The experience and expression of identity disturbances in schizophrenia are profoundly influenced by cultural conceptions of the self. In Arab-Muslim societies, traditional philosophical and religious views shape patients’understanding of selfhood, potentially modifying symptom presentation and treatment engagement.

This study aims to investigate how cultural and philosophical constructs of the self within Arab-Muslim contexts affect the clinical manifestation and management of identity disturbances in schizophrenia.

A mixed-methods approach was employed. First, a systematic literature review (2000–2025) was conducted across PubMed, PsycINFO, Scopus, and Google Scholar using keywords: “schizophrenia,” “identity disturbances,” “self-concept,” “Arab-Muslim,” “culture,” and “philosophy.” Inclusion criteria encompassed studies addressing cultural or philosophical aspects of self in schizophrenia. Secondly, qualitative interviews were conducted with 20 Arab-Muslim patients diagnosed with schizophrenia at a regional psychiatric clinic, exploring their subjective experiences of self and illness. Data were analyzed using thematic analysis to identify culturally specific patterns influencing symptom expression and treatment adherence.

The systematic review identified 18 relevant studies, with 65% reporting that cultural and spiritual beliefs significantly shape symptom expression in schizophrenia among Arab-Muslim populations. Qualitative interviews with 20 patients revealed that 70% interpreted their identity disturbances through spiritual frameworks, such as possession or divine punishment. Additionally, 60% reported initial reliance on religious or traditional healers before seeking psychiatric care. Treatment adherence was affected, with 45% of patients expressing skepticism towards biomedical interventions when cultural beliefs were not acknowledged. Family influence was prominent, with 80% of participants noting that familial attitudes guided help-seeking behavior and symptom The literature and patient narratives revealed that Arab-Muslim cultural frameworks emphasize a relational and spiritual conception of self, contrasting with Western individualistic models. This influences the presentation of identity disturbances, often manifested through spiritual interpretations.

Cultural conceptions of self significantly shape identity disturbances in schizophrenia among Arab-Muslim populations. Incorporating philosophical and cultural insights into psychiatric practice enhances diagnostic accuracy and fosters culturally congruent, patient-centered care. Future research should focus on developing culturally adapted clinical tools and therapeutic interventions to improve outcomes in this population.

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Pandemics fracture not only biological and institutional systems but also the ontological integrity of human experience. Resistance to preventive behaviours often reflects an existential protest—a refusal to accept vulnerability, impermanence, and proximity to death. Crisis thus operates as a site of ontological reckoning, revealing tensions between Eros and Thanatos, intimacy and withdrawal, control and surrender.

To investigate behavioural resistance in pandemic contexts as a psychodynamic and existential phenomenon. The study examines unconscious motives, symbolic enactments, and relational vulnerability, exploring how actions during crises reflect complex ontological and emotional tensions rather than simple irrationality or neglect.

A philosophical–psychoanalytic approach was adopted, drawing on clinical literature, phenomenology, and psychoanalytic theory. Textual sources include accounts from HIV/AIDS and COVID-19 crises, exploring constructs such as irrationalism, solipsism, altruistic surrender, and the Samos Syndrome. The interpretive focus was placed on affective ambivalence, unconscious desire, and symbolic meaning in health-risking behaviors.

Critical incidents revealed intricate psychodynamic narratives underpinning pandemic-era decisions. Examples include individuals who engaged knowingly in unprotected sex with high-risk partners, framing such acts as relational commitment or sacrificial love. Resistance to protective measures often emerged through unconscious conflict, preconscious impulses, or existential disavowal. Behaviour patterns reflected disruptions in self–other boundaries and ontological coherence, challenging conventional prevention frameworks.Table 1.

Pandemic resistance behaviours are shaped by symbolic reasoning, psychodynamic vulnerability, and existential distress. These enactments defy purely rational intervention and call for psychiatric models that integrate phenomenological depth, narrative understanding, and ontological sensitivity. Prevention strategies must engage with the emotional architecture of crisis, recognising the lived complexity of human behaviour under threat.

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Certain behaviours during pandemics—including intentional exposure to illness despite awareness of risk—reflect an irrational mode of health decision-making. Such actions may emerge from unconscious drives, existential ambivalence, and psychosocial conflict. The phenomenon known as Samos Syndrome, inspired by an historical episode documented by Zambaco Pacha and narrated by Ceronetti (1990), illustrates health-risking behaviours driven by symbolic devotion, fatal attraction, or unconscious desire.

To define irrational health behaviour in pandemic contexts and analyse how psychological vulnerability and existential factors shape high-risk sexual decision-making. The study examines the psychodynamic foundations of Samos Syndrome and provides a framework for understanding behavioral resistance despite knowledge and awareness of transmission risks.

A qualitative and conceptual methodology was adopted, drawing on psychoanalytic literature, historical accounts, and clinical interviews. Case studies from HIV/AIDS and COVID-19 crises were analysed alongside theoretical perspectives from Freud, Brenner (1988), and Borlotti (2015). The concept of capacity assessment was utilised to evaluate the cognitive and affective conditions underpinning health decisions.

Risky sexual behaviour under existential stress often reflects unconscious conflict between Eros and Thanatos. In high-stimulation settings, individuals may override health knowledge in pursuit of gratification, symbolic meaning, or emotional relief. Samos Syndrome describes such enactments, particularly in populations with depressive or borderline personality features. Observed decisions included disregard for viral latency and self-harm through intimate contact, akin to slow-motion suicide.Table 1.

Irrational health behaviours during pandemics cannot be solely attributed to lack of information. They often derive from impaired reflective capacity, unresolved psychological distress, and symbolic expressions of suffering or desire. Psychiatric interventions must engage with the existential and psychodynamic substrates of decision-making to foster more effective prevention strategies.

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The COVID-19 pandemic destabilised not only public health systems but also fundamental constructs of identity, reason, and reality. Traditional models grounded in rationality and epidemiological logic proved inadequate for capturing how individuals and collectives behave under existential threat. Ontological stratification, as proposed by Guerrero Fernandez (2020), posits that pandemics unfold across layered realities—biological, social, and experiential—necessitating a philosophical reappraisal of public health behaviour.

To examine how irrationalism and solipsism shape behavioural responses to pandemics, particularly in the face of public health guidance. The study aims to introduce the Quadruplex Helix framework as a conceptual model for understanding health-related decision-making across individual, relational, peer, and cultural domains.

The study employed a philosophical–clinical methodology, integrating traditions from metaphysics, epistemology, and phenomenology. Definitions of irrationalism were reviewed across philosophical and linguistic sources, while clinical literature and behavioural data were analysed to trace pandemic-era epistemic shifts. A four-tier analytical framework—the Quadruplex Helix of Pandemic Health Ontology—was developed to map behavioural stratification.

Findings indicate that irrationalism during crises operates as an adaptive epistemic response rather than a deviation from logic. At the micro level, individuals rejected public health measures based on subjective certainty. At the meso level, couples consolidated shared beliefs, occasionally manifesting in folie à deux. Peer groups at the macro level reinforced identity through opposition to norms, while at the mega level, cultural narratives fostered denialism and exceptionalism. These behaviours were not reducible to information deficits but reflected deeper ontological tensions.Image 2:

Pandemic health behaviour is shaped by multi-layered ontologies wherein affect, belief, and identity override rationalist paradigms. The Quadruplex Helix provides a framework for understanding how metaphysical orientations and social embeddedness produce divergent responses to health crises. Recognising the philosophical dimensions of irrationalism and solipsism may inform more effective public health strategies and psychiatric engagement during future emergencies.

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Pandemics intensify moral scrutiny of individual and collective behavior. Axiology—the philosophical study of values—offers critical insight into the ethical dilemmas surrounding disease prevention, personal autonomy, and social obligation. In pandemics such as HIV/AIDS and COVID-19, moral agency is illuminated through actions like mask-wearing, vaccination, and disclosure of health status, revealing tensions between rational knowledge and emotional reasoning.

To examine how axiological frameworks shape ethical behavior in pandemic contexts, particularly regarding prevention, disclosure, and interpersonal risk. The study explores how emotional ambivalence, stigma, and dialogical engagement influence public health adherence.

A philosophical–clinical approach was employed, drawing on published case studies, historical analyses, and theoretical contributions from Douglas (2009), McClimans (2017), Thompson & Upshur (2017), and Lazzari et al. (1995–2016). Axiological principles were applied to assess the relational and moral dynamics embedded in disease-transmissible interactions, with emphasis on risk externalization, intimate vulnerability, and affective cognition.

Preventive ethics emerged as both procedural and emotional. Compliance with health guidance depended not solely on epistemic clarity but also on perceived fairness, dialogue, and trust. Concealment of health status illustrated the emotional cost of stigma and fear, while intimate relationships revealed moral conflict between desire and duty. Historical patterns of moral disengagement and affective denial significantly undermined prevention strategies.Table 1.

Pandemic prevention must be framed not only through biomedical rationality but also through axiological sensitivity. Public health ethics requires attunement to emotional and relational contexts. Prevention is most effective when co-created with communities, acknowledging the value-laden dimensions of risk, responsibility, and care.

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Pandemics redefine more than epidemiological terrain—they fragment the ontological coherence of daily life. COVID-19 and HIV/AIDS both revealed that behaviour under crisis conditions cannot be fully explained by rationalist models or epidemiological logic. Instead, pandemic responses emerge from layered existential orientations shaped by perception, affect, and symbolic meaning.

To explore resistance to public health measures as a form of ontological dislocation and psychological enactment. This paper introduces the Quadruplex Helix framework as a model for understanding how unconscious drives, affective epistemologies, and social ontologies across relational levels shape dissemination resistance and critical incidents.

A philosophical–psychoanalytic approach was adopted, integrating process ontology, phenomenology, and clinical literature. Textual analysis of case reports, ethnographic observations, and psychoanalytic theory (e.g., Samos Syndrome, irrationalism, solipsism) informed the development of a four-tier framework mapping behavioural responses across micro (individual), meso (dyadic), macro (peer), and mega (cultural) scales.

Resistance to preventive measures was observed not as ignorance but as an ambivalent negotiation of bodily boundaries and existential threat. Clinical and ethnographic findings revealed patterns of unconscious intent, such as self-endangerment, denial, and psychic conflict. The Quadruplex Helix delineated how different social strata produce distinctive behavioural expressions, including symbolic defiance, folie à deux dynamics, and cultural exceptionalism.Table 1.

Pandemic behaviours often emerge as meaning-making strategies under existential pressure, rather than as failures of knowledge. By reframing these actions through an ontologically informed lens, psychiatric models can better interpret disintegration of self–world boundaries, unconscious drives, and the phenomenology of risk. Future crisis interventions must recognise the symbolic, emotional, and relational architectures that shape public health behaviour.

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Pandemics disrupt not only biological systems but also the foundations of identity, perception, and meaning. COVID-19 exposed the fragility of traditional knowledge structures and evidenced the psychiatric consequences of ontological uncertainty. This study positions pandemics as existential crises requiring philosophical engagement to understand their impact on mental health fully.

To examine how pandemic-induced ontological instability manifests in psychiatric contexts, and how ethical interpretation—through religious and secular frameworks—shapes clinical understanding and therapeutic response.

A combined philosophical–clinical methodology was employed. Drawing on process ontology, pragmatism, and phenomenology, the study included an analysis of a documented case report involving reactive psychosis triggered by COVID-19-related existential distress. The focus was placed on disrupted identity, delusional patterns, and the collapse of relational meaning.

The case involved a 50-year-old male presenting with paranoid delusions and identity confusion during the pandemic, including beliefs in impostor family members and conspiracy-driven narratives. Diagnosed with acute paranoid reaction, the patient responded to antipsychotic treatment. The episode illustrates ontological breakdown as a psychiatric event, conditioned by fear, uncertainty, and epistemic instability.Image 1:

Pandemics provoke ontological and psychological disintegration, especially in vulnerable individuals. Psychiatric models that integrate existential, phenomenological, and ethical dimensions are essential to address the depth of crisis-induced mental health challenges. Philosophical engagement offers critical insight into how reality, identity, and institutional dynamics interact in times of collective disruption.

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The category of “quality of life” in modern scientific literature requires a clear distinction from related concepts such as “standard of living”, “welfare” and “well-being”.

To conduct a comparative analysis of the definition of “quality of life”, “standard of living”, “welfare” and “well-being”, identifying substantive overlaps and fundamental differences.

The primary method employed is bibliographic analysis.

Quality of life is a comprehensive evaluation tool that characterizes various spheres of life. This concept is a broader indicator than material security, and encompasses both objective and subjective factors, such as health, life expectancy, environmental conditions, nutrition, household comfort, social environment, the fulfillment of cultural and spiritual needs, psychological comfort, etc. Quality of life as an indicator of individual socialization includes a person’s perception of their position in life in the context of the culture and value system in which they live, in accordance with goals, expectations, and norms.

The concept of “quality of life” in modern science requires a clear distinction from related concepts such as “standard of living”, “welfare” and “well-being”, since each of them has a specific meaning. The standard of living emphasizes material aspects, measured through income, housing and access to services, whereas quality of life encompasses both objective indicators (health, ecology, infrastructure), and subjective evaluation of satisfaction within the cultural and value context. Welfare, being an economy-centric category, focuses on the material security, while well-being reflects an individual’s internal psychological state, formed by external conditions and personal characteristics.

Quality of life is a more comprehensive category, integrating economic, social, environmental and psychological aspects of human existence, which makes it a key focus of interdisciplinary research.

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Meditation is increasingly integrated into psychiatry, often presented as a culturally neutral intervention. Yet meditative forms emerge from distinct traditions, each framed by particular ontologies, aims, and techniques. When imported into psychiatry, these practices are reinterpreted, sometimes shedding elements central to their original meaning and mechanism. This project examines how cultural origins shape both the function and the ethical reception of meditation in psychiatric contexts.

To (1) compare selected meditative traditions by cultural-philosophical origin, (2) assess how these are modified in clinical adaptation, and (3) identify ethical and clinical issues when culturally embedded practices are reframed as therapy.

A targeted literature review in cultural psychiatry, anthropology of religion, and clinical psychology, supplemented by reference mining of key ethnographic and phenomenological studies. Analytical comparison considered intentionality, ritual form, and epistemic authority in source traditions, and clinical modifications noted in psychiatric literature.

Traditions differ in their logic of change: some focus on cultivating insight into impermanence and selfhood; others employ symbolic visualization or repetitive sound for spiritual alignment. In psychiatric adaptation, these are typically reframed in physiological or attentional terms, omitting metaphysical context. While this can increase accessibility, it may also alter efficacy or generate dissonance when patients expect spiritual depth. Ethical concerns arise when origins are obscured or selectively acknowledged, especially with patients for whom religious identity is clinically relevant.

Meditation in psychiatry is not a single, context-free method but a family of culturally rooted practices. Responsible integration requires attention to both mechanism and meaning, and transparent dialogue with patients about origins, aims, and possible cultural tensions.

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The psychiatric incorporation of mindfulness has advanced without a parallel precision in definition. Within both clinical and lay discourse, mindfulness is often conflated with meditation broadly, or with forms of contemplation oriented toward ethical or spiritual ends. This conceptual slippage obscures distinct phenomenological structures and risks importing unexamined assumptions into psychiatric care. Drawing from philosophy of mind, phenomenology, and clinical literature, this project examines the attentional, affective, and epistemic contours that differentiate meditation, mindfulness, and contemplation, and their respective implications for psychiatric practice.

To (1) differentiate meditation, mindfulness, and contemplation as distinct attentional modes; (2) map their cognitive-affective mechanisms and therapeutic relevance; and (3) identify ethical and clinical consequences of categorical conflation.

A targeted literature review was conducted across psychiatry, cognitive neuroscience, and philosophical sources on attention, self-regulation, and contemplative traditions. Reference mining from seminal works supplemented database searches. Analytical comparison was guided by phenomenological description and conceptual analysis, with emphasis on constructs applicable to psychiatric intervention.

Meditation is best understood as a structured practice of sustained attentional modulation, which may include but is not limited to mindfulness. Mindfulness, when defined with clinical precision, constitutes a present-focused, non-reactive attentional stance aimed at reducing maladaptive cognitive elaboration. Contemplation, in contrast, privileges intentional reflection—often value-laden—toward moral, spiritual, or existential objects. These modes diverge in intentionality, cognitive load, and affective orientation, with empirical evidence supporting mindfulness as the most directly applicable to relapse prevention in depression and anxiety (Psychother Psychosom 2018;87:184-186). Conflating these constructs risks inappropriate application, ethical overreach, and dilution of therapeutic effect.

A philosophy of psychiatry approach clarifies that the clinical import of mindfulness depends on its distinction from related practices. When these attentional modes are properly differentiated, psychiatry can deploy mindfulness with greater epistemic transparency, cultural sensitivity, and therapeutic precision—avoiding the erosion of its conceptual integrity under the weight of undifferentiated wellness rhetoric.

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Ethical debates on suicide and end-of-life choices have evolved significantly over time. Aristotle’s virtue ethics emphasized that human flourishing (eudaimonia) depended on moral character as well as sound judgment, including decisions about life and death (MacIntyre A. After Virtue. 3rd ed. Notre Dame: University of Notre Dame Press; 2007). However, modern debates are more focused on autonomy, beneficence, and the clinician’s duty towards preserving life, particularly within psychiatric settings.

To critically appraise historical and contemporary ethical frameworks on suicide and end-of-life decisions, with particular emphasis on the transition from virtue ethics to modern psychoanalytic approaches.

A conceptual literature review was conducted, analyzing philosophical, psychiatric, and ethical sources. Key themes included virtue ethics, principles of biomedical ethics, psychodynamic theories of suicidality, and relational models of autonomy.

The review shows a continuous shift in ethical reasoning about suicide and end-of-life care, moving from character-based to principle-driven and relational approaches. Virtue ethics emphasized the importance of moral character and the pursuit of a meaningful life within the community, whereas modern frameworks focus on autonomy while also incorporating relational dimensions (Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 8th ed. Oxford: Oxford University Press; 2019). Psychodynamic perspectives enrich this discussion by highlighting the influence of hopelessness, guilt, and interpersonal dynamics in suicidality (Maltsberger JT. The descent into suicide. Int J Psychoanal. 2004;85(3):653–670). More recent research promotes relational autonomy, emphasizing family involvement and community values in guiding end-of-life decisions (Dove ES, Kelly SE. BMC Med Ethics 2015;16:45). Together, these perspectives demonstrate how ethical analysis has expanded from the individual to the relational and societal level, offering clinicians a more comprehensive framework for practice.

The evolution from Aristotelian virtue ethics to psychoanalytic and relational approaches marks a shift towards a more nuanced perspective on suicide and end-of-life care. Thus, integrating autonomy, beneficence, and relational ethics provides clinicians with a balanced and compassionate framework for practice.

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Electroconvulsive therapy (ECT) discloses a paradox at the core of psychiatric intervention: its efficacy depends upon the induction of a seizure, yet the seizure is always already bounded by forces that both enable and constrain it. Stimulus technique, anesthetic mediation, cumulative exposure, and symptomatic change all act upon a shifting limit known as the seizure threshold. This threshold is not a fixed property but a dynamic frontier—rising across a treatment course, adapting with clinical response, and requiring continual recalibration.

To reconceive the seizure threshold as an ontological problem rather than a purely physiological measure: a moving boundary where suppression and expression, risk and efficacy, converge.

Conceptual analysis, informed by psychiatric literature but oriented toward philosophy of science, interrogating how “threshold” functions less as a quantifiable marker than as a contingent interface that resists closure within static models.

The seizure threshold emerges as a dynamic limit shaped by multiple forces. It rises with treatment progression and often in parallel with symptomatic improvement, forcing clinicians to adjust stimulus dosing upward across a course. Anesthetic technique modulates its expression, altering seizure duration and cardiovascular tolerability, while stimulus parameters (unilateral vs. bilateral, pulse width, dosing algorithms) influence its trajectory. Clinical response itself feeds back into the system: as patients improve, the biological substrate of excitability shifts, altering the very boundary psychiatry relies upon. Failure to recalibrate risks underdosing and therapeutic non-response on the one hand, or excessive dosing and physiological burden on the other. What seems at first a technical issue is thus a conceptual one: the threshold is less a number to be measured than a liminal zone where psychiatry and anesthesia, biology and technique, illness and recovery meet.

ECT’s reliability is paradoxically grounded in ontological instability. The seizure threshold adapts with time, technique, and therapeutic effect, obliging psychiatry to recognize efficacy as relational and contingent rather than fixed. To think the threshold philosophically is to see that suppression and emergence are not opposites but co-constitutive: the therapeutic act is continually reconstituted at their border. For psychiatry, this has practical implications—thresholds must be anticipated as moving targets, not assumed as constants—and conceptual ones, challenging the discipline to acknowledge that its most effective intervention depends on unstable, shifting conditions of possibility.

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Psychiatry often orients around pathological deviation from normative life stages. Menopause challenges this framework: a universal, predictable transition that nonetheless generates profound psychiatric vulnerability. This raises questions about psychiatry’s conceptual boundaries — how suffering is defined, when universality shields conditions from recognition, and how temporality shapes psychiatric risk.

To explore the philosophical dimensions of menopause in psychiatry, with emphasis on (1) universality versus pathology, (2) temporality and psychiatric risk, and (3) the ethics of invisibility in women’s midlife suffering.

We conducted a focused literature review spanning philosophy of psychiatry, feminist theory, and phenomenology of time. Sources included theoretical texts on universality, stage transitions, and recognition, as well as psychiatric and philosophical scholarship addressing menopause and midlife suffering.

Three philosophical tensions emerged. (1) Universality versus pathology: Because menopause is normative, its psychiatric sequelae are often excluded from nosological frameworks, revealing a bias toward deviation rather than transition. (2) Temporality: Menopause highlights psychiatry’s difficulty conceptualizing time, since risk emerges not from disorder alone but from a predictable biological threshold—paralleling how PMDD ties affective change to cyclical temporality. (3) Invisibility of suffering: The under-recognition of menopause in psychiatric discourse perpetuates structural neglect, leaving women’s suffering conceptually and clinically unacknowledged.

Menopause demonstrates psychiatry’s need to reconceptualize universality and temporality within its frameworks of suffering. Recognizing menopause as both a natural transition and a psychiatric risk state unveils the invisibility of women’s suffering, challenging psychiatry to reframe its philosophical boundaries. Such engagement would advance psychiatry not only clinically, but conceptually, by foregrounding life transitions as central to mental health.

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Internal dialogue, particularly second person self-address (e.g “Why are you doing this?”) has long been noted in clinical psychotherapy where it manifests as both a symptom (fragmented voices in splitting or dissociation) and a tool of integration. Despite its relevance to therapeutic change, the philosophical structure of internal dialogue remains underexplored in psychiatry. Thinkers such as This project investigates the role of internal dialogue and attempts to offer a unified account linking phenomenology, therapeutic processes, neurological mechanisms and philosophical concepts of selfhood.

To synthesize evidence on neurobiological bases of inner speech, (1) neurobiological bases of inner speech, (2) its dysfunction in split defenses and affective fragmentation, (3) its role as a mechanism of therapeutic change, and (4) its philosophical grounding in dialogic selfhood (Jaspers, Bakhtin, Vygotsky, Benjamin).

A selective literature review and conceptual synthesis were conducted, integrating philosophical texts, psychotherapy process studies, neuroimaging research on self-referential processing, and anonymized clinical vignettes observed during medical school clerkships, with attention to second-person self-address as a transitional marker.

Dialogic inner speech recruits language regions alongside default mode and self-referential networks. Disruptions in these circuits contribute to phenomena such as misattributed voices in psychosis and rigid, punitive inner critics in depression. In borderline and dissociative states, split-off self-voices remain unintegrated, sustaining affective instability. Psychotherapy process research shows that the emergence of second-person self-address (eg “You need to calm down”) often marks a turning point, enabling patients to observe themselves and create an internal conversation between parts that were previously disconnected. Clinical techniques such as chair dialogues, parts work, and guided imagery capitalize on this dynamic by fostering constructive self-to-self communication.

This analysis proposes that internal dialogue should be recognized not only as a coping strategy, but as a philosophically rich marker of recovery. It challenges models that treat intrapsychic conflict as pathology and invites renewed attention to voice, address, and dialogic structure in psychotherapy. Further research may explore how therapeutic interventions can facilitate this inner dialogic emergence.

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The Dark Triad refers to a cluster of three interrelated personality traits – Machiavellianism, narcissism, and psychopathy – which can significantly influence professional behavior. In managerial contexts, these traits often manifest in decision-making strategies, interpersonal attitudes, and preferred leadership styles.

To examine differences in the expression of Dark Triad traits among managers at various organizational levels and to analyze their association with leadership styles.

The study involved 30 managers from different levels of organizational responsibility.

Dark Triad traits were assessed using the “Dirty Dozen” questionnaire.

Leadership styles were evaluated with the Management Decision-Making Styles Scale (Fetiskin et al.).

The relationship between variables was calculated using Pearson’s correlation coefficient.

Managers at the highest organizational level showed the highest expression of Dark Triad traits, particularly in combination with situational and implementer leadership styles.

In contrast, middle- and lower-level managers predominantly demonstrated a permissive leadership style, which was associated with lower Dark Triad scores.

Correlation analysis revealed:

• - a positive association between the implementer style and narcissism;

• - a negative relationship between the permissive style and all three Dark Triad traits;

• - a moderate positive association between the situational style and Machiavellianism.

The findings suggest that certain Dark Triad traits may function as adaptive mechanisms in managerial contexts and are linked to more flexible and outcome-oriented leadership styles, particularly at higher organizational levels.

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Introduction- After cervical spine injuries, disabling problems are generally related to neuropsychiatric results, such as personality change and cognitive impairment.

Aim-Aim of this study was to present cases of long-term psychiatric disorders after cervical spine injuries in middle age patients

Material and Methods-10 middle age patients are presented. 8 males(80%) and 2 female(20%). 7 of them present cognitive impairment and 3 of them personality change. Cognitive impairment main characteristic is impaired speed of information processing, poor memory and executive problems. Personality change include poor motivation, and a tendency to be selfcentred and less aware of the needs of others.

Resuslts-Good results in 7 cases (70%) and moderate in 2 (30%). Collaboration between various medical disciplines is essential in order to achive optimal results and clarify the theory, the etiology, and treatment effectiveness.

Conclusions-Recommendations regarding effective psychotherapy, neurological,psychiatric and pharmacotherapy, emerging treatment, and accurate management are necessary in order to achieve optimal overall treatment.Accurate rehabilitation pr minimizes the risk of psychiatric sequelae, but specific psychological and pharmacological treatments may be needed.

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Introduction- After traumatic brain injuries, the most disabling problems are generally related to neuropsychiatric results, such as personality change and cognitive impairment.

Aim-Aim of this study was to present cases of long-term psychiatric disorders after traumatic brain injuries in geriatric patients.

Material and Methods-10 geriatrc patients are presented. 9 males(90%) and 1 female(10%). 6 of them present cognitive impairment and 4 of them personality change. Cognitive impairment main characteristic is impaired speed of information processing, poor memory and executive problems. Personality change include poor motivation, and a tendency to be selfcentred and less aware of the needs of others.

Results-Good results in 8 cases (90%) and moderate in 2 (20%). Collaboration between various medical disciplines is essential in order to achive optimal results and clarify the theory,the etiology, and treatment effectiveness.

Conclusions-Recommendations regarding effective psychotherapy, neurological,psychiatric and pharmacotherapy, emerging treatment, and accurate management are necessary in order to achieve optimal overall treatment.Accurate rehabilitation pr minimizes the risk of psychiatric sequelae, but specific psychological and pharmacological treatments may be needed.

None Declared

Introduction-According to the medical literature in the long term period after severe traumatic brain injuries often related in disabling problem such as personality changes and cognitive impairment.

Aim-Aim of this study is to evaluate 40 cases of young male patients(<45 years old). Range of age between 15-45 years old and mean age 28,5 years. Radiological investigation with MRI studies, neurological and psychiatric evaluation in all 40 cases-100%.

Results-20 cases with personality changes,50%. Impaired speed and/or information processing in 10 cases and poor memory and executive problems in other 10.20 cases with personality changes, 50%, poor motivation in 8 cases and 12 cases with self-centerd tendency and less aware of the needs of others. Good rehabilitation in 30 cases,75% and moderate in 10 cases, 25%.

Conclusion-Patients may be: 1) lazy and thoughtless 2) disinhibited and rude 3) with agitation- aggression 4) with anxiety-depression.

All these factors play a role in the development of various combined types of post traumatic stress disorders, such us depression, psychosis, schizophrenia and Alzheimer’s disease. Multiple combined approaches of various medical disciplines is more than necessary.

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Aim- Evaluation of the diverse personality and psychiatric symptom dimensions predict in traumatic brain injury recovery in young male athletes.

Material –Methods- This retrospective study involved psychological assessments of young male patients with traumatic brain injuries (n = 40, median = 2 days post-injury, range = 0-12 days, 15-35 years old, median age 25) .Chronic symptoms were evaluated at 6 months and in 1 year period after the traumatic events using the Sport Concussion Assessment Tool (SCAT) symptom checklist.

Results:- Radiological investigation with MRI studies, neurological and psychiatric evaluation in all 40 cases-100%. In these traumatic events, trait psychoticism directly predicted chronic traumatic symptoms and was the strongest personality predictor overall (30 cases, 75%).

Also internalizing personality dimension emphasizing negative affect/emotionality and detachment predicted chronic traumatic symptoms indirectly through enhancement of acute somatic complaints (20 cases, 50%). %. Good rehabilitation in 30 cases, 75% and moderate in 10 cases, 25%.

Conclusions- Multiple combined approaches of various medical disciplines is more than necessary in order to achieve optimal results.

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Pseudologia fantastica (PF), also referred to as pathological lying in literature, consists of fantastically fabricated distortions with no apparent reason or personal gain. PF is not recognized as an independent clinical entity in the DSM-V, resulting in a diagnostic challenge and significant legal implications for competency assessment to stand trial.

Discuss demographics, intention and content of the fabrications, reaction on confrontation, psychiatric comorbidities and concurrent substance abuse associated with pseudologia fantastica through a systematic review and qualitative analysis.

We conducted a systematic search through 3 databases - PubMed, PsycINFO, and Scopus, to discuss the demographics, substance use, dynamics of the lies told by the patients with PF, and their psychiatric comorbidities. After applying inclusion and exclusion criteria for the title, abstract, and full-text assessments, we included a total of 34 articles consisting of 55 cases of PF in our final study. PRISMA guidelines were followed throughout (Figure 1).

A total of 55 cases from existing literature were selected and evaluated. Approximately 49% of pseudologues presented in their 3rd and 4th decade of life with a marked male predominance (72.73%). The three leading motives behind the fabrications seemed to be self-aggrandizing (38.18%), seeking attention (36.36%), and assumption of a sick role (29.09%). Exaggerations about life events (38.18%), education, and occupation (43.64%) closely followed health-related lies (67.27%) closely (Figure 2). Pseudologues assumed a different name/identity (32.73%), which posed serious legal ramifications. The most common psychiatric comorbidities associated with PF were cluster B personality disorders (25.45%), depressive disorders (16.36%), trauma/stress disorders (16.36%), and somatic and factitious disorders (14.55%) (Figure 3). Pseudologues also exhibited high suicidality (27.27%), with 16.36% attempting suicide. Substance abuse was also prevalent (30.91%), with significant alcohol use disorder (21.82%).Image 1:

PF puts considerable strain on employment, societal relationships, and legal and medical systems, and it is crucial to identify it early and empower physicians and law practitioners on best practices to manage the condition.

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