Chronic pain is a complex and multidimensional experience that persists beyond normal tissue healing and affects a substantial proportion of the adult population. Traditional diagnostic frameworks have been strongly based on subjective reports, limiting the understanding of the neurobiological mechanisms underlying their onset, maintenance, and cognitive-emotional impact.

This presentation aims to synthesize recent neuroimaging evidence elucidating how advances in brain imaging technologies are redefining our understanding of chronic pain, with implications for diagnosis, mechanistic models and personalized therapies.

We reviewed contemporary findings from structural and functional neuroimaging studies - primarily magnetic resonance imaging (MRI), resting-state fMRI, and advanced connectivity analyses - as well as integrative meta-analyses and systematic reviews (PubMed up to 2025).

Emerging neuroimaging research demonstrates that chronic pain is associated with widespread brain alterations in both structure and function. Key findings indicate widespread structural and functional brain alterations in chronic pain. Structurally, individuals with chronic pain show consistent reductions in grey matter volume and disruptions in white matter integrity across regions including the insula, cingulate cortex, thalamus, hippocampus, motor areas, and cerebellum, resembling patterns associated with accelerated brain ageing and neurodegeneration. Functionally, altered resting-state connectivity within salience and default mode networks has been observed, along with variable yet meaningful changes in pain-related activation. Emerging evidence from machine learning approaches and direct neural recordings suggests the presence of pain-specific brain signatures with potential as objective biomarkers. Together, these neuroimaging findings provide mechanistic insight into disrupted pain modulation, affective–sensory integration, and large-scale network dysregulation, supporting the view of chronic pain as a disorder of the central nervous system rather than solely a peripheral condition.

Brain imaging has reshaped paradigms of chronic pain by moving beyond stimulus-response models toward network-based conceptualizations that integrate sensory, emotional and cognitive components. These methods challenge traditional clinical frameworks by offering more objective markers of pain experience and suggest potential targets for neuromodulatory and personalized interventions.

chronic pain, neuroimaging, MRI, functional connectivity, biomarkers, brain networks, chronic pain mechanisms.

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Eating disorders (ED) and psychotic disorders are traditionally considered distinct clinical entities. However, their co-occurrence presents significant diagnostic and therapeutic challenges. Psychotic symptoms may emerge in the context of severe malnutrition, as part of a primary psychotic disorder, or as a comorbidity that worsens prognosis. Early identification and comprehensive management are essential to reduce morbidity and improve functional outcomes.

To describe a clinical case of co-occurring eating disorder and psychosis. To highlight the diagnostic challenges and differential considerations. To discuss therapeutic strategies and the importance of a multidisciplinary approach.

We present a detailed clinical case of an adolescent patient with restrictive eating behaviors, rapid weight loss, and the subsequent emergence of psychotic symptoms. Information was obtained from clinical interviews, medical records, standardized psychometric assessments, and multidisciplinary team evaluations.

The patient initially presented with restrictive eating patterns, significant weight loss, and preoccupation with body image. During follow-up, psychotic features including paranoid delusions and auditory hallucinations emerged, complicating both diagnosis and treatment. Multiple interventions were implemented: nutritional rehabilitation, antipsychotic treatment, and family-based therapy. Partial remission of psychotic symptoms and gradual weight stabilization were achieved after several months of integrated care.

This case illustrates the complex interplay between eating disorders and psychosis. The overlap of symptoms may delay diagnosis and hinder effective treatment. A comprehensive, multidisciplinary approach combining medical, psychiatric, and psychosocial interventions is crucial. Awareness of this comorbidity is necessary to optimize outcomes and guide future research.

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Robust evidence supports the co-occurrence of dissociation and psychosis and their subclinical manifestations in both clinical and non-clinical populations. However, it remains unclear whether specific dissociative symptoms are uniquely associated with individual psychotic symptoms, particularly within the positive dimension. The network theory of psychopathology offers a useful theoretical framework for understanding the co-occurrence of these phenomena, proposing that psychiatric symptoms interact with and reinforce one another as a dynamic network. Network modeling facilitates the investigation of the complex and interactive relationships between psychotic and dissociative symptoms, and these findings warrant replication across independent samples, particularly in non-Western contexts.

We compared the psychopathological network of dissociative and psychotic symptoms across three independent samples of undergraduates recruited in the Philippines, Malaysia and Turkey.

Undergraduate students from the Philippines (N = 219), Malaysia (N = 240), and Turkey (N = 150) completed the 15-item Community Assessment of Psychic Experiences (CAPE-15) and the Multidimensional Dissociation Inventory (MDI) as measures of psychotic (i.e., persecutory ideation, bizarre experiences, perceptual abnormalities) and dissociative (i.e., disengagement, depersonalization, derealization, emotional constriction, memory disturbance, and identity dissociation) symptoms, respectively. Gaussian graphical models were estimated separately for each sample, with psychotic and dissociative symptoms as nodes. Edges in the models represented unique associations between nodes. Network comparison tests were conducted to examine the invariance of network structure across the different samples.

The networks of psychotic and dissociative symptoms of each sample are shown in Figure 1. There were no differences in network structure across samples after correction for multiple comparisons. The edge weights between facets of psychotic and dissociative symptoms did not differ significantly across samples. Among these edges, the connection between identity dissociation and perceptual abnormalities was consistently identified as the strongest across samples (rs = 0.09–0.27).Image 1:

The network models revealed interactive relationships between specific psychotic and dissociative symptoms that are consistent across the three non-Western samples. The three samples provide corroborative evidence for a unique association between identity dissociation and perceptual abnormalities, suggesting a close relationship in their development and maintenance.

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Lumateperone is an FDA-approved antipsychotic to treat schizophrenia and depressive episodes associated with bipolar I or bipolar II disorder. Efficacy and safety of lumateperone adjunctive to antidepressant therapy (ADT) was established in 2 Phase 3, randomized, double-blind, placebo-controlled trials (501, NCT04985942; 502, NCT05061706) in patients with major depressive disorder (MDD) with inadequate ADT response.

This pooled analysis of Studies 501/502 evaluated lumateperone 42mg+ADT in demographic and clinical subgroups of patients with MDD.

Data were pooled from Studies 501/502 which enrolled adults with DSM-5–diagnosed MDD with inadequate response to 1-2 ADT in the current depressive episode (Montgomery-Åsberg Depression Rating Scale [MADRS] Total score ≥24, Clinical Global Impression-Severity [CGI-S] score ≥4). Patients were randomized to 6-week oral lumateperone 42mg+ADT or placebo+ADT. MADRS Total and CGI-S scores were evaluated in the pooled population and patient subgroups by demographic and clinical characteristics. Safety was assessed.

The pooled population comprised 950 patients (lumateperone+ADT, n = 471; placebo+ADT, n = 479). Lumateperone+ADT significantly improved MADRS Total score (least squares mean difference vs placebo [LSMD]=‒4.7; effect size [ES]=‒0.59; P < .0001) and CGI-S score (LSMD=‒0.6; ES=‒0.59; P < .0001) from baseline to Day 43 vs placebo+ADT.

Lumateperone+ADT significantly improved (P < .05) MADRS Total score at Day 43 in all patient subgroups vs placebo+ADT based on age (≤40 years: LSMD=‒4.5; >40 years: LSMD=‒4.9), sex (male: LSMD=‒4.2; female: LSMD=‒5.0), region (US: LSMD=‒4.7; non-US: LSMD=‒4.6), disease severity (baseline MADRS Total score <32: LSMD=‒4.6; baseline score ≥32: LSMD=‒5.0), type of ADT (SSRI: LSMD=‒4.9; SNRI: LSMD=‒3.8), number of ADT failures (1 failure: LSMD=‒4.5; 2 failures: LSMD=‒6.3), race (White: LSMD=‒5.0; non-White: LSMD=‒3.2), and baseline anxious distress (Yes: LSMD=-5.9; No: LSMD=-4.0). Lumateperone+ADT significantly improved (P<.01) CGI-S score vs placebo+ADT at Day 43 in all subgroups (age, sex, race, region, baseline disease severity, type of ADT, number of ADT failures, baseline anxious distress).

Lumateperone+ADT was generally well tolerated. Common treatment-emergent AEs (≥5%; twice placebo+ADT) were dizziness, dry mouth, somnolence, nausea, and fatigue. No notable changes occurred in body morphology, prolactin levels, cardiometabolic parameters, or extrapyramidal symptom scales with lumateperone+ADT.

In this pooled analysis, lumateperone 42mg+ADT had robust efficacy vs placebo+ADT in demographic and clinical subgroups and was generally well tolerated, indicating lumateperone as an adjunctive treatment option in patients with MDD with inadequate ADT response.

W. Earley Employee of: Intra-Cellular Therapies, a Johnson & Johnson Company, S. Durgam Employee of: Intra-Cellular Therapies, a Johnson & Johnson Company, C. Chen Employee of: Intra-Cellular Therapies, a Johnson & Johnson Company, R. Migliore Employee of: Intra-Cellular Therapies, a Johnson & Johnson Company, J. Riise Employee of: Johnson & Johnson, S. Kornstein Grant / Research support from: National Institutes of Health and the National Science Foundation, Consultant of: Lilly, Sage Therapeutics, Reunion Neuroscience, Relmada, AbbVie, Gerbera, and Arrivo Bioventures, R. McIntyre Grant / Research support from: CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute, Speakers bureau of: Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Neurawell, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris Pharma, Sanofi, Eisai, Intra-Cellular Therapies, NewBridge Pharmaceuticals, Viatris, AbbVie, and Atai Life Sciences, M. Fava Shareholder of: Compellis; Neuromity; Psy Therapeutics; Revival Therapeutics; Sensorium Therapeutics, Grant / Research support from: AbbVie; Acadia Pharmaceuticals; Aditum Bio Management Company, LLC; Allergan, Alkermes, Inc.; Altimate Health Corporation; Alto Neuroscience, Inc.; Ancora Bio, Inc.; Angelini S.p.A; Aptinyx; Arbor Pharmaceuticals LLC; Avanir Pharmaceuticals Inc.; Axsome; Benckiser Pharmaceuticals, Inc.; BioClinica, Inc.; Biogen; BioHaven; BioShin Limited; Cambridge Science Corporation; Centrexion Therapeutics Corporation; Cerecor; Cybin IRL Limited; Damona Pharmaceuticals; EmbarkNeuro; Eliem Therapeutics LTD; Gate Neurosciences, Inc.; GenOmind, LLC; Gentelon, LLC; Gerbera Therapeutics, Inc.; Happify; Johnson & Johnson; Lundbeck Inc.; Marinus Pharmaceuticals; Medpace, Inc.; Methylation Sciences, Inc.; Millennium Pharmaceutics, Inc.; Minerva Neurosciences; Neuralstem; Neurocrine Biosciences, Inc.; NeuroRX Inc.; Novaremed; Novartis; Otsuka; Pfizer; Premiere Research International; Praxis Precision Medicines; Protagenic Therapeutics, Inc.; Relmada Therapeutics Inc.; Reckitt; Shenox Pharmaceuticals; Stanley Medical Research Institute (SMRI); Taisho; Takeda; University of Michigan; Vistagen; WinSanTor, Inc.; Xenon Pharmaceuticals, Inc.; National Institute of Drug Abuse (NIDA); National Institutes of Health (NIH); National Institute of Mental Health (NIMH); and PCORI, Consultant of: Massachusetts General Hospital, except for Revival Therapeutics and Sensorium Therapeutics

In recent years, there has been increasing attention on the potential of lay health workers and peer support models to address PND. These interventions are considered cost-effective, culturally appropriate, and accessible alternatives to traditional mental health services. This review serves as an update to a previous literature review (Potter CL. European Psychiatry. 2011;26(S2):1105-1105) that covered studies published between 1980 and 2010, focusing on the new evidence that has emerged since then.

This review aimed to evaluate published evidence on the effectiveness of lay support models for managing postnatal depression (PND), with a focus on studies published between 2010 and 2024. It was hypothesised that lay support interventions may benefit maternal mental health, with effectiveness varying by intervention type and target population.

A systematic review was conducted using MEDLINE, EMBASE, PsycINFO, and the Cochrane Library to identify randomised controlled trials (RCTs) published from August 2010 to October 2024. Studies included in this review focused on lay-led interventions for postnatal women, with outcomes related to PND, maternal mental health, and self-esteem. A total of 42 studies were included in the review.

The findings highlight the varied effectiveness of lay support models. Peer-led telephone support, especially for high-risk groups, showed significant reductions in depressive symptoms, as measured by the Edinburgh Postnatal Depression Scale (EPDS). Similarly, mindfulness-based childbirth courses and doula services demonstrated improvements in maternal self-efficacy and infant care practices, although they did not consistently reduce depressive symptoms. Interventions in low- and middle-income countries, such as group interpersonal therapy (g-IPT) and peer-led women’s groups, were associated with improved maternal mental health and stronger mother-infant bonding. Digital support models, including telemedicine and peer counselling, proved effective in settings with limited face-to-face care options. However, some interventions, including self-help manuals and community group support, showed no significant impact on PND.

This review provides evidence that lay support models can offer benefits for managing PND, particularly for high-risk and underserved populations. However, the effectiveness of different interventions varies, and further research is needed to determine which approaches are most effective in diverse cultural and socioeconomic contexts. The findings suggest that while lay support can be a promising strategy, additional studies are required to better understand its long-term impacts and cost-effectiveness.

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During adolescence, children become acutely aware of the necessity of planning their actions with regard to the anticipation of future events. Anticipation enables adolescents to shape their future, achieve higher academic success, manage interpersonal relationships, and adapt successfully within society. However, adolescents with speech disorders encounter difficulties in the process of regulating their behavior on the basis of subjective anticipation.

To examine the ability of adolescents with speech disorders to anticipate future events.

The empirical study involved 94 adolescents aged 11 to 14 years (M = 12.46; SD = 0.659): 46 adolescents with speech disorders and 48 adolescents without speech impairments. The following instruments were employed in the study: Anticipatory Competence Test (V. D. Mendelevich); the method Anticipation of the Outcome of a Situation Involving a Norm Violation (V. P. Ulyanova); the questionnaire Study of Anticipatory Competence in Adolescents (A. I. Akhmetzyanova, T. V. Artemyeva); as well as statistical methods for data analysis (SPSS v.24).

It was found that adolescents with speech disorders experience difficulties in anticipating future events, encounter problems in controlling their own movements, orienting themselves in space, and planning time: the mean score for the indicator ‘general anticipatory competence’ does not reach the normative threshold (M = 238.67; Gn = 241). Adolescents with speech disorders were fairly successful in identifying external features of situations involving a violation of social norms: they understood when a norm was being violated, who the violator was, and who the victim was in the given situation. However, they experienced difficulties in responding to questions about the motives of other participants’ behavior (M = 8.91; Max = 32). A comparative analysis of anticipatory competence in adolescents with and without speech disorders was conducted using Student’s t-test, which revealed statistically significant differences: adolescents with speech disorders were less able to anticipate communicative situations, encountered difficulties in interactions with adults and peers, and struggled to formulate verbal utterances (T = 2.90); they had difficulties organizing their free time and were unable to plan their time adequately (T = 3.38); and they experienced difficulties in anticipating their parents’ verbal utterances and in communicating freely with their parents (T = 2.99).

The results obtained in the study make it possible to develop programs aimed at enhancing the ability of adolescents with speech disorders to anticipate future events. This work was carried out with the financial support of the Russian Science Foundation under the project ‘Prognostic Competence of Adolescents with Disabilities: A Structural-Functional Model and the Potential of Digital Socialization’.

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Targeted therapy significantly improves survival in metastatic colorectal cancer (mCRC). However, its neuropsychiatric side effects remain poorly understood. The mitogen-activated protein kinase (MAPK) cascade plays a crucial role in synaptic plasticity and memory formation; therefore, its inhibition through targeted therapy, including EGFR blockade, is a matter of interest for studying patients with mCRC.

This study aimed to evaluate the impact of anti-EGFR-targeted therapy, compared with anti-VEGF-targeted therapy, on cognitive performance in patients with stage IV colorectal cancer.

Eighty patients with mCRC were enrolled. The main group (n = 55) received FOLFOX6 combined with an anti-EGFR monoclonal antibody (cetuximab or panitumumab), which inhibits the MAPK cascade. The control group (n = 25) received FOLFOX6 plus bevacizumab, which does not affect the MAPK cascade. Cognitive status was assessed at baseline and after 3–4 months using the Addenbrooke’s Cognitive Examination-Revised (ACE-R) and the Frontal Assessment Battery (FAB).

At baseline, cognitive scores were comparable between groups. After 3–4 months, the anti-EGFR targeted group showed a marked decline in ACE-R total scores from 94[90; 95] to 86[85; 90] (p = 0.001), whereas the control group remained stable (94[91; 97] to 94[90; 96]; p> 0.05). Memory scores declined in the anti-EGFR group from 22[22; 24] to 19[19; 20] (p= 0.001), while the control group showed only a mild reduction (23[21; 26] to 22[21; 25]; p= 0.034). Attention/orientation also decreased in the anti-EGFR group (18[16; 18] to 17[15; 18]; p= 0.024), but remained unchanged in controls (18[18; 18] throughout). Other ACE-R domains and FAB subscores demonstrated no significant changes.

Anti-EGFR-targeted therapy, which involves inhibiting the MAPK cascade, is found to be associated with selective cognitive impairment, predominantly affecting memory and attention. Regular cognitive monitoring may support timely psychiatric referral, optimize management strategies, and ultimately improve patients’ quality of life.

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The House–Tree–Person (HTP) test, developed by J. Buck in 1948, is a projective drawing technique widely used in child and adolescent psychology. Although projective tests have been criticized for subjectivity, they may offer valuable insights into emotional conflicts and self-concept in patients who struggle with verbal expression. This case study explores the interpretive potential of subconscious pencil strokes in the HTP test applied to an adolescent with emotional disorders.

To analyze subconscious drawing features in the HTP test and examine their clinical relevance by comparing the results with established interpretive frameworks and the patient’s psychiatric history.

A 15-year-old second-generation immigrant female, admitted repeatedly to the Child Psychiatry Ward due to self-harm and suicide risk, underwent the HTP test. Her psychiatric diagnoses included adolescent-onset emotional disorders and mixed adjustment disorder. Drawings were assessed by two independent clinicians, focusing on stroke characteristics, placement, and symbolic content. A brief literature review was conducted to contrast findings with prior evidence.

House drawing (Figure 1): Placed in the center, without smoke, curtains, or flowers, and with two doors, reflecting emotional emptiness and ambivalence about belonging.

Tree drawing (Figure 2): Cut off on the left margin, suggesting impulsivity and preoccupation with past experiences. The wide trunk base indicates dependency, while the absence of fruit may reflect lack of fulfillment.

Person drawing (Figure 3): A faceless, hooded figure drawn from behind, without arms, symbolizing social withdrawal, isolation, and feelings of inadequacy.

Stroke quality: Across all drawings, lines were executed with a single, clean stroke, indicating decisiveness but emotional restraint.

Size: All three drawings were small, consistent with low self-esteem.

Stroke quality: Executed with a single, clean line, indicating decisiveness but emotional restraint.

Symbolic content: The house lacked signals of habitation (no smoke, curtains, or flowers), showing possible emotional emptiness. The tree displayed a strong trunk base (dependency) but no fruit (absence of fulfillment). The person was faceless, hooded, and without arms, consistent with social withdrawal, isolation, and feelings of inadequacy.Image 1:Image 2:Image 3:

The HTP drawings projected key aspects of the patient’s internal world, including limited sense of belonging, impulsive tendencies, and pronounced isolation. Although projective techniques should not be used in isolation, the HTP test may complement standardized measures by highlighting unconscious emotional conflicts. Future research should examine whether specific stroke patterns can be systematically correlated with psychopathological features in larger clinical samples.

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Personality traits influence professional performance, yet their impact may be distorted by behavioral addictions.

To determine whether smartphone addiction mediates the relationship between personality traits and work performance among medical residents.

A cross-sectional study was conducted in 2025 among 429 Tunisian medical residents. Personality was assessed with the BFI-20, smartphone addiction with SAS-SV, and performance with IWPQ. Mediation models using hierarchical linear regression estimated indirect effects.

Conscientiousness was a strong positive predictor of job performance (β=0.488, p<0.001). However, smartphone addiction significantly mediated the effects of extraversion (indirect effect β=–0.219, p<0.001) and neuroticism (β=–0.161, p<0.001) on performance. While these traits were directly associated with higher performance, their benefits were partly offset when residents exhibited problematic smartphone use.

Smartphone addiction acts as a mediating pathway, attenuating the positive effects of certain personality traits on performance. Targeted interventions to reduce smartphone overuse could preserve the beneficial influence of personality on residents’ occupational efficiency.

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Antidepressants are essential for treating major depressive disorder, yet weight gain remains a significant side effect. It contributes to metabolic morbidity, reduced treatment adherence, and long-term cardiovascular risks.

This review provides an overview of the prevalence, pharmacological mechanisms, and clinical implications of antidepressant-associated weight gain, alongside prevention and management strategies.

A selective literature review was conducted, analyzing randomized controlled trials, meta-analyses, and large cohort studies focusing on compound-specific weight changes.

Weight gain varies significantly by substance. It is most pronounced with tricyclic antidepressants, mirtazapine, and maprotiline. Among SSRIs, paroxetine is the most weight-promoting, while fluoxetine is the most favorable. Conversely, bupropion and agomelatine are associated with weight neutrality or modest loss.

While short-term treatment may cause initial weight loss, long-term use often results in gradual gain. Mechanisms include H1, M1, and 5-HT2C receptor antagonism and modulation of appetite-regulating neuropeptides (leptin, ghrelin). Notably, a 5% weight increase within the first month correlates with a 5.5-fold increased risk of metabolic syndrome (MetS) by the sixth month. Newer agents like vortioxetine and vilazodone show promise in minimizing these metabolic burdens.

Weight gain is a critical adverse effect that requires proactive management. Treatment should integrate careful drug selection, early monitoring, and emerging therapies such as GLP-1 receptor agonists. Balancing psychiatric efficacy with metabolic safety is essential to improve adherence and restore the “whole person.”

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The BFI-2-S measures the Big Five personality factors including Extraversion, Agreeableness, Conscientiousness, Negative Emotionality, and Open-Mindedness. The PID-5- BF, however, is a brief measure of Personality Inventory for DSM-5, including Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism.

The study examines the BFI-2-S in relation to a similar-length version of the PID-5-BF. The core purpose was to see how well the pathological traits of the PID-5-BF aligned with their theoretically corresponding domains in the established Five-Factor Model.

The Arabic version of the PID-5-BF (25-item with 0–3 Likert-type scale) and the BFI-2-S (30-item with 1-5 Likert-type scale) scales were administered to 3900 Kuwait university undergraduates (1440 males mean age = 21.79±1.06 and 2460 females; mean age = 20.95±1.31).

Cronbach’s alphas ranged from 0.68 to 0.79 for the BFI-2-S Domains and 0.62 to 0.74 for the PID-5-BF Domains denoting moderate to acceptable internal consistency. The determined reciprocity pattern supports the theoretical expectations between the PID-5-BF and the BFI-2-S domains and confirms the relationship between normative and pathological personality. As expected, the PID-5-BF Negative Affectivity domain and the BFI-2-S Neuroticism (0.78), while the PID-5-BF Detachment, Antagonism, Disinhibition, and Psychoticism domains had negative relationships with the BFI-2-S Extraversion (–0.49), Agreeableness (–0.70), Conscientiousness (–0.76) and Openness (–0.85).

This pattern indicates that most normal-range traits measured by the BFI-2-S inversely relate to maladaptive personality characteristics assessed by the PID-5-BF, supporting the theoretical continuity between adaptive and pathological personality functioning.

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An accurate assessment of the mental state of the patient in the conditions of hostilities and in the remote period is a prerequisite for the timely provision of medical and rehabilitation assistance.

The purpose of the study. Develop an algorithm for assessing the condition of a patient with traumatic brain injury and the course of mental disorders at different stages of a traumatic brain injury, taking into account the dynamic changes in the patient’s condition. Materials. Patients with mental disorders who suffered a closed craniocerebral injury in the conditions of hostilities.

Clinical-psychopathological, anamnestic, study of medical documentation.

The possibility of changes from non-psychotic variants of impaired consciousness to an acute psychotic state was established immediately after a craniocerebral injury. Most patients reported a period of imaginary wellbeing or psychomotor excitement in the conditions of hostilities after a craniocerebral injury. On the one hand, this made it possible to survive in the conditions of a combat encounter, on the other hand, it delayed the provision of qualified medical assistance. Factors studied in the development of psychotic forms of impaired consciousness in the acute period of craniocerebral injury. The general patterns characteristic of all types of traumatic brain damage are presented as follows. The acute period - the suddenness of the lesion, which causes a maximum of pathological changes immediately after the craniocerebral injury; the regression of the further development of painful phenomena (from severe to milder) in the acute and intermediate periods; the formation of new symptoms of the disease in connection with the growth of the scar (in case of contusion) or involving new foci in the process; persistence of psychopathological disorders in the remote period of craniocerebral injury. Thus, the main difference between the intermediate and remote period is the possibility of reducing the manifestations of brain damage and preventing the development of some cointermediate and distant period. They turned out to be the presence of a mental illness before the injury, addiction to psychoactive substances, acute stress, other accompanying somato-neurological diseases. In the long-term period of craniocerebral injury, depending on the severity, persistent various organic mental disorders were observed. Deterioration of the mental state (primarily cognitive abilities) in the remote period was associated with repeated craniocerebral injury, addiction to psychoactive substances, other toxic factors, accumulated diseases during life.

Mental disorders in craniocerebral injuries are dynamic, which must be considered during the initial assessment of the patient’s condition and during further planning of treatment and rehabilitation.

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The interaction between psychiatric disorders and orthopedic injuries is clinically relevant but often underestimated. Self-harming behaviors, impulsivity, and impaired judgment in psychiatric patients may result in traumatic injuries requiring specialized medical care. These cases demand close collaboration between psychiatry and traumatology to optimize outcomes.

To present a clinical case illustrating the overlap between psychiatric symptoms and traumatic injury.

To emphasize the importance of an integrated, multidisciplinary approach.

To discuss diagnostic and therapeutic challenges.

We report the case of an adolescent patient admitted to the emergency department following a fracture sustained during an impulsive act related to psychiatric symptomatology. Data were collected from emergency records, psychiatric evaluations, and follow-up in both services.

The patient, with a history of mood instability and self-harm, presented with a distal radius fracture following an episode of agitation and impulsivity.

• • Traumatology: Urgent orthopedic stabilization was performed, followed by routine postoperative care.

• • Psychiatry: Comprehensive assessment revealed underlying depressive symptoms and emotional dysregulation. Psychotherapy and pharmacological treatment with SSRIs were initiated.

• • Multidisciplinary care: Joint follow-up visits allowed coordination of physical rehabilitation and psychiatric stabilization.

  After several months, fracture healing was achieved, and the patient showed significant improvement in mood regulation and reduction of self-harming behaviors.

This case highlights the critical intersection of psychiatry and traumatology. Traumatic injuries in psychiatric patients are not merely physical events but markers of psychological vulnerability. A collaborative, multidisciplinary approach ensures both physical recovery and mental health stabilization, ultimately improving prognosis.

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In recent years, the number of aggressive incidents in psychiatric wards has progressively increased, representing one of the main challenges to staff safety and the overall quality of the work environment. Ensuring protection and well-being for healthcare professionals is not merely an organizational requirement, but a key factor in the effectiveness of care and in safeguarding the mental health of those working in such high-demand settings.

This study aimed to assess the prevalence of aggression among healthcare professionals in the Campania region and its psychological impact on them.

A cross-sectional observational study was conducted using an ad hoc questionnaire administered to psychiatric ward staff in the Campania region. The questionnaire collected sociodemographic and professional data, experiences of aggression, and job satisfaction. Psychological distress was assessed using the Depression Anxiety Stress Scales–21 items (DASS-21).

Fifty healthcare professionals were enrolled in the study: 42.0% were medical or psychological staff, and the remainder were nursing or other healthcare workers. Females comprised 54.0% of the sample, with a mean age of 44.4±10.0 years. Overall, 94.0% reported experiencing at least one aggressive episode, either verbal (82.0%) and/or physical (52.0%), while 78.0% reported feeling unsafe at work. Pearson correlation analyses revealed a significant inverse relationship between age and DASS-21 anxiety (r=-0.294, p<0.05) and stress (r=-0.289, p<0.05) subscales, as well as between years of psychiatric ward experience and the anxiety subscale (r=-0.315, p<0.05). Women had significantly higher mean scores on the DASS-21 anxiety and depression subscales compared to men (p<0.01). Participants considering leaving their job exhibited significantly higher mean scores across all DASS-21 subscales (p<0.05).

The findings confirm the high prevalence of aggression in psychiatric wards and its psychological impact on staff, with greater levels of distress among women and less experienced professionals, to the point of fostering intentions to leave their job. These results underscore the urgent need for targeted interventions in prevention, support, and training, as well as a critical reassessment of the effectiveness of current safety measures.

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Electroconvulsive therapy (ECT) is highly effective for several severe psychiatric conditions, but its cognitive adverse effects remain a key concern and are challenging to monitor with resource-intensive objective tests.

This prospective observational study aims to validate two patient-reported outcome measures (PROMs) for assessing cognitive adverse effects in patients with unipolar depression undergoing ECT. The psychometric properties of the PROMs will be assessed against several clinician-administered scales.

Participants will complete the Squire Subjective Memory Questionnaire (SSMQ) and the Global Self-Evaluation of Memory (GSE-My) at baseline, after the sixth ECT session, and at the end of the treatment course. Clinician-administered assessments will include the Screen for Cognitive Impairment in Psychiatry (SCIP) and the Columbia Autobiographical Memory Interview Short-Form (CAMI-SF), along with measures of depressive symptom severity, functional impairment, and global clinical impression. Psychometric evaluation will focus on test–retest reliability, construct validity, and responsiveness of the PROMs compared with the clinician-rated scales.

Enrollment and data collection are expected to begin at the end of September 2025. Preliminary findings will be presented at the 34th European Congress of Psychiatry in March 2026.

If a patient-reported scale is found to have acceptable psychometric properties, this could be a highly feasible method of monitoring cognitive adverse effects of ECT in clinical practice, thereby supporting clinicians in making informed, timely adjustments to treatment in order to minimize these effects.

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In patients with bipolar disorder (BD), psychosocial functioning, particularly autonomy, often remains impaired despite clinical remission. Several factors may influence this domain, including clinical profile, neurocognitive performance, and emotion regulation abilities. However, few studies have specifically examined the determinants of autonomy in euthymic patients with bipolar disorder.

To assess the impact of neurocognition and emotion regulation on autonomy among euthymic patients with bipolar disorder.

A cross-sectional descriptive and analytical study was conducted among patients diagnosed with BD type I, II, or unspecified, who had been in euthymia for at least six months.

Autonomy was assessed using the Functioning Assessment Short Test (FAST), with the autonomy sub-score used to classify patients as having preserved or impaired autonomy.

Cognitive functions were evaluated using a battery of neuropsychological tests assessing verbal learning and memory, attention, and executive functions.

Emotion regulation was assessed using the Difficulties in Emotion Regulation Scale (DERS) and the Regulation of Emotion Questionnaire (REQ).

Statistical analyses explored correlations and associations between autonomy, clinical variables, cognitive performance, and emotion regulation indices (significance level p < 0.05).

A total of 60 patients were included.

Autonomy impairment was identified in 58% of the sample.

Patients with preserved autonomy demonstrated better cognitive performance, particularly in verbal learning (p = 0.039), semantic memory (p = 0.021), visuospatial working memory (p = 0.007), and cognitive flexibility (p = 0.039).

They also showed superior attentional performance (p = 0.045).

Emotionally, autonomous patients had significantly lower DERS scores, reflecting better overall emotion regulation (p < 0.001), especially in emotional clarity (p < 0.001), emotional acceptance (p = 0.002), impulse control (p < 0.001), and access to regulation strategies (p = 0.001).

Additionally, the use of functional internal emotion regulation strategies (REQ) was significantly associated with preserved autonomy (p = 0.018).

This study highlights that autonomy in euthymic patients with bipolar disorder is closely linked to cognitive abilities and emotion regulation. Early identification of cognitive and emotional difficulties may guide targeted remediation and psychoeducational interventions aimed at improving autonomy and, more broadly, psychosocial reintegration in bipolar disorder.

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Menopause is a near-universal transition, yet its psychiatric dimensions remain insufficiently recognized in medical training and practice. Pharmacological interventions—such as selective serotonin reuptake inhibitors (SSRIs) and estrogen-based therapies—are effective for mood and vasomotor disturbances, but their incorporation into psychiatric care remains inconsistent. Beyond clinical underutilization, this oversight reflects broader ethical concerns about the invisibility of midlife women’s mental health.

To evaluate evidence-based strategies for managing psychiatric symptoms in perimenopausal and postmenopausal women, and to examine the ethical implications of underdiagnosis and undertreatment of psychiatric distress during this ubiquitous but often marginalized life stage.

We conducted a targeted review of clinical guidelines and empirical studies on SSRIs, estrogen therapy, and combined approaches, supplemented by feminist and bioethical literature addressing the structural neglect of women’s suffering in medical contexts.

SSRIs and estrogen therapy each demonstrate efficacy for mood and vasomotor symptoms, with combined regimens conferring additive benefit. Cognitive behavioral therapy has also been shown to reduce the subjective burden of vasomotor symptoms. Despite this, psychiatric curricula rarely identify menopause as a high-risk period, and cognitive symptoms—often described as “mental fog”—remain underrecognized, despite their significant occupational and relational consequences. Ethically, this omission perpetuates what Bordo and Bartky have characterized as the systemic minimization of women’s embodied transitions, thereby reinforcing structural invisibility within psychiatry.

Addressing menopause in psychiatry constitutes both a clinical and ethical imperative. Integrative care models embedding psychiatric screening within gynecological and primary care, supported by validated instruments such as the Meno-D scale, may enable earlier recognition of mood, cognitive, and anxiety symptoms. Reframing midlife women’s mental health as central to psychiatric care would not only improve clinical outcomes but also advance feminist commitments to visibility and justice.

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Cyberchondria, defined as excessive and repetitive online searching for health-related information, is an emerging challenge in mental health. It may aggravate health anxiety, reduce quality of life, and increase healthcare utilization. While studied in other regions, little evidence exists from North Africa.

To assess the prevalence of cyberchondria, health anxiety, Internet addiction, and eHealth literacy among Tunisian university students.

We conducted a cross-sectional online survey among university students in Sfax (Tunisia) between March and April 2025. Validated instruments were used: Cyberchondria Severity Scale-15 (CSS-15), Short form of Health Anxiety Inventory (SHAI), Internet addiction test (IAT), and eHealth literacy scale (eHEALS). Sociodemographic and clinical data included gender, academic year, and psychiatric history.

A total of 283 Tunisian students participated (58.7% were male, mean age 21.32 ± 1.41 years). Cyberchondria was moderate in 64% and high in 3.9%. Health anxiety was moderate/high in 8.8% and substantial in 7.4%. Internet addiction was moderate in 53.7% and severe in 13.4%. eHealth literacy was low in 44.5% and high in 16.6%. Cyberchondria was higher in females (p<0.001), in those with family psychiatric history (p<0.001), and in students with Internet addiction (ρ=0.22, p<0.001).

Cyberchondria is highly prevalent among Tunisian university students, strongly linked to health anxiety and problematic Internet use. Preventive interventions should include psychoeducation and digital health literacy programs.

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Job satisfaction is a key psychological construct reflecting workers’ attitudes toward their work and organizational environment. Identifying its determinants is crucial, as job satisfaction can significantly influence both productivity and overall performance among laboratory workers.

This study aimed to study the determinants of job satisfaction among laboratory workers.

A descriptive, analytical, cross-sectional survey was conducted among laboratory workers. Data were collected on sociodemographic and occupational characteristics. Job satisfaction was rated on a 0–10 scale, where 0 indicated low and 10 indicated high satisfaction. Participants reported their height and weight, which were used to calculate Body Mass Index (BMI). Perceived stress was assessed using the 4-item Perceived Stress Scale (PSS-4).

The study included 91 laboratory workers with a mean age of 44.2 ± 9.2 years. The majority were women (92.2%, n = 83), and 80% were married. On average, participants had 14.8 ± 9.5 years of work experience. The mean job satisfaction score was 6.5 ± 2.6. the mean BMI was 26 ±7.1, and the mean perceived stress score was 6.3 ± 2.6. Job satisfaction was significantly higher among participants with lower BMI and lower perceived stress (p < 0.05).

Job satisfaction among laboratory workers was influenced by both BMI and perceived stress, with lower stress levels and healthier BMI associated with higher satisfaction. These findings underscore the importance of promoting physical health and stress management to enhance workplace well-being and performance.

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Sexuality is a fundamental human need. Contrary to popular belief, sexual activity is maintained in patients with mental illness, whose sexual interest and desire evolve with treatment without disappearing. Despite the importance of sexual health for patients receiving psychiatric care, communication about sexuality between doctors and patients faces several obstacles and shortcomings. Among these limiting factors are the practices of psychiatric residents with regard to patient sexuality.

The objectives of our study were to evaluate the practices of psychiatric residents with regard to patient sexuality in Tunisia and to determine the factors associated with the nature of these practices in this population.

This was a descriptive and analytical study with cross-sectional data collection conducted on a population composed of a sample of psychiatry residents practicing in Tunisia at all levels: from the first to the fifth year. Our study was based on an online questionnaire and assessed participants’ Practices of sexuality. It took place from March 1 to April 1, 2025.

Forty-two young psychiatrists were identified. The average age of these young practitioners was 27.95 years. The majority of psychiatrists participating in the study were female (83%; n=35). The majority of participants (31%) were fourth-year psychiatry residents. The pharmacological approaches that psychiatrists often used to treat SDs were mainly the prescription of IPDE5 (often or sometimes prescribed by 26% and 12% of practitioners, respectively). Specific sexological approaches were only practiced by a minority of psychiatrists (only 17% for CBT and 33% for couples therapy), with the exception of supportive psychotherapy and marital counseling (43% of psychiatrists) and sexual information provided by 71% of psychiatrists. Regarding the factors influencing doctors’ practices, we found a significant negative relationship between gender and pharmacological approaches (p=0.001). We observed a statistically significant difference between the different stages of residency in terms of pharmacological approaches to patients’ sexuality (p=0.001). Furthermore, a significant relationship was found between pharmacological approaches and residents with degrees in sexology (p=0.01). Finally, a significant relationship was found between pharmacological approaches and patient satisfaction (p=0.023).

There are several gaps in Tunisian doctors’ practices regarding their patients’ sexuality. At the end of this study, we suggest the generalization of sexology education in all medical schools in Tunisia and, above all, the participation of residents in specific sexology consultations. This will promote the good sexual health of our patients and contribute to better mental balance.

None Declared