Search

Gut microbiota and infectious diseases affect neurological disorders, brain development, and function. Compounds generated in the gastrointestinal system by gut microbiota and infectious pathogens may mediate gut-brain interactions, which may circulate throughout the body and spread to numerous organs, including the brain. Studies shown that gut bacteria and disease-causing organisms may pass molecular signals to the brain, affecting neurological function, neurodevelopment, and neurodegenerative diseases. This article discusses microorganism-producing metabolites with neuromodulator activity, signaling routes from microbial flora to the brain, and the potential direct effects of gut bacteria and infectious pathogens on brain cells. The review also considered the neurological aspects of infectious diseases. The infectious diseases affecting neurological functions and the disease modifications have been discussed thoroughly. Recent discoveries and unique insights in this perspective need further validation. Research on the complex molecular interactions between gut bacteria, infectious pathogens, and the CNS provides valuable insights into the pathogenesis of neurodegenerative, behavioral, and psychiatric illnesses. This study may provide insights into advanced drug discovery processes for neurological disorders by considering the influence of microbial communities inside the human body. [ABSTRACT FROM AUTHOR]

Background:Increasing suicide rates, mental health problems and the need for intensive care have become an important health problem. Therefore, analyzing the sociodemographic and clinical characteristics of patients hospitalized in intensive care for suicide attempts is critical for developing effective intervention and prevention strategies. This study aims to analyze the sociodemographic characteristics and mental health of individuals who attempted suicide. Materials and Methods: In this retrospective descriptive study, suicide cases in the adult intensive care unit of a university hospital between 01.11.2017 and 01.11.2023 were analyzed through the hospital automation system. Results: The mean age of patients hospitalized in the intensive care unit in the last 10 years was 27.06 ± 10.15 years and 61% were female. 79.6% of the patients were admitted with a prediagnosis of suicide and 17.7% with alcohol or substance intoxication. Family pressure (32.7%), economic p roblems (17.7%) and psychiatric problems (15%) w ere the main reasons for suicide. The most common methods of suicide were drug abuse (67%), insecticide use (26%) and h anging (4%). S eventy per c ent of the patients were discharged with nausea and vomiting, 92 percent were discharged, and 8 per cent died. Suicide cases occurred mostly in July (15%) in 2017 (21%) and 2022 (18%). Suicides were frequently observed at night, especially at 23:00 (14.6%). Conclusions: This study investigated the sociodemographic and clinical characteristics of patients admitted to an intensive care unit in Turkey for suicide attempts. Results showed that most patients were young females who often attempted suicide by drug ingestion. Key contributing factors included family pressure, economic challenges, and psychiatric issues, with suicide cases peaking in the summer. These findings may aid in developing targeted prevention and intervention strategies by identifying high-risk groups and periods. [ABSTRACT FROM AUTHOR]

Background: Medical clearance for patients presenting with psychiatric-like illnesses has been a topic of debate for years. This study aimed to determine the predictors of diagnosing psychiatric illness in the emergency department (ED). Methods: The study included patients aged ≥13 years presenting to the adult ED with psychiatric-like illness over 1 year (January 01, 2019–December 31, 2019). Medical charts were reviewed, and multiple variables were coded and analyzed. Results: Our study included 361 patients, constituting 0.89% of the total ED visits. The majority (335 patients, 92.8%) were diagnosed with primary psychiatric illnesses, while 26 patients (7.2%) had underlying medical conditions contributing to their symptoms. Bivariate and multivariate logistic regression analysis identified the predictors for initial psychiatric diagnoses, including abnormal behavior (odd’s ratio [OR]: 8.29; 95% confidence interval [CI]: 2.04–33.65; P < 0.01) and substance abuse (adjusted OR: 17.27; 95% CI: 3.88–76.88; P < 0.01). Notable findings involved family history or previous psychiatric illness (OR: 2.32; 95% CI: 0.59–6.09; P < 0.01), absence of medical comorbidities (adjusted OR: 2.47; 95% CI: 1.05–5.86; P < 0.01), and no new medication initiation before illness (OR: 6.43; 95% CI: 1.52–27.18; P < 0.01), normal sensorium (adjusted OR: 2.84; 95% CI: 0.81–10.00; P < 0.01) and intact orientation (adjusted OR: 6.73; 95% CI: 1.24–36.42; P < 0.01) demonstrated statistically significant predictors of an initial psychiatric diagnosis in the ED. Conclusion: Significant predictors of initial psychiatric illness included abnormal behavior, substance abuse, family psychiatric history, absence of major medical conditions, no recent medication changes before illness onset, normal sensorium and orientation, and normal laboratory markers at presentation.

Introduction: Psychiatric disorders are clinically significant behavioral or psychological syndromes that are associated with distress or disability. The global burden of these disorders is increasing because they are considered a stigma in society and this is worsened by medication nonadherence. Many studies show that attitudes toward drugs have a direct or indirect impact on psychiatric illness. This study will help to understand the relationship between drug attitude and medication adherence. Materials and Methods: A cross-sectional analytical research design was used. Data were collected from 100 patients using nonprobability convenience sampling technique. The Drug Attitude Inventory scale-30 and Medication Adherence Rating Scale were administered. Statistical analysis was performed by employing the statistical package, SPSS version 20. Karl Pearson’s correlation coefficient, Pearson’s Chi-squared test, and Fisher’s exact test were used. Results: The majority of patients (85%) had positive drug attitudes with a mean score and a standard deviation (SD) was 10.54 ± 8.722, while 63% of patients adhered to the medications with a mean score and SD was 6.60 ± 1.902. Further, drug attitude was found to be a moderately positive correlation with medication adherence (r = 0.408). Moreover, drug attitude and medication adherence were significantly associated with the age of the patients (P < 0.05). Conclusion: A positive correlation was noted between drug attitude and medication adherence, suggesting an effective intervention program can be developed to change patients’ attitude toward medications and thus increase their compliance.

Background: Over 450 million individuals worldwide suffer from mental illnesses, according to epidemiological data, making this one of the biggest problems facing modern medicine. People often react in a fairly discriminatory way to those with mental illness, and stigmatizing views toward those with mental illness are ubiquitous. In India, people who suffer from mental illness live with their families, and the stigma associated with mental illness has a significant impact on how effectively these people are treated over time by their families and communities. Objective: This study aims to specifically investigate how undergraduate medical students who participated in a two-week psychiatric posting and teaching program and those who did not learn about mental illness from the course curriculum or clinical experience differed in their perceived stigma toward people with mental illness. Materials and Methods: This cross-sectional study used a self-reported Perceived devaluation-discrimination scale (PDDS) questionnaire distributed via Google form to undergraduate medical students who were exposed (n = 72) to a two-week psychiatry posting and attended lectures and those who were not exposed (n = 176) to psychiatry training. Results: The results show that medical students’ perceptions of the stigma associated with mental illness remain unchanged following their exposure to psychiatry training. Nonetheless, it was discovered that students’ perceptions of the stigma associated with mental health patients were influenced by their urban domicile. Conclusions: Our research indicates that there was perceived stigma among medical students about patients with mental illnesses, and that this tendency was more pronounced among students belonging from rural areas.

Abstract Background Insomnia is common among patients with psychiatric disorders and affects the clinical presentation and outcomes of the psychiatric disorder. The presentation of insomnia varies according to the type and severity of the psychiatric disorder. Objectives This cross-sectional study aimed to assess the prevalence and severity of insomnia in adult psychiatric outpatients attending Psychiatry and Addiction Medicine Hospital, Faculty of Medicine, Cairo University. The study included 390 patients diagnosed with the following disorders: depressive disorders (n = 126 (32.2%)), anxiety disorders (n = 69 (17.6%)), psychotic spectrum disorders (n = 67 (17.1%)), bipolar and related disorders (n = 50 (12.8%)), trauma and stress-related disorders (n = 46 (11.8%)), obsessive–compulsive disorder (n = 30 (7.7%)), and somatic symptoms disorders (n = 2 (0.5%)). Patients were assessed using the Sleep Disorder Interview, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Global Assessment of Functioning Scale (GAF). Results Among the assessed patients, 314 (80.5%) had insomnia, with a higher prevalence in females (91.5%) compared to males (67.2%). The prevalence of insomnia was 96% in depressive disorders, 97.1% in anxiety disorders, 49.3% in psychotic disorders, and 32% in bipolar and related disorders; while all patients with trauma and stress-related disorders, obsessive–compulsive disorders, and somatic symptoms disorders had insomnia. The severity of insomnia as measured by ISI was positively correlated with the global functioning score (r = 0.341, p =

It is already a well-known fact how important early life experiences are in shaping an individual's personality, and one of the most important factors that influence a person's psychological development are parenting styles and the attachment that develops between parents and children. Parenting is a complex process that carries with it a great responsibility, and consists of taking care of the child's basic, physiological needs, as well as raising, guiding and encouraging the child's cognitive, emotional and social development. Parenting can be a particularly big challenge for people suffering from mental disorders, and some studies show that children of parents suffering from mental disorders have a higher risk of developing mental disorders compared to the general population. They are at increased risk of experiencing emotional, developmental and social problems. The mentioned difficulties can be caused by biological predispositions, but also by environmental factors. Mental illness of parents can result in less emotional availability of parents to children and insecure forms of attachment, insufficiently adequate way of establishing communication towards the child, weaker ability to recognize the child's needs and in extreme situations can result in increased hostility towards the child, complete neglect, rejection and potential abuse. Numerous social and economic factors associated with the psychiatric illness of the parents can also adversely affect the child's development, and some of the more prominent ones are social stigma towards psychiatric illnesses, which affects not only the sick person but also family members, lack of social support, poverty and difficult access to education and employment. However, for many parents suffering from psychiatric illnesses, children represent a strong motivation for treatment. Providing support to children and parents, education and strengthening social support can significantly reduce the risk of developing psychological disorders in children themselves. We will present the findings so far in more detail on the case of a girl who grows up with a mother suffering from a mental illness. A 13-year-old girl comes to a psychologist because of the risky behaviors she has been prone to recently. After the psychological treatment, she was included in the counseling treatment of a psychologist, and the mother was referred to a psychiatrist by the psychologist. Only by synchronized work and cooperation in the treatment of the parents (in this case the mother) can we strengthen the mental health of the girl.

Background: The question of the role of personal values in the constitution of and recovery from mental illness is a divisive subject discussed in contemporary psychopathology. This article critically examines the psychopathological theories and contributions of Antoni Kępiński – a seminal yet internationally under-recognized Polish psychiatrist. Summary: Drawing upon a multilayered framework incorporating biological, affective-emotional, and sociocultural dimensions, Kępiński posited mental disorders as disturbances in the energy and information metabolism with the environment leading to an increase in entropy. Kępiński’s work also contributes to a richer understanding of schizophrenia (whose essence he metaphorically described as the plasma membrane rupture) and the complexities inherent in the decision-making processes of patients. In a quasi-phenomenological vein, Kępiński encouraged to re-evaluate delusions and hallucinations as opportunities to access unfiltered insights into reality. He also argued for the potential for moral growth within psychiatric treatment. Key Messages: Kępiński’s theories anticipated many concepts now foundational in neuroscientific research and clinical psychiatry, showcasing his role as a forward-thinking figure in the history of the profession. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Over 450 million individuals worldwide suffer from mental illnesses, according to epidemiological data, making this one of the biggest problems facing modern medicine. People often react in a fairly discriminatory way to those with mental illness, and stigmatizing views toward those with mental illness are ubiquitous. In India, people who suffer from mental illness live with their families, and the stigma associated with mental illness has a significant impact on how effectively these people are treated over time by their families and communities. Objective: This study aims to specifically investigate how undergraduate medical students who participated in a two-week psychiatric posting and teaching program and those who did not learn about mental illness from the course curriculum or clinical experience differed in their perceived stigma toward people with mental illness. Materials and Methods: This cross-sectional study used a self-reported Perceived devaluation-discrimination scale (PDDS) questionnaire distributed via Google form to undergraduate medical students who were exposed (n = 72) to a two-week psychiatry posting and attended lectures and those who were not exposed (n = 176) to psychiatry training. Results: The results show that medical students' perceptions of the stigma associated with mental illness remain unchanged following their exposure to psychiatry training. Nonetheless, it was discovered that students' perceptions of the stigma associated with mental health patients were influenced by their urban domicile. Conclusions: Our research indicates that there was perceived stigma among medical students about patients with mental illnesses, and that this tendency was more pronounced among students belonging from rural areas. [ABSTRACT FROM AUTHOR]

Background: Insomnia is common among patients with psychiatric disorders and affects the clinical presentation and outcomes of the psychiatric disorder. The presentation of insomnia varies according to the type and severity of the psychiatric disorder. Objectives: This cross-sectional study aimed to assess the prevalence and severity of insomnia in adult psychiatric outpatients attending Psychiatry and Addiction Medicine Hospital, Faculty of Medicine, Cairo University. The study included 390 patients diagnosed with the following disorders: depressive disorders (n = 126 (32.2%)), anxiety disorders (n = 69 (17.6%)), psychotic spectrum disorders (n = 67 (17.1%)), bipolar and related disorders (n = 50 (12.8%)), trauma and stress-related disorders (n = 46 (11.8%)), obsessive–compulsive disorder (n = 30 (7.7%)), and somatic symptoms disorders (n = 2 (0.5%)). Patients were assessed using the Sleep Disorder Interview, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Global Assessment of Functioning Scale (GAF). Results: Among the assessed patients, 314 (80.5%) had insomnia, with a higher prevalence in females (91.5%) compared to males (67.2%). The prevalence of insomnia was 96% in depressive disorders, 97.1% in anxiety disorders, 49.3% in psychotic disorders, and 32% in bipolar and related disorders; while all patients with trauma and stress-related disorders, obsessive–compulsive disorders, and somatic symptoms disorders had insomnia. The severity of insomnia as measured by ISI was positively correlated with the global functioning score (r = 0.341, p = < 0.001) and negatively correlated with the duration of the psychiatric illness (r = − 0.285, p = < 0.001). Conclusions: Insomnia is highly prevalent in outpatients with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: Suicide has been noted as a distressing phenomenon among the society, in one way or the other. It poses a serious public health problem and requires meticulous in depth probing with all the compassion for the victims of suicide. The aim of this study is to assess the predictors of suicidal behaviour in young adults and suggest novel suicide prevention policies. Materials and Methods: It was a hospital based descriptive cross-sectional study conducted over 18 months amongst suicide attempters in the age range of 18 to 35 years who were brought to the Casualty and Psychiatry department of a tertiary care hospital of north India.100 consecutive suicide attempters, gave voluntary written informed consent were enrolled. Socio-demographic profile, details of past psychiatric illness, family history of psychiatric illness, previous suicidal attempt and history of substance abuse were recorded. Psychiatric morbidity was assessed using Mini International Neuropsychiatric Interview (MINI) and confirmed on International Classification of Diseases 10th edition (ICD-10).Depression, Anxiety and Stress were assessed on Depression anxiety and Stress Scale-21(DASS-21). Beck Suicide Intent Scale (BSIS) was used to measure severity of suicide intent and to find out any association between presence of past psychiatric history/family history of psychiatric illness/previous suicide attempt with suicide intent Results: Out of 100 attempted suicidal patients, male to female ratio was 1.44:1.Past psychiatric illness, family history of psychiatric illness, previous suicidal attempt and substance abuse was observed among 23% (n=23), 19%(n=19), 23% (n=23)and 34% (n=34) patients, respectively. 59%(n=59) patients were found to be having psychiatric illness currently. Overall Mean±SD score of severe depression was 25.64±12.36, severe anxiety (19.38±9.39) and moderate stress (24.18±8.61) as assessed on Depression anxiety and Stress Scale-21 items(DASS-21).67%(n=67) patients had high suicide intent on Beck Suicide Intent Scale (BSIS).There was positive association between past psychiatric illnesses and BSIS i.e.,91.3% compared to 59.7% without psychiatric illness (χ²=18.589, p=0.001). Conclusion: Multifactorial indicators and psychological aspects such as depression, anxiety, stress and substance abuse reaffirm its causality with high suicide intent and a forerunner for subsequent attempts. [ABSTRACT FROM AUTHOR]

Burn injuries remain a significant cause of disability, impacting long term quality-of-life and imposing large costs on our health systems. Readmission is a metric of quality and an important contributor to this economic burden. The association of socioeconomic and insurance status with burn readmission is not well established. The aim of our study is to develop a predictive risk model of factors associated with readmission after burns. Using the Healthcare Cost and Utilization Project's 2018 Nationwide Readmission Database, we identified patients ≥18 y of age with burns admitted between January and October 2018. We excluded patients who died during index admission. Our primary outcome was readmission within 60 d postdischarge. We performed a Lasso regression analysis with adaptive selection to generate a predictive model with least deviance using patients' demographics and socioeconomic status, burn location and severity, past medical history, and hospital characteristics. Weighted multiple logistic regression was performed to obtain population estimates of adjusted odds ratios (ORs) of each element in the model. Our cohort included 11,380 burn patients. Of those, 1625 (14.3%) were readmitted and 67% were males. Readmitted patients were older (55 ± 17 versus 49 ± 18, P = 0.0001). Weighted logistic regression for the selected model showed higher odds of readmission for patients with lowest income quartile (OR: 1.19, 95% confidence interval [CI]: 1.04-1.36), Medicare or Medicaid insurance (OR: 1.35, 95% CI: 1.17-1.55), history of psychiatric illness (OR:1.19, 95% CI: 1.02-1.39), diabetes (OR: 1.46, 95% CI: 1.25-1.69), chronic kidney disease (OR: 1.66, 95% CI: 1.30-2.11), chronic obstructive pulmonary disease (OR: 1.55, 95% CI:1.26-1.89), and alcohol use disorder (OR: 1.33, 95% CI: 1.13-1.58). Third degree burns and foot burns had higher OR of readmission (OR: 1.21, 95% CI: 1.38-1.98 and 1.66, 95% CI: 1.02-1.45, respectively), while face and hand burns had lower OR of readmission (OR: 0.77, 95% CI: 0.66-0.90 and 0.84, 95% CI: 0.72-0.98, respectively). Burn readmissions are multifactorial and directly related to the patient's comorbidities, including markers that reflect barriers to care such as socioeconomic characteristics, as well as the anatomical location of burn injuries. Early identification of these high-risk patients may aid in early intervention, resource allocation, and outreach program development in an attempt to reduce readmission rates and improve outcomes. Future prospective validation of these risk factors is warranted. [ABSTRACT FROM AUTHOR]

Background: Psychotropic polypharmacy involves the concurrent prescription of two or more psychotropic medications to a patient. The prevalence varies from 13% to 90%. Polypharmacy may increase the effectiveness of treatment but can increase the chances of adverse effects, drug interactions, cost, and lower adherence. Aim and Objective: The aim and objective of the study are to assess the frequency and the factors associated with psychotropic polypharmacy. Materials and Methods: A crosssectional study was conducted among adult patients attending a psychiatry clinic in a tertiary care center. The study was initiated after obtaining clearance from the institutional ethics committee and informed consent from the patients. Detailed demographic, disease, and drug data were collected through interviewing and reviewing the case record forms of patients. The Chi-square test and binary logistic regression were used to determine the factors associated with polypharmacy. Results: Of the 125 study participants, 87.2% were aged between 20 and 60 years. The overall frequency of polypharmacy was 68.8%. The frequency of polypharmacy was 100% in bipolar disorder (BPD), 85.2% in psychosis, 81.3% in anxiety, 64.7% in depression, and 52.4% in alcohol dependence syndrome. 70% of BPD and 37% of psychosis patients had antipsychotic polypharmacy and 19% of anxiety patients had selective serotonin reuptake inhibitor polypharmacy. 11% of psychosis patients had polypharmacy of sedatives. On regression analysis, the factors significantly associated with psychotropic polypharmacy were the primary diagnoses of the patient, i.e., psychosis and anxiety. Conclusion: More than half of the patients were noted to have psychotropic polypharmacy. The frequency was higher in BPD and psychosis. [ABSTRACT FROM AUTHOR]

Abstract Background Dimension reduction methods do not always reduce their underlying indicators to a single composite score. Furthermore, such methods are usually based on optimality criteria that require discarding some information. We suggest, under some conditions, to use the joint probability density function (joint pdf or JPD) of p-dimensional random variable (the p indicators), as an index or a composite score. It is proved that this index is more informative than any alternative composite score. In two examples, we compare the JPD index with some alternatives constructed from traditional methods. Methods We develop a probabilistic unsupervised dimension reduction method based on the probability density of multivariate data. We show that the conditional distribution of the variables given JPD is uniform, implying that the JPD is the most informative scalar summary under the most common notions of information. B. We show under some widely plausible conditions, JPD can be used as an index. To use JPD as an index, in addition to having a plausible interpretation, all the random variables should have approximately the same direction(unidirectionality) as the density values (codirectionality). We applied these ideas to two data sets: first, on the 7 Brief Pain Inventory Interference scale (BPI-I) items obtained from 8,889 US Veterans with chronic pain and, second, on a novel measure based on administrative data for 912 US Veterans. To estimate the JPD in both examples, among the available JPD estimation methods, we used its conditional specifications, identified a well-fitted parametric model for each factored conditional (regression) specification, and, by maximizing the corresponding likelihoods, estimated their parameters. Due to the non-uniqueness of conditional specification, the average of all estimated conditional specifications was used as the final estimate. Since a prevalent common use of indices is ranking, we used measures of monotone dependence [e.g., Spearman’s rank correlation (rho)] to assess the strength of unidirectionality and co-directionality. Finally, we cross-validate the JPD score against variance–covariance-based scores (factor scores in unidimensional models), and the “person’s parameter” estimates of (Generalized) Partial Credit and Graded Response IRT models. We used Pearson Divergence as a measure of information and Shannon’s entropy to compare uncertainties (informativeness) in these alternative scores. Results An unsupervised dimension reduction was developed based on the joint probability density (JPD) of the multi-dimensional data. The JPD, under regularity conditions, may be used as an index. For the well-established Brief Pain Interference Inventory (BPI-I (the short form with 7 Items) and for a new mental health severity index (MoPSI) with 6 indicators, we estimated the JPD scoring. We compared, assuming unidimensionality, factor scores, Person’s scores of the Partial Credit model, the Generalized Partial Credit model, and the Graded Response model with JPD scoring. As expected, all scores’ rankings in both examples were monotonically dependent with various strengths. Shannon entropy was the smallest for JPD scores. Pearson Divergence of the estimated densities of different indices against uniform distribution was maximum for JPD scoring. Conclusions An unsupervised probabilistic dimension reduction is possible. When appropriate, the joint probability density function can be used as the most informative index. Model specification and estimation and steps to implement the scoring were demonstrated. As expected, when the required assumption in factor analysis and IRT models are satisfied, JPD scoring agrees with these established scores. However, when these assumptions are violated, JPD scores preserve all the information in the indicators with minimal assumption.

Background: Dimension reduction methods do not always reduce their underlying indicators to a single composite score. Furthermore, such methods are usually based on optimality criteria that require discarding some information. We suggest, under some conditions, to use the joint probability density function (joint pdf or JPD) of p-dimensional random variable (the p indicators), as an index or a composite score. It is proved that this index is more informative than any alternative composite score. In two examples, we compare the JPD index with some alternatives constructed from traditional methods. Methods: We develop a probabilistic unsupervised dimension reduction method based on the probability density of multivariate data. We show that the conditional distribution of the variables given JPD is uniform, implying that the JPD is the most informative scalar summary under the most common notions of information. B. We show under some widely plausible conditions, JPD can be used as an index. To use JPD as an index, in addition to having a plausible interpretation, all the random variables should have approximately the same direction(unidirectionality) as the density values (codirectionality). We applied these ideas to two data sets: first, on the 7 Brief Pain Inventory Interference scale (BPI-I) items obtained from 8,889 US Veterans with chronic pain and, second, on a novel measure based on administrative data for 912 US Veterans. To estimate the JPD in both examples, among the available JPD estimation methods, we used its conditional specifications, identified a well-fitted parametric model for each factored conditional (regression) specification, and, by maximizing the corresponding likelihoods, estimated their parameters. Due to the non-uniqueness of conditional specification, the average of all estimated conditional specifications was used as the final estimate. Since a prevalent common use of indices is ranking, we used measures of monotone dependence [e.g., Spearman's rank correlation (rho)] to assess the strength of unidirectionality and co-directionality. Finally, we cross-validate the JPD score against variance–covariance-based scores (factor scores in unidimensional models), and the "person's parameter" estimates of (Generalized) Partial Credit and Graded Response IRT models. We used Pearson Divergence as a measure of information and Shannon's entropy to compare uncertainties (informativeness) in these alternative scores. Results: An unsupervised dimension reduction was developed based on the joint probability density (JPD) of the multi-dimensional data. The JPD, under regularity conditions, may be used as an index. For the well-established Brief Pain Interference Inventory (BPI-I (the short form with 7 Items) and for a new mental health severity index (MoPSI) with 6 indicators, we estimated the JPD scoring. We compared, assuming unidimensionality, factor scores, Person's scores of the Partial Credit model, the Generalized Partial Credit model, and the Graded Response model with JPD scoring. As expected, all scores' rankings in both examples were monotonically dependent with various strengths. Shannon entropy was the smallest for JPD scores. Pearson Divergence of the estimated densities of different indices against uniform distribution was maximum for JPD scoring. Conclusions: An unsupervised probabilistic dimension reduction is possible. When appropriate, the joint probability density function can be used as the most informative index. Model specification and estimation and steps to implement the scoring were demonstrated. As expected, when the required assumption in factor analysis and IRT models are satisfied, JPD scoring agrees with these established scores. However, when these assumptions are violated, JPD scores preserve all the information in the indicators with minimal assumption. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Psychiatric disorders are clinically significant behavioral or psychological syndromes that are associated with distress or disability. The global burden of these disorders is increasing because they are considered a stigma in society and this is worsened by medication nonadherence. Many studies show that attitudes toward drugs have a direct or indirect impact on psychiatric illness. This study will help to understand the relationship between drug attitude and medication adherence. Materials and Methods: A cross-sectional analytical research design was used. Data were collected from 100 patients using nonprobability convenience sampling technique. The Drug Attitude Inventory scale-30 and Medication Adherence Rating Scale were administered. Statistical analysis was performed by employing the statistical package, SPSS version 20. Karl Pearson's correlation coefficient, Pearson's Chi-squared test, and Fisher's exact test were used. Results: The majority of patients (85%) had positive drug attitudes with a mean score and a standard deviation (SD) was 10.54 ± 8.722, while 63% of patients adhered to the medications with a mean score and SD was 6.60 ± 1.902. Further, drug attitude was found to be a moderately positive correlation with medication adherence (r = 0.408). Moreover, drug attitude and medication adherence were significantly associated with the age of the patients (P < 0.05). Conclusion: A positive correlation was noted between drug attitude and medication adherence, suggesting an effective intervention program can be developed to change patients' attitude toward medications and thus increase their compliance. [ABSTRACT FROM AUTHOR]

Self-immolation, a form of self-harm involving setting oneself on fire, is associated with high mortality, morbidity, and healthcare burden. This study aimed to characterize potential clinical correlates and predisposing factors for self-immolation based on burn severity using TBSA percentage scoring. Additional objectives included identifying motivational elements, associated risk factors, and clinical characteristics to optimize patient care and reduce future self-immolation incidents. A retrospective review of admissions to the Arizona Burn Center from July 2015 to August 2022 identified 103 self-immolation patients for the study. Burn severity was categorized as mild to moderate (TBSA < 20%) or severe (TBSA ≥ 20%) based on TBSA. This study population had a mortality rate of 21%. Positive urine drug screens were found in 44% of subjects, and 63% having chronic substance use, with methamphetamine (37%) and alcohol (30%), being the most prevalent. Underlying psychiatric illnesses were present in 83% of patients. Suicidal intent strongly predicted severe burns (P <.001) among the 68 severe burn cases identified. In conclusion, this study emphasizes that the presence of suicidal intent among self-immolation patients significantly correlates with burn severity. These findings highlight the importance of involving psychiatric services early in patient care to improve outcomes and reduce the recurrence of self-immolation acts. [ABSTRACT FROM AUTHOR]

Informed consent is a fundamental tenet of patient-centred clinical practice as it upholds the ethical principle of patient autonomy and promotes shared decision-making. In the medicolegal realm, failure to meet the accepted standards of consent can be considered as medical negligence which has both legal and professional implications. In general, valid consent requires three core components: (1) the presence of mental capacity – characterised by the patient's ability to comprehend, retain information, weigh options and communicate the decision, (2) adequate information disclosure – based on the 'reasonable physician' or 'reasonable patient' standards and (3) voluntariness in decision-making. Nonetheless, in real-world clinical settings, informed consent is not always optimally achieved, due to various patient, contextual and systemic factors. In this article, I herein discuss three major challenges to informed consent in clinical practice: (1) patient literacy and sociocultural factors, (2) psychiatric illnesses and elderly patients with cognitive impairment and (3) artificial intelligence in clinical care, and sought to offer practical mitigating strategies to address these barriers. [ABSTRACT FROM AUTHOR]

The brain is a living organ with distinct metabolic constraints. However, these constraints are typically considered as secondary or supportive of information processing which is primarily performed by neurons. The default operational definition of neural information processing is that (1) it is ultimately encoded as a change in individual neuronal firing rate as this correlates with the presentation of a peripheral stimulus, motor action or cognitive task. Two additional assumptions are associated with this default interpretation: (2) that the incessant background firing activity against which changes in activity are measured plays no role in assigning significance to the extrinsically evoked change in neural firing, and (3) that the metabolic energy that sustains this background activity and which correlates with differences in neuronal firing rate is merely a response to an evoked change in neuronal activity. These assumptions underlie the design, implementation, and interpretation of neuroimaging studies, particularly fMRI, which relies on changes in blood oxygen as an indirect measure of neural activity. In this article we reconsider all three of these assumptions in light of recent evidence. We suggest that by combining EEG with fMRI, new experimental work can reconcile emerging controversies in neurovascular coupling and the significance of ongoing, background activity during resting-state paradigms. A new conceptual framework for neuroimaging paradigms is developed to investigate how ongoing neural activity is "entangled" with metabolism. That is, in addition to being recruited to support locally evoked neuronal activity (the traditional hemodynamic response), changes in metabolic support may be independently "invoked" by non-local brain regions, yielding flexible neurovascular coupling dynamics that inform the cognitive context. This framework demonstrates how multimodal neuroimaging is necessary to probe the neurometabolic foundations of cognition, with implications for the study of neuropsychiatric disorders.

BackgroundSuicide is the second most common cause of death among adolescents and young adults. In the pediatric population, gunshot wounds (GSWs) and hangings are common mechanisms of pediatric suicide. Comorbid psychiatric illness is prevalent in this population, but psychiatric resource utilization after self-inflicted traumatic injury is not well characterized.MethodsWe analyzed patients

Abstract Objectives This study purposed to analyze perceived attitudes toward LGBTQ + physicians and related factors among individuals with psychiatric illnesses in southern Thailand. Materials and methods From May to July 2023, a cross-sectional study was conducted at four psychiatric outpatient clinics in Southern Thailand. The questionnaires utilized were: 1) a demographic information questionnaire, 2) a questionnaire regarding attitudes toward LGBTQ + physicians, 3) a questionnaire evaluating individuals’ attitudes toward LGBTQ + physicians while receiving medical attention, and 4) a patient-doctor relationship questionnaire. All data were analyzed using descriptive statistics, and the factors associated with perceived attitudes toward LGBTQ + physicians were analyzed using the Wilcoxon rank sum test, the Kruskal–Wallis test, and linear regressions. The analyses were conducted using the R Foundation for Statistical Computing software, version 4.3.1. Statistical significance was defined as a p-value of less than 0.05. Results Among our 542 participants, the mean age was 36.3 ± 14.1 years. The majority were female (64.6%), Buddhist (62.4%), and diagnosed with depression (46.3%). Approximately three-quarters showed a good doctor-patient relationship (74.0%). The median (IQR) score of the perceived attitudes toward LGBTQ + physicians was 75 (66, 88). Predominantly, the LGBTQ + physicians were perceived as normal (76.3%) and being a viable part of society (88.7%). Moreover, our participants disagreed with the view that being an LGBTQ + physician was a sin (70.6%) or immoral (68.2%). They felt comfortable during history taking (79.0%), physical examination not involving private parts of the body (72.5%), and management for both medical (78.4%) and psychiatric conditions (81.4%) at the hands of LGBTQ + physicians. However, they reported feeling uncomfortable during history taking involving private matters (6.3%) and the physical examination of private parts (16.4%). Older age, absence of LGBTQ + close relatives/friends, and being a Muslim were associated with lower scores of perceived attitudes toward LGBTQ + physicians. Conversely, a higher level of education and a reported mismatch between the patient’s sex and gender were associated with higher scores. Conclusions Most participants reported positive perceived attitudes toward LGBTQ + physicians. However, some age groups and adherents of Islam showed lower perceived attitude scores and reported feeling uncomfortable receiving medical treatment from LGBTQ + physicians. On the one hand, LGBTQ + physicians have cause to be concerned about this point; on the other hand, finding appropriate approaches to promote positive attitudes toward LGBTQ + physicians among these groups of people remains a necessity.

It is well-known that suicide and excess mortality are high in patients with psychiatric illnesses and this has long been an important issue in the field of mental health. We aim to investigate suicide and other-cause deaths in patients with psychiatric illnesses. This retrospective, population-based cohort was based on the National Health Insurance claims data of the first admission with a principal diagnosis of major psychiatric disorder between 2010 and 2011, and followed up to 2020. A total of 95,855 participants were enrolled. Suicide and other-cause mortality were assessed through Log-rank test and Kaplan-Meier curve. There were 95,855 patients, with an average age of 48.2 years. The number of suicide deaths and other-cause deaths was 2408 (288.1 per 100,000 person-years) and 15,192 (1817.6 per 100,000 person-years), respectively. The rate of healthcare utilization prior to suicide was 95.0 %, and the rate of utilization prior to one week before suicide was 43.5 %. The risk of suicide was highest in patients with depression, followed by alcohol use disorder, schizophrenia, and bipolar disorder. This study revealed various factors related to healthcare utilization associated with suicide and other-cause deaths in psychiatric patients. Educating frontline healthcare professionals, psychiatrists, emergency department personnel, and general practice doctors using such as Gatekeeper program is important to prevent suicides. • The death by suicide in psychiatric patients has a discrete entity compared to other-cause death. • There is a significantly higher number of deaths by suicide in patients with depressive disorder compared to other psychiatric illnesses. • 95.9 % used healthcare services before death by suicide and 43.5 % used them within a week prior to suicide. [ABSTRACT FROM AUTHOR]

Objectives: This study purposed to analyze perceived attitudes toward LGBTQ + physicians and related factors among individuals with psychiatric illnesses in southern Thailand. Materials and methods: From May to July 2023, a cross-sectional study was conducted at four psychiatric outpatient clinics in Southern Thailand. The questionnaires utilized were: 1) a demographic information questionnaire, 2) a questionnaire regarding attitudes toward LGBTQ + physicians, 3) a questionnaire evaluating individuals' attitudes toward LGBTQ + physicians while receiving medical attention, and 4) a patient-doctor relationship questionnaire. All data were analyzed using descriptive statistics, and the factors associated with perceived attitudes toward LGBTQ + physicians were analyzed using the Wilcoxon rank sum test, the Kruskal–Wallis test, and linear regressions. The analyses were conducted using the R Foundation for Statistical Computing software, version 4.3.1. Statistical significance was defined as a p-value of less than 0.05. Results: Among our 542 participants, the mean age was 36.3 ± 14.1 years. The majority were female (64.6%), Buddhist (62.4%), and diagnosed with depression (46.3%). Approximately three-quarters showed a good doctor-patient relationship (74.0%). The median (IQR) score of the perceived attitudes toward LGBTQ + physicians was 75 (66, 88). Predominantly, the LGBTQ + physicians were perceived as normal (76.3%) and being a viable part of society (88.7%). Moreover, our participants disagreed with the view that being an LGBTQ + physician was a sin (70.6%) or immoral (68.2%). They felt comfortable during history taking (79.0%), physical examination not involving private parts of the body (72.5%), and management for both medical (78.4%) and psychiatric conditions (81.4%) at the hands of LGBTQ + physicians. However, they reported feeling uncomfortable during history taking involving private matters (6.3%) and the physical examination of private parts (16.4%). Older age, absence of LGBTQ + close relatives/friends, and being a Muslim were associated with lower scores of perceived attitudes toward LGBTQ + physicians. Conversely, a higher level of education and a reported mismatch between the patient's sex and gender were associated with higher scores. Conclusions: Most participants reported positive perceived attitudes toward LGBTQ + physicians. However, some age groups and adherents of Islam showed lower perceived attitude scores and reported feeling uncomfortable receiving medical treatment from LGBTQ + physicians. On the one hand, LGBTQ + physicians have cause to be concerned about this point; on the other hand, finding appropriate approaches to promote positive attitudes toward LGBTQ + physicians among these groups of people remains a necessity. [ABSTRACT FROM AUTHOR]

Introduction: An amount of literature has heavily focused on homicidal mothers. Nevertheless, little is known about paternal filicides due to the lower frequency of these events. This study aimed to identify the spatiotemporal coordinates, authors' and victims' characteristics, and the context in which these murders occur to identify specific patterns. Methods: We analyzed 76 events in Italy between 1996 and 2012 involving 134 victims. The data were collected through a careful and thorough review of the daily press and encoded on an Excel ® sheet specially designed for data collection. Results: Findings show a significant incidence of psychiatric disorders, a history of violent behavior, employment problems, and low-skilled professional roles. In particular, violence seems to be determined by the fear of loss, which is more common among the common law partner and among the youngest male, especially when the son is far. Conclusion: The in-depth analysis of the phenomenon may contribute to its best knowledge and identify the areas in which psychosocial intervention is required based on prevention best practices.

Background: The National Mental Health Survey was borne out of the felt need for a comprehensive epidemiological survey on mental health to understand the magnitude of psychiatric morbidities in India to aid in mental health policymaking, service planning, and delivery. Kerala was one of the 12 surveyed states, representing southern India. Aims: To estimate the prevalence and pattern of various mental illnesses and substance use disorders in a representative sample from Kerala state. Settings and Design: A household survey using a multi-stage, stratified, random cluster sampling technique, with selection based on probability proportionate to size at each stage. Materials and Methods: The community-based survey was carried out by trained field staff on individuals from systematically selected households from three randomly selected districts of Kerala. The instruments used in the survey included M.I.N.I adult version 6.0, a modified version of the Fagerström Nicotine Dependence Scale and questionnaires to screen for epilepsy, intellectual disability, and autism spectrum disorders. Results: A total of 2479 respondents aged >18 years were interviewed. The lifetime and current prevalence of mental morbidity (excluding tobacco use disorders) was 14.14% and 11.36%, respectively. Neurotic/stress-related disorders and depressive disorders were 5.43% and 2.49%, respectively, while severe mental disorders were prevalent in 0.44% of the sample. The prevalence of high risk for suicide was 2.23%. Conclusions: The survey revealed high rates of common mental illnesses and suicide risk in the state when compared to national estimates.

BackgroundPsychiatric diseases are a serious threat to human health. Studies have shown an association between ambient air pollution and psychiatric diseases, yet the results are inconsistent. ObjectiveTo explore the potential effects of air pollution exposure on psychiatric diseases using Zhengzhou City as an example. MethodsOutpatient consultation data of the Clinical Psychology Clinic at The First Affiliated Hospital of Henan University of Traditional Chinese Medicine as well as air quality data between 28 October 2013 and 28 August 2019 were collected. The exposure-lag effect between air pollutant exposure and daily outpatient visits was assessed using a distribution lag nonlinear model (DLNM), and subgroup analyses were conducted including sex (male and female), age (59 years), season (spring, summer, autumn, and winter), and types of diseases (depression and anxiety). ResultsA total of 112986 valid confirmed outpatient visit records for psychiatric diseases were collected. The largest proportions of visits in each subgroup were females, 18-59 years old, spring, and depression. The results of one-day lagged risk of total outpatient visits showed that PM2.5, PM10, SO2, and NO2 all significantly associated with an increased risk of psychiatric outpatient visits. The one-day lagged risk peaks were: PM2.5 (RR=1.0016, 95%CI: 1.0011, 1.0022), PM10 (RR=1.0012, 95%CI: 1.0001, 1.0022), SO2 (RR=1.0060, 95%CI: 1.0002, 1.0117), and NO2 (RR=1.0144, 95%CI: 1.0100, 1.0187). The cumulative lagged risk peaks were: PM2.5 (CumRR=1.0274, 95%CI: 1.0158, 1.0392), PM10 (CumRR=1.0124, 95%CI: 1.0044, 1.0205), SO2 (CumRR=1.0214, 95%CI: 1.0009, 1.0423), and NO2 (CumRR=1.0613, 95%CI: 1.0460, 1.0770). The results of subgroup analysis showed more significant impacts of air pollution exposure on females and people aged 18-59 years, and in winter. To be specific, PM2.5 (RR=1.0022, 95%CI: 1.0006, 1.0037), PM10 (RR=1.0015, 95%CI: 1.0003, 1.0027), SO2 (RR=1.0082, 95%CI: 1.0016, 1.0148), and NO2 (RR=1.0156, 95%CI: 1.0106, 1.0206) exposures associated with an increased risk of outpatient visits for psychiatric disorders in women; PM2.5 (RR=1.0018, 95%CI: 1.0011, 1.0024), PM10 (RR=1.0012, 95%CI: 1.0001, 1.0023), and NO2 (RR=1.0142, 95%CI: 1.0095, 1.0189) associated with an increased risk of visits in those 18-59 years of age; PM2.5 (RR= 1.0043, 95%CI: 1.0001, 1.0085), PM10 (RR= 1.0038, 95%CI: 1.0007, 1.0069), and NO2 (RR= 1.0215, 95%CI: 1.0117, 1.0313) in winter months significantly associated with an increased risk of psychiatric outpatient visits. In addition, the risk of depression and anxiety visits varied depending on the concentration of air pollutants and the duration of exposure. The risk of visits for depression were more affected by CO, NO2, and SO2, and the risk of visits for anxiety were more affected by PM2.5, PM10, and O3. ConclusionExposure to air pollution is associated with an increased risk of psychiatric outpatient visits. The effects vary by air pollutants as well as by sex, age, type of psychiatric illness, and season.

In science, bezoar is a mass of hair or undigested vegetable matter, found in a human or animal's intestines, similar to a hairball. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar which is an indigestive object voluntarily introduced into the digestive tract. The term Bezoar is from Arabic bāzahr, “bezoar” or ultimately from Middle Persian pʾtzhl pādzahr, “antidote, bezoar”ægagropile o egagropile It should be a universal antidote that works against any poison, and could neutralize any poison. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Authors report a case of fecal impaction by pumpkin seeds bezoar with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction. Guidelines do not require IRB approval Authors examined the literature about occlusion from bezoar The most common causes of occlusion from bezoar are: a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in literature, bezoars of pumpkin seeds have rarely been reported.

Depression and anxiety are prevalent mental health issues worldwide, especially among parental caregivers. By expanding the family stress model, this cross-sectional study investigated the relevant factors associated with depressive symptoms, anxiety symptoms, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients. Data were collected through questionnaires (N = 207) across five major public hospitals through convenience sampling. Participants answered questionnaires measuring financial strain, caregiver burden, relationship quality, belief in mental illness, perceived COVID-19 stress, satisfaction with health services, depressive symptoms, anxiety symptoms and life satisfaction. Findings revealed that relationship quality among spouses, COVID-19 stress and caregiver burden were significantly correlated with anxiety symptoms, depressive symptoms and satisfaction with life. The multiple regression model also suggested that depressive symptoms (β = .613, p < .001), anxiety symptoms (β= .657, p < .001) and relationship quality among spouses (β = .264, p < .001) were the most influential predictors of anxiety symptoms, depressive symptoms and satisfaction with life respectively. By addressing the mental health needs of parental caregivers, this study can contribute to improving the overall quality of care and support provided to adolescent patients and their caregivers in Malaysia and beyond. [ABSTRACT FROM AUTHOR]

The study aimed to examine the effectiveness of an intervention using a smartphone application for psychological self-help among adolescents at risk of suicidal behavior. Over 12 weeks, a proprietary program was implemented for children aged 13–15. The questionnaire results of the experimental and control groups were compared using the independent samples t-test. The research results underscore the practical significance of employing self-help psychological apps as an additional tool in working with youth at risk of suicidal behavior. Integrating such technologies into adolescent interventions can contribute to enhancing the effectiveness of psychological support and preventing negative mental health consequences. [ABSTRACT FROM AUTHOR]

Introduction: Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and Métis), who are highly represented in rural communities, have additional risk factors related to colonialism, and historical and ongoing trauma. Understanding how to best respond to elevated rates of psychiatric illness in rural and remote communities requires an understanding of the unique challenges these communities face in accessing and providing high quality psychiatric services. This article reports a review of published literature on prevalence of non-psychotic psychiatric conditions, as well as the risk and protective factors influencing rates and experience of mental illness in rural and remote communities in Canada to help inform approaches to prevention and treatment. Methods: This focused narrative review of literature related to rural non-psychotic psychiatric illness in rural and remote Canada published over a 20-year period (October 2001 - February 2023). A review of CINAHL, Medline and Academic Search Complete databases supplemented by gray literature (eg federal and provincial documents, position papers, and clinical practice guidelines) identified by checking reference lists of identified articles, and web searches. A textual narrative approach was used to describe the literature included in the final data set. Results: A total of 32 articles and 13 gray literature documents were identified. Findings were organized and described in relation to depression and anxiety and substance use suicidality and loss; rates for all were noted as elevated in rural communities. Different mental health strategies and approaches were described. Variability in degree of rurality, or proximity to larger metropolitan centers, and different community factors including cohesiveness and industrial basis, were noted to impact mental health risk and highlighted the need for enhancing family physician capacity and responsiveness and innovative community-based interventions, in addition to telepsychiatry. Conclusion: Further focus on representative community-based research is critical to expand our knowledge. It is also critical to consider strategies to increase psychiatric care access, including postgraduate medical training and telehealth training. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos Médico Sociales is the property of Colegio Medico de Chile (A.G.) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fizioterapija is the property of Slovenian Association of Physiotherapists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study explores the effects of the COVID-19 pandemic on caregivers of individuals with chronic psychiatric illnesses. The research reveals that caregivers faced challenges in accessing healthcare services and medications for their patients, and the use of telemedicine was limited due to lack of awareness and training. Caregivers experienced heightened mental stress, financial strain, and even suicidal thoughts. The study emphasizes the importance of improving healthcare access, promoting awareness of telemedicine, and providing support for the mental and physical well-being of caregivers. [Extracted from the article]

Background: A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training. Materials and Methods: This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data. Result: Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting. Conclusion: Opinions can change based on one’s experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

The two novels Le libere donne di Magliano by Mario Tobino and L’arte di legare le persone by Paolo Milone, despite having been published almost seventy years apart from each other, present an affine structural approach, which can be illuminated through a critical reading and a thematic investigation that places them in mutual dialogue, highlighting any continuity and caesures. The essay intends to examine the narrative modalities, the expressive resources and the rhetorical strategies through which the two writers-psychiatrists outline their experience within mental hospital communities (Tobino), mental health centers and psychiatric wards (Milone), highlighting not only the primary characterizations of the multiform dialectic that is triggered in the relationship between doctor (narrating voice) - patient (narrated voice), but also the relational significance that is expressed in the authorial posture adopted, from which derive then the entire baggage of formal and linguistic operations, the proximity to the subjects told, the subjectivity never zeroed.

Introduction: Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and Métis), who are highly represented in rural communities, have additional risk factors related to colonialism, and historical and ongoing trauma. Understanding how to best respond to elevated rates of psychiatric illness in rural and remote communities requires an understanding of the unique challenges these communities face in accessing and providing high quality psychiatric services. This article reports a review of published literature on prevalence of non-psychotic psychiatric conditions, as well as the risk and protective factors influencing rates and experience of mental illness in rural and remote communities in Canada to help inform approaches to prevention and treatment. Methods: This focused narrative review of literature related to rural non-psychotic psychiatric illness in rural and remote Canada published over a 20-year period (October 2001 - February 2023). A review of CINAHL, Medline and Academic Search Complete databases supplemented by gray literature (eg federal and provincial documents, position papers, and clinical practice guidelines) identified by checking reference lists of identified articles, and web searches. A textual narrative approach was used to describe the literature included in the final data set. Results: A total of 32 articles and 13 gray literature documents were identified. Findings were organized and described in relation to depression and anxiety and substance use suicidality and loss; rates for all were noted as elevated in rural communities. Different mental health strategies and approaches were described. Variability in degree of rurality, or proximity to larger metropolitan centers, and different community factors including cohesiveness and industrial basis, were noted to impact mental health risk and highlighted the need for enhancing family physician capacity and responsiveness and innovative community-based interventions, in addition to telepsychiatry. Conclusion: Further focus on representative community-based research is critical to expand our knowledge. It is also critical to consider strategies to increase psychiatric care access, including postgraduate medical training and telehealth training.

Objective: Individuals with psychiatric illness suffer from poorer physical health compared with the general population and have a higher risk of developing cardiovascular and metabolic diseases. This cross-sectional study aims to describe the prevalence of lifestyle and cardiovascular risk factors and the association with self-reported psychiatric symptoms in a population of 40-year-old individuals screened with targeted Health Dialogues in southern Sweden. Methods: All 40-year-old individuals registered at 99 primary healthcare centers in southern Sweden were invited to participate. Self-reported lifestyle habits on a web questionnaire, anthropometric measurements, blood pressure, and blood tests were collected. The Health Dialogue resulted in a risk level assessment for different lifestyle habits and a meeting with a trained coach. Results: A total of 1831 individuals completed a Health Dialogue between 1st January 2021 and 30th June 2022. There were more individuals with high-risk levels for several lifestyle habits in the group with self-reported psychiatric illness compared with the rest of the study population. The analysis showed that physical inactivity, unhealthy diet, high-risk alcohol intake, tobacco use, psychosocial strain, higher BMI, and waist-hip ratio were associated with increased levels of psychiatric symptoms after adjustment for sex and socioeconomic factors. Conclusion: Unhealthy lifestyle habits were associated with self-reported psychiatric symptoms in 40-year-old individuals assessed with targeted Health Dialogues in a primary care context. Organized screening might contribute to early detection of modifiable risk factors for cardiovascular disease. Individuals with psychiatric symptoms should be prioritized for screening of unhealthy lifestyle behaviors.

Background: Brain imaging studies have thoroughly investigated brain gray matter abnormalities to assess pathophysiological mechanisms underlying psychiatric illnesses, however white matter has only recently been investigated. Abnormalities in myelination and white matter structures found in the cerebral cortex, known as intracortical myelin (ICM), have been linked with psychiatric illnesses including bipolar disorder (BD) and schizophrenia (SCZ). Here, we provide a comprehensive review of findings that investigate the nature of ICM abnormalities in psychiatric illnesses from neuroimaging studies. Methods: This systematic search collected studies that evaluated ICM abnormalities using gray/white matter contrast, cortical magnetization transfer ratios or thickness measurements in SCZ, BD, major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Results: 20 studies were included. Evidence suggests that ICM abnormalities in the frontal lobe are common to all studied psychiatric illnesses. Prominent deficits were also identified across the gyri and insular regions in SCZ; and temporal, parietal and occipital cortices in both BD and MDD. In contrast, increases in ICM were identified across the parietal and temporal cortices in SCZ, and parietal cortex in OCD. Limitations: This review exclusively used published, peer-reviewed articles which may overlook other available literature. Few studies across each psychiatric illness with non-standardized protocols may explain discrepancies in findings and limit a meta-analysis from being performed Conclusions: Overall, studies report that selective ICM abnormalities with prominent changes in the frontal cortices are associated with the aforementioned psychiatric illnesses. Further studies are required to elucidate how ICM alterations may be underpinning symptomatology including cognitive difficulty, emotional dysregulation, and memory impairment.

Background and objectives: Investigate the frequency of psychosocial issues among teenage females residing in tribal welfare hostels. Analyse the person's sociodemographic characteristics. Research the psychiatric morbidity of this group. Look into the issues with adolescent adjusting. Methods: 150 adolescent girls who lived in the tribal area for a year had a descriptive study done to assess their psychological and social difficulties at Department of Psychiatry, Osmania Medical College/Institute of Mental Health, Hyderabad, Telangana, India, between December 2021 to November 2022. Results: Current marital status of the parent's majority are married and living together (80%). Girls adjustment in with hostel, peers of the children majority 55.3% above averagely adjusted. Mother annual income majority (46.0%) being 50,000 mean was 52000.0 with a standard deviation of 42536.995. Relationship between type of family and adolescent adjustment showed chi-square value 2.03 and p value 0.843 statistically not significant. Conclusion: 16% of tribal welfare hostel teenage females had mental problems. Most of the girls were in eighth grade and 13-15 years old. Psychiatric disorder is more common among adolescents from broken houses, according to current marital data. Single-parent children have trouble adjusting. Psychiatric illness and adjustment concerns affected school performance. This research found a high frequency of psychiatric disease among tribal welfare hostel youth, requiring careful surveillance and sufficient mental health care for treatment and evaluation. [ABSTRACT FROM AUTHOR]

Background: In India, only about 10% of persons with psychiatric illnesses receive evidence-based treatments. Stigma, mistrust in allopathic medicine, allegiance toward faith healers, cultural and traditional practices, and beliefs are some of the major hindrances to the treatment of mentally ill patients. Aim: To assess supernatural attitudes toward mental health among tribal and non-tribal populations. Materials and Methods: A total of 100 subjects were included in the study after informed consent, 50 of whom were tribal and 50 non‑tribal. All were required to fill a self‑constructed proforma, the Supernatural Attitude Questionnaire (SAQ), and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). The scales were scored, compiled, and statistically analyzed. Results: The tribal and non-tribal subjects were well‑matched on socio‑demographic variables. The score of SAQ was significantly higher in the tribal group as compared to the non-tribal group. On the ATSPPH-SF, the scores of the two groups were not significant. Conclusion: Even though the tribal populations of India hold a higher supernatural attitude toward mental illnesses as compared to the non-tribal populations, their treatment-seeking attitude remains unaffected. [ABSTRACT FROM AUTHOR]

Objective: Returning Veterans often have conditions (e.g. posttraumatic stress disorder [PTSD], depression, and history of traumatic brain injury [TBI]) associated with cognitive dysfunction and problems with work, school, housing, and relationships. Rehabilitative efforts in Veterans aim to promote community reintegration, or successful adjustment in one's home, community, and desired social roles. We examined associations between neuropsychological performance, neurobehavioral symptoms, and community reintegration in Veterans. Method: 89 Iraq/Afghanistan Veterans at risk for homelessness and receiving residential mental healthcare completed a neuropsychological assessment and the Community Reintegration for Service Members–Computer Adaptive Test (CRIS-CAT). Neuropsychological components were derived using Principal Component Analysis. Bivariate Pearson correlations between neuropsychological variables, neurobehavioral symptoms, and CRIS-CAT scales (Extent of Participation, Perceived Limitations, and Satisfaction) were used to determine significant correlates of community reintegration. Regression models were used to examine associations between bivariate-significant neuropsychological components, neurobehavioral symptoms, and CRIS-CAT scales. Results: Bivariate analyses revealed that better community reintegration was associated with better performance in attention/executive functioning and fewer neurobehavioral symptoms. Three regression models examining predictors of variance in Extent of Participation, Perceived Limitations, and Satisfaction in community reintegration were statistically significant overall, with only fewer affective symptoms emerging as significantly and uniquely associated with greater participation and greater satisfaction in community functioning. Conclusions: Veterans with fewer affective symptoms reported greater participation and satisfaction with community functioning. Future longitudinal research examining associations between neurobehavioral symptoms, cognition, and risk factors of poorer community reintegration in unstably housed Veterans is warranted. [ABSTRACT FROM AUTHOR]