multifaceted role of pets in their relationship, content analysis was conducted on all interviews.

Their experiences shed light on the significance of this bond for promoting healthy and fulfilling intimate relationships, with the following themes: (1) contributing to emotional well-being (87.3%), (2) improving mental health in later life (83.1%), (3) fostering a deep relationship between couples (78.7%), (4) facilitating the formation of new emotional connections with others (72.1%), and (5) boosting physical and sensory functions (67.2%).

The findings emphasize the diverse advantages of pet companionship among older adults. These include enhancing emotional well-being, bolstering mental health, fostering interpersonal bonds, and improving physical capacities. These insights underscore the potential for integrating pet interventions into comprehensive strategies aimed at promoting the overall quality of life for older individuals.

Keywords: Pet companionship; intimate relationships; mental health; older couples; well-being.

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Violent, abusive, and harmful behavior enacted by older adults upon their caregivers represents a distressing and frequently disregarded facet within the domain of caregiving.

This qualitative study aims to 1) explore family caregivers’ experiences of violent, abusive, and harmful behavior by the older person and 2) explore how violent, abusive, and harmful behavior by the older person affects family caregivers’ mental health.

This qualitative study encompassed 307 participants, with a diverse age range spanning from 65 to 87 years. All the interviews went through the process of content analysis.

For the first objective, findings indicated six emerging themes: Persistent and intense verbal abuse (79.1%); Subjugation and manipulation by older adults (72.5%); Unexpected illicit activities initiated by older adults (62.1%); Financial exploitation by older adults (39.8%); Physical abuse (31.5.%); and Sexual abuse (30.7%). The second objective highlighted four themes: High levels of anxiety and depression (87.9%), Intense rage (79.4%), Feelings of moral isolation (77.4%), and Intense explosions (63.6%). Brazilian participants mainly experienced persistent and intense verbal abuse (64.1%). Moreover, higher levels of depression and anxiety were mainly verbalized by English participants (81.8%).

These findings underscore the significant toll that older individuals’ violent, abusive, and harmful behavior can have on the mental well-being of family caregivers. This study sheds light on the complex experiences faced by family caregivers and emphasizes the urgent need for targeted interventions to foster healthier caregiving environments.

Keywords: Carers; family caregivers; mental health; older adults; violent, abusive and harmful behavior.

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Despite increasing social acceptance over the past two decades, lesbian, gay, bisexual, and transgender (LGBT) individuals continue to face unequal treatment in society (Institute of Medicine, 2011; Caceres et al., 2020). Elderly LGBT adults include the population of sexual and gender minorities over the age of 50 (Choi et al., 2016).They continue their lives under the shadow of negative societal stereotypes and assumptions about their physical and mental health, sexuality, sexual lives, and ability to contribute to society, as well as their family and societal values. When individuals find themselves at the intersection of being elderly and LGBT, they encounter a combined situation that leads to an increased risk of discrimination, social exclusion, and violence.Over time, this can lead to high levels of depression, anxiety, loneliness, and other mental health issues. When they are not accepted by social circles, it often results in social isolation and loneliness. (Geneva, 2023)

The aim of this study is to examine the challenges faced by elderly LGBT individuals by addressing issues of discrimination and elder abuse. By evaluating the extent to which current services meet the needs of these individuals, it aims to propose solutions from the perspective of social equality and human rights.

The study was conducted between December 2024 and February 2025 using the keywords “elderly,” “elderly LGBT individuals,” and “LGBT discrimination” “elder abuse” in databases (PubMed, Scopus, Springer, etc.). These databases have been preferred because they contain a significant amount of evidence-based literature in the field of psychology. Studies conducted between 2000 and 2024, with full texts accessible and written in Turkish and English, have been included in the study

As of November 2024, 28 national and international research articles related to the subject have been reached. The literature review is ongoing. When the literature review is completed, all the study results will be presented together.

The human rights violations, discrimination, social exclusion, and risk of violence faced by elderly LGBT individuals are not only individual but also societal issues.Developing policies that are sensitive to the needs of elderly LGBT individuals in social services, healthcare services, and the legal system is an important step toward improving their physical, mental, and social health.Awareness-raising activities need to be expanded to reduce stigma and discrimination against elderly LGBT individuals in society. Additionally, establishing LGBT-friendly elderly care centers and strengthening social support networks are crucial to preventing social isolation.In conclusion, achieving a more inclusive, equal, and fair society is only possible by respecting the rights of every individual.

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As the world population continues to age, understanding the psychological well-being of older people is becoming increasingly vital. Among the various aspects affecting their quality of life, psychological distress, feelings of loneliness and life satisfaction stand out as key dimensions to explore. With age, individuals face a multitude of physical, social and emotional changes that can significantly affect their overall well-being. Consequently, examining the complex relationship between these factors provides valuable insights for promoting healthy ageing and improving the overall quality of life of older people. Psychological distress, often resulting from a range of factors such as chronic health conditions, cognitive decline and social isolation, can manifest itself in various forms, such as anxiety, depression and stress.

To investigate the correlation between psychological burden (depression, anxiety, and stress), feeling of loneliness and satisfaction with life among elderly.

The sample consisted of 148 elderly people over 65 years old. The research instruments used were a) the Depression Anxiety Stress Scale-21, b) the Life Satisfaction Index, c) The UCLA Loneliness Scale, and d) the Athens Insomnia Scale (AIS).

There is a statistically significant association between engagement in domestic activities and a reduction in depressive symptoms. The frequency of children’s visits and the presence of social support networks significantly influence psychological burden. Those who received infrequent or no visits from their children exhibited higher levels of depression. Loneliness was affected by family interactions, and life satisfaction was influenced by gender and education. Participants who had people in their immediate environment helping them with daily needs reported reduced depressive symptoms. Finally, the study revealed statistically significant differences in reported life satisfaction based on participants’ gender and educational level.

These findings emphasize the need for personalized interventions that acknowledge the complex interplay of these factors in shaping the mental health of older adults.

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Caprags syndrome is a rare syndrome characterized by a false belief that an identical duplicate has replaced someone significant to the patient. It is widely regarded as the most prevalent of the delusional misidentification syndromes and appears in psychiatric and non-psychiatric cases, including organic disorders.

To present a case report of 84 years old male patient with severe organic comorbidities who developed Capgras syndrome.

Psychiatric interview

An 84-year-old male patient came to the first psychiatric examination accompanied by his son, due to the suspicion and hostility he has been showing towards his wife for the past month. A few days before the examination, patient became extremely aggressive in the evening hours, he accused his wife that she was not his wife, that another person had been framed instead of her, he demanded that she show him her identity card and threatened to report her to the police. The wife locked herself in the bathroom in fear, but the patient broke down the door. Neighbors called the police, who then restrained him. The patient calmed down after that, but wife went to live with her son. During the examination, patient was completely calm and cooperative, with a neat appearance, oriented, his thought process was normal, conversation was conducted adequately in the desired direction. When asked about thought content he dissimulated it by stating that he was angry because his wife often hangs out with other women and doesn’t pay enough attention to him. He denied the presence of hallucinations. Affect was stable, cognitive capacities seemed appropriate for his age. Patient has been treated for several organic comorbidities, including prostate cancer, which was removed a few years ago, but due to problems with urination after surgery he wears a permanent catheter. He was diagnosed with atrial fibrillation and diabetes. He had a heart attcak a year ago, when a stent was implanted, while a bypass was implanted 12 years ago. Laboratory findings indicate elevated glucose and HbA1c values while other parameters are within reference values. He takes all prescribed medicine alone and on time. I diagnose Capgras syndrome and did psychoeducation. Patient showed an interest in taking medication and a desire for his wife to come back to live with him. Low doses of typical antipsychotic was prescribed, which led to cessation of psychomotor restlessness and harmonization of sleep rhythms. Further neuroradiological diagnostics and regular internist follow-up were recommended.

Previous studies showed the link between Capgras syndrome and aggression, which this case report confirms. Probable basis for emergence of this form of delusional disorder is this patient in not dementia, but rather the consequence of serious organic comorbidities. Further diagnostic processing is in progress.

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The high symptom burden of lung cancer, coupled with the emotional strain of diagnosis and treatment, often leads to disrupted sleep patterns and heightened levels of anxiety and depression.

The aim of this study was to assess the prevalence and severity of insomnia in patients with primary bronchopulmonary cancers, and to explore its relationship with anxiety and depression.

This was a cross-sectional, descriptive and analytical study conducted among patients followed up for bronchopulmonary cancer at the palliative care unit in the pneumology and allergology department of the Hedi Chaker University Hospital in Sfax. The questionnaire used included patients’ sociodemographic characteristics, clinical and treatment data. Sleep disturbance was assessed using the insomnia severity index (ISI) and psychological distress using the Hospital Anxiety and Depression Scale (HADS).

A total of 49 patients participated, with a mean age of 61,8 years, the majority being male (85,7%). The disease duration was less than one year in 61,2% of cases, and 59,2% of patients had stage IV lung cancer, with tumor progression observed in 32,7%.

Mild to moderate insomnia affected 49% of the patients.

The mean anxiety score was 7,08 (SD = 3,6), with a prevalence of anxiety observed in 4,1% of patients. The mean depression score was 6,92 (SD = 3,4), and 34,7% of patients exhibited signs of depression.

A significant association was found between insomnia and depression (p=0,005), but no significant relationship was observed between insomnia and anxiety (p=0,14).

The relationship between sleep disturbance and psychological distress highlights the need for comprehensive management that addresses both physical symptoms and mental health in this population. Early identification and intervention for insomnia and depression in lung cancer patients may enhance their overall well-being and quality of life.

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Lung cancer remains one of the leading causes of cancer-related morbidity and mortality worldwide. Despite being a crucial treatment, chemotherapy often brings a range of side effects that can significantly impact the overall quality of life of the patients.

To evaluate the quality of life (QoL) in lung cancer patients undergoing chemotherapy.

The sample consisted of 49 lung cancer patients undergoing chemotherapy at the Pneumology and Allergology Department of the Hedi Chaker University Hospital in Sfax. The questionnaire used included patients’ sociodemographic characteristics, cancer and treatment data, and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire 30-item version (EORTC QLQ-C30).

The mean age of the patients surveyed was 61,8 years, with a male predominance (85,7%). The most frequently reported functional signs of lung cancer were dyspnea (36,7%), cough (34,7%) and chest pain (20,4%). Disease duration was less than 1 year in 61,2% of the cases, and 59,2% were classified as stage IV. Tumor progression occurred in 32,7% of cases. Of the patients, 20,4% were on a single chemotherapy agent, while 79.6% were on a combination regimen.

According to QLQ-C30, the mean global QoL score was 61,24 ± 24,5 for the entire sample. Physical functioning and role functioning were the most affected on the functional scale, while fatigue and appetite loss were the most frequent symptoms.

The findings indicate that lung cancer patients undergoing chemotherapy experience significant challenges to their quality of life, particularly in physical functioning and symptom management. These results highlight the critical need for integrating routine QoL assessments into clinical practice to better address patients’ needs and improve supportive care.

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Delusional parasitosis is a psychotic disorder where individuals firmly believe they are infested with parasites despite no medical evidence. It can be primary or secondary, the latter being a symptom of other medical conditions like neurological diseases. Effective management requires collaboration between psychiatry and other specialties.

The evaluation of each patient with an interdisciplinary team increases adherence to treatment in patients with cancer and psychiatric illness.

Clinical history, complementary studies, and review of the literature on the case of a 66-year-old woman subjected to multiple dermatological treatments due to a sensation of body infestation. History of type 2 diabetes and diabetic neuropathy since 2021. In 2022, she was diagnosed with stage IIIA luminal B breast cancer and treated with surgery, chemotherapy, and radiotherapy. She is currently on adjuvant treatment with Anastrozole. The oncologist referred her due to the presence of psychotic symptoms. The General Health Questionnaire (GHQ-28), Functional Assessment of Cancer Therapy—General (FACT-G), and Positive and Negative Syndrome Scale (PANSS) were applied.

The patient presents with a psychotic disorder secondary to vascular pathology, manifested by delusions of infestation and sudden-onset hypodermic tactile hallucinations. Test results show a GHQ-28 score of 10/84, FACT score of 24/108, and PANSS score of 49 points. Although denying affective symptoms, anxiety, or cognitive impairment, neurological findings indicate decreased brain parenchyma, suggesting small vessel disease. Treatment includes Risperidone 1 mg once daily, along with therapeutic interventions such as psychoeducation and continued multidisciplinary monitoring by neurology for comprehensive disease management.

Evaluating psychotic symptoms requires assessing organic and non-organic factors. Neuroimaging aids diagnosing delusional parasitosis, improving treatment through interdisciplinary collaboration.

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Somatic genomic variation testing has become an integral part of breast cancer management. Genetic tests based on gene expression profiles in cancer cells (biopsy or surgical specimen) are used for diagnostic, prognostic and theranostic purposes, helping to make therapeutic decisions: selection of adjuvant therapy, prediction of therapeutic responses and of breast cancer recurrence, in patients with early-stage breast cancer. The currently used gene expression assays including MammaPrint, Oncotype DX, Prosigna, etc..

The aim of this study was to collect, through a recent review of the literature, the guidelines concerning psychological support before and after predictive genomic exploration in order to situate the role of the geneticist in this mental care.

We conducted a comprehensive review of the scientific literature with the following keywords: genomic predictive diagnosis, breast cancer and mental health. Through the papers emerging from this research, we assessed guidelines concerning mental health care and genetic counselling.

There is not any guidelines or frameworks concerning the psycho-management of the new predictive genomic tests of breast cancer. Our review show that psychological support is systematically offered in oncology (psycho-oncology) and that the American Society of Clinical Oncology (ASCO) has established guidelines for the management of anxiety and depression in adult survivors of cancer. Moreover, the most recent ASCO guidelines recommend the use of each genomic assay according to the level of evidence available for specific clinical conditions, in breast cancer. There are few papers dealing with genetic counselling and psychological support during the oncotype Dx and MammaPrint tests that are the incorporated into in everyday practice and recommended in clinical guidelines for women with node-negative, hormone-receptor-positive breast cancer. While, in pre-test genetic counselling is well established in breast cancer genetic predisposition, the frameworks in predictive tests and their emotional and psychological impact during prescription, testing and discussion of results as well as the therapeutic choices, are not clear until now.

Genetic counseling includes both informative and educational aspects, as well as advice on personal decisions that may affect the rest of the patient’s life. During next-generation predictive testing, the objectives would also be to provide the patient with the ability to gain a sense of control by reducing uncertainty, to determine her own level of risk of recurrence and her therapeutic chances and to receive psychological support during the shared therapeutic decision. Thus, the role of the genetic counsellors must be an essential key in the recent era of mainstreaming of genomic sequencing.

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Laryngeal cancer patients who undergo total laryngectomy (TL) face significant physical, emotional, and psychological challenges. This group of patients often struggle with feelings of social isolation, depression, and anxiety, as the surgery alters both their appearance and daily interactions. Despite these difficulties, patients can experience remarkable resilience in adapting to life post-surgery, with important individual differences though. Understanding factors associated with resilience among laryngeal cancer patients who had TL is crucial for improving mental health interventions and enhancing rehabilitation efforts.

The objective of this study was to examine the resilience of patients who had TL for laryngeal cancer and identify the associated factors.

We carried-out a descriptive cross-sectional study including 30 patients treated for laryngeal cancer with TL in the Head and Neck Carcinologic Surgery Department at Salah Azaiez Institute.The operations took place during the period 2019-2022.All patients completed the Arabic versions of the Brief Resilience Scale (BRS) and the Arabic Multidimensional Scale of Perceived Social Support (MSPSS).

The study involved 30 male participants with a mean age of 62 years (±10 years).The mean BRS score was 17.6 ± 3.6. Patients from urban areas had lower BRS scores (P=0.005). Additionally, a higher level of education, particularly secondary or higher, was associated with lower BRS scores (P=0.001). Similarly, a higher socio-economic status correlated with lower BRS scores (P=0.02). Furthermore, greater resilience was significantly associated with higher perceived social support (P=0.001).

This study reveals that patients who have undergone total laryngectomy may experience varying levels of resilience based on socio-demographic factors and perceived social support. Higher social support is linked to greater resilience, emphasizing the need for robust support systems to aid in recovery. Further research is needed to refine support strategies for these patients.

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Approximately 450,000 new cases of head and neck cancers are diagnosed annually worldwide, with laryngeal cancer representing a significant proportion. In Tunisia, these cancers account for approximately 7.3% of all cancers diagnosed. Among those receiving surgical treatment, total laryngectomy is performed in nearly 50% of cases. Total laryngectomy (TL) is regarded as one of the most emotionally challenging surgical procedures due to its profound psychological and functional impacts.

This study aimed to investigate psychological distress (i.e. depression, anxiety, and stress) in Tunisian patients who had TL for laryngeal cancer.

A descriptive cross-sectional study was conducted among 30 patients treated with TL in the Head and Neck Carcinologic Surgery Department at Salah Azaiez Institute.The operations took place during the period 2019-2022.Socio-demographic and clinical data were gathered. All patients completed the Arabic version of Depression, Anxiety and Stress scale (DASS-21).

The study involved 30 male participants with a mean age of 62 years (±10 years). All patients were married and tobacco users, and 53% lived in urban areas. Regarding the Tumor, Node and Metastasis (TNM) staging: 63% were classified as T3, 83% as N0, and 100% as M0. The therapeutic modalities include primary total laryngectomy (TL) followed by radiotherapy, an organ preservation protocol (OPP) followed by TL, partial laryngectomy (PL) followed by TL, and primary TL followed by both radiotherapy and chemotherapy.A total of 67%, 100% and 3% patients had moderate to severe levels of depression, anxiety, and stress respectively.In addition, our study found that a higher level of education was significantly associated with lower levels of depression and anxiety (P=0.001 and P= 0.012, respectively). Urban living was linked to reduced anxiety (P=0.05). Stage N1 was associated with higher depression levels (P=0.013). Finally, previous conservative treatments, such as partial laryngectomy or organ preservation protocol were associated with higher depression scores (P=0.001).

Our findings showed high levels of psychological distress in patients with laryngeal cancer after total laryngectomy. Some factors correlated to distress in this group have been identified, enabling the identification of at-risk groups and effective prevention approaches.

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Quality of life is a subjective evaluation that individuals make of the various aspects of their lives in relation to their health. Head and neck cancers and their surgical treatments, such as total laryngectomy (TL), change some of the most basic and important vital functions and can affect patients’ lives in many ways. The patient’s altered appearance, loss of their normally used voice, difficulty swallowing, and certain complications from this kind of surgery, all contribute to impaired quality of life by imposing daily limitations. Despite these considerable impacts, there is no or only very limited research addressing the quality of life of patients post- TL, highlighting the need for further exploration into this critical aspect of patient care.

The purpose of this study was to assess self-perceived quality of life in Tunisian male patients who underwent TL for laryngeal cancer.

A descriptive cross-sectional study was conducted in the Head and Neck Carcinologic Surgery Department at Salah Azaiez Institute. Socio-demographic and clinical data were gathered. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N35), Depression, Anxiety and Stress scale, and Voice Handicap Index.

The study involved 30 male participants with a mean age of 62 years (±10 years). The mean EORTC QLQ-H&N35 total score was 60 ± 9.8. The areas of EORTC QLQ- H&N35 score most affected are shown in Figure 1.

Our results indicated that younger patients (P=0.002) and those from rural areas (P=0.04) tended to report better quality of life scores. Additionally, higher socioeconomic status was linked to a reduced quality of life (P=0.006). Patients who were classified as (N+) according to the Tumor, node and metastasis (TNM) staging, showed significantly better quality of life (P=0.004).A higher quality of life was significantly correlated with primary TL (P=0.004), while a lower quality of life was significantly associated with TL followed by radio-chemotherapy (P=0.005).Depression, anxiety, and stress were significantly correlated with poorer quality of life (P=0.002, P=0.001, P=0.001, respectively). Finally, lower quality of life scores were strongly associated with the Voice Handicap Index score (P=0.0001).

Figure 1. Distribution of patients according to their EORTC QLQ- H&N35 scores.

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In conclusion, patients who underwent TL for laryngeal cancer seem to exhibit an impaired quality of life, with factors like age, socioeconomic status, treatment type, voice handicap and psychological distress likely playing an important role. These findings underscore the need for comprehensive post-surgical care aiming at improving quality of life for people affected by this condition.

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