Search results for: psychosis proneness

Authors: Anum Atiq, Haya Fatimah

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Lucid dream is a dream where one is aware that one is dreaming, and they also might be able to influence their dreaming states. Logically, since lucidity cues towards high awareness, it should be negatively associated with proneness to psychosis. However, this association is scarcely studied. Furthermore, although gender differences and similarities in psychopathology have been thoroughly studied, there is room for research in the influence of masculinity and femininity, regardless of one’s sex, on proneness to psychosis. The aim of this study is twofold: 1) We investigated if dream lucidity was negatively associated with psychosis proneness; and 2) We explored the influence of masculinity and femininity on psychosis proneness, over and above the sex. Data were collected by convenience sampling from the undergraduate students enrolled at the University of Management and Technology, Lahore. The sample consisted of 53 students among the age range of 18-26 (men=24, women=29). Masculinity and femininity were measured using the masculinity and femininity subscales of the Personality Attributes Questionnaire. Dream lucidity was measured with The Lucidity and Consciousness in Dreams Scale; and the reality testing sub scale of The Inventory of Personality Organization was used to measure proneness to psychosis. Pearson correlation analysis revealed that psychosis proneness was significantly and negatively correlated with dream lucidity-insight and negative emotion in dreams, but not with other aspects of dream lucidity. Furthermore, masculinity, in both men and women, was positively related with lucid dreaming, and negatively with psychosis proneness. Following this, linear regression analysis showed that psychosis proneness was negatively predicted by masculinity even after controlling for gender. Lucid dreamer and masculinity both have characteristic of independence, emotional control and internal locus of control. Therefore, masculinity makes lucid dreaming less risk of psychosis in both genders.

Keywords: lucid dreaming, psychosis, gender, masculinity and femininity

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Authors: Usha Barahmand, Ruhollah Heydari Sheikh Ahmad

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Distress refers to an unpleasant metal state or emotional suffering marked by negative affect such as depression (e.g., lost interest; sadness; hopelessness), anxiety (e.g., restlessness; feeling tense). These negative affect have been mostly suggested to be concomitant of metal disorders such as positive psychosis symptoms and also of proneness to psychotic features in non-clinical population. Psychotic features proneness including hallucination, delusion and schizotypal traits, have been found to be associated with metacognitive beliefs. Metacognition has been conceptualized as ‘thinking about thoughts, monitoring and controlling of cognitive processes’. The aim of the current study was to investigate the role of psychosis proneness in the association of metacognitions and distress. We predicted psychosis proneness would mediate the association of metacognitive beliefs and the distress. A sample of 420 university students was randomly recruited to endorse questionnaires of the study that consisted of DASS-21questionnaire for assessing levels of distress, Cartwright–Hatton & Wells, Meta-cognitions Questionnaire (MCQ-30) for assessing metacognitive beliefs, Launay-Slade Hallucination Scale-revised (LSHS-R), Peters et al. Delusions Inventory, Schizotypal Personality Questionnaire-Brief. Conducting a bootstrapping approach in order to investigate our hypothesis, the result showed that there was no a direct association between metacognitive dimensions and psychological distress and psychosis proneness significantly mediated the association. Finding suggested that individuals with dysfunctional metacognitive beliefs experience high levels of distress if they are prone to psychosis symptoms. In other words, psychosis proneness is a path through which individuals with dysfunctional metacognitions experience high levels of psychological distress.

Keywords: metacognition, non-clinical population, psychological distress, psychosis proneness

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Authors: Matthew Perkins-McVey

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The pharmacological arm of mental health treatment is in a state of crisis. The promises of the Prozac century have fallen short; the number of different therapeutically significant medications that successfully complete development shrinks with every passing year, and the demand for better treatments only grows. Answering these hardships is a renewed optimism concerning the efficacy of controlled psychedelic therapy, a renaissance that has seen the return of a familiar concept: intoxication as a model psychosis. First appearing in the mid-19th century and featuring in an array of 20th century efforts in psychedelic research, model psychosis has, once more, come to the foreground of psychedelic research. And yet, little has been made of where this peculiar, perhaps even intoxicatingly mad, the idea originates. This paper seeks to uncover the conceptual foundations underlying the early emergence of model psychosis. This narrative will explore the conceptual foundations behind their independent development of the concept of model psychosis, considering their similarities and differences. In the course of this examination, it becomes apparent that the definition of endogenous psychosis, which formed in the mid-19th century, is the direct product of emerging understandings of exogenous psychosis, or model psychosis. Ultimately, the goal is not merely to understand how and why model psychosis became thinkable but to examine how seemingly secondary concept changes can engender new ways of being a psychiatric subject.

Keywords: history of psychiatry, model psychosis, history of medicine, history of science

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Authors: Hilary P. Stevenson, Alexander J. Hayek, Amie Dereczyk

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In this case report, we provide an example of an asymptomatic COVID-19 positive patient who presented with new-onset psychosis with severe paranoid delusions. He was seen in our ED after ingesting isopropyl alcohol which he reported was an attempt to escape presumed attackers, which at the time was logical to the patient. The patient’s family had COVID-19 symptoms that corresponded to those typically observed from the Omicron variant. The patient was treated successfully, within ten days, with Risperdal twice-daily dosing resulting in the resolution of the patient’s delusions and improved insight regarding the events that led to his hospitalization. In this work, we examine possible contributing factors to new-onset psychosis in the context of COVID-19, a phenomenon that is becoming increasingly notable in the literature. One area of importance is the already established inflammatory hypothesis of psychosis in which defects in the innate immune system, which result in its overactivation, may play a role in a typical first-episode psychosis, in addition to subsequent episodes. Given that COVID-19 is known to cause derangements in the innate immune system, such as cytokine storm reactions, this link may be critical in further understanding the etiologies of new-onset COVID-19 psychosis and its risk factors. Also included in this work is a brief review of antipsychotic interventions that have been described in the literature to date for the first episode of COVID-19-related psychosis. This will explore the potential of some antipsychotics to innately diminish the production of pro-inflammatory cytokines, further enhancing their usefulness in COVID-19 first-episode psychosis patients.

Keywords: COVID-19, first break psychosis, inflammatory hypothesis of psychosis, Risperdal

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Authors: Eirini Petratou, Pezirkianidis Christos, Anastassios Stalikas

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Nostalgia is characterized as a mental state of human’s emotional longing for the past that activates both positive and negative emotions. The bittersweet emotions that are activated by nostalgia aid psychological functions to humans and are depended on the type of stimuli that evoke nostalgia but also on the nostalgia activation context. In general, despite that nostalgia can be activated and experienced by all people; however, it differs both in terms of nostalgia experience but also nostalgia frequency. As a matter of fact, nostalgia experience along with nostalgia frequency differs according to the level of the nostalgia proneness. People with high nostalgia proneness tend to experience nostalgia more intensely and frequently than people with low nostalgia proneness. Nostalgia proneness is considered as a basic individual difference that affects the experience of nostalgia, and it can be measured by the Southampton Nostalgia Scale (SNS); a psychometric instrument that measures human’s nostalgia proneness consisting of seven questions that assess a person’s attitude towards nostalgia, the degree of experience or tendency to nostalgic feelings and the nostalgia frequency. In the current study, we translated, validated and calibrated the SNS in Greek population (N = 267). For the calibration process, we used several scales relevant to positive dimensions, such as life satisfaction, positive and negative emotions, time perspective and wellbeing. A confirmatory factor analysis revealed the factors that provide a good Southampton Nostalgia Proneness model fit for young adult Greek population.

Keywords: nostalgia proneness, nostalgia, psychometric instruments, psychometric properties

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Authors: Zsanett Bahor, Cristina Nunes-Fonseca, Gillian L. Currie, Emily S. Sena, Lindsay D.G. Thomson, Malcolm R. Macleod

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Psychosis is ranked as the third most disabling medical condition in the world by the World Health Organization. Despite a substantial amount of research in recent years, available treatments are not universally effective and have a wide range of adverse side effects. Since many clinical drug candidates are identified through in vivo modelling, a deeper understanding of these models, and their strengths and limitations, might help us understand reasons for difficulties in psychosis drug development. To provide an unbiased summary of the preclinical psychosis literature we performed a systematic electronic search of PubMed for publications modelling a psychotic disorder in vivo, identifying 14,721 relevant studies. Double screening of 11,000 publications from this dataset so far established 2403 animal studies of psychosis, with the most common model being schizophrenia (95%). 61% of these models are induced using pharmacological agents. For all the models only 56% of publications test a therapeutic treatment. We propose a systematic review of these studies to assess the prevalence of reporting of measures to reduce risk of bias, and a meta-analysis to assess the internal and external validity of these animal models. Our findings are likely to be relevant to future preclinical studies of psychosis as this generation of strong empirical evidence has the potential to identify weaknesses, areas for improvement and make suggestions on refinement of experimental design. Such a detailed understanding of the data which inform what we think we know will help improve the current attrition rate between bench and bedside in psychosis research.

Keywords: animal models, psychosis, systematic review, schizophrenia

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Authors: Belinda Crissman

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Serious mental disorder is greatly overrepresented in prisoners compared to the general community, with consequences for prison management, recidivism and the prisoners themselves. Incarcerated individuals with psychotic disorders experience insufficient detection and treatment and higher rates of suicide in custody. However direct evidence to explain the overrepresentation of individuals with psychosis in prisons is sparse. The current study aimed to use a life course criminology perspective to answer two key questions: 1) What is the temporal relationship between psychosis and offending (does first mental health contact precede first recorded offence, or does the offending precede the mental health diagnosis)? 2) Are there key temporal points or system contacts prior to incarceration that could be identified as opportunities for early intervention? Data from the innovative Queensland Linkage project was used to link individuals with their corrections, health and relevant social service systems to answer these questions.

Keywords: mental disorder, crime, life course criminology, prevention

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Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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Authors: Eva Tolmeijer, Emmanuelle Peters, Veena Kumari, Liam Mason

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Cognitive behavioral therapy for psychosis (CBTp) is effective in many but not all patients, making it important to better understand the factors that determine treatment outcomes. To date, no studies have examined whether neuroimaging can make clinically useful predictions about who will respond to CBTp. To this end, we used machine learning methods that make predictions about symptom improvement at the individual patient level. Prior to receiving CBTp, 22 patients with a diagnosis of schizophrenia completed a social-affective processing task during functional MRI. Multivariate pattern analysis assessed whether treatment response could be predicted by brain activation responses to facial affect that was either socially threatening or prosocial. The resulting models did significantly predict symptom improvement, with distinct multivariate signatures predicting psychotic (r=0.54, p=0.01) and affective (r=0.32, p=0.05) symptoms. Psychotic symptom improvement was accurately predicted from relatively focal threat-related activation across hippocampal, occipital, and temporal regions; affective symptom improvement was predicted by a more dispersed profile of responses to prosocial affect. These findings enrich our understanding of the neurobiological underpinning of treatment response. This study provides a foundation that will hopefully lead to greater precision and tailoring of the interventions offered to patients.

Keywords: cognitive behavioral therapy, machine learning, psychosis, schizophrenia

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Authors: Radu Soflau, Lia-Ecaterina Oltean

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Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

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Authors: Herlandson C. Moura, Jorge H. Bidinotto, Eduardo M. Belo

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The present work proposes the development of an adaptive control system which enables the suppression of Pilot Induced Oscillations (PIO) in Digital Fly-By-Wire (DFBW) aircrafts. The proposed system consists of a Modified Model Reference Adaptive Control (M-MRAC) integrated with the Gain Scheduling technique. The PIO oscillations are detected using a Real Time Oscillation Verifier (ROVER) algorithm, which then enables the system to switch between two reference models; one in PIO condition, with low proneness to the phenomenon and another one in normal condition, with high (or medium) proneness. The reference models are defined in a closed loop condition using the Linear Quadratic Regulator (LQR) control methodology for Multiple-Input-Multiple-Output (MIMO) systems. The implemented algorithms are simulated in software implementations with state space models and commercial flight simulators as the controlled elements and with pilot dynamics models. A sequence of pitch angles is considered as the reference signal, named as Synthetic Task (Syntask), which must be tracked by the pilot models. The initial outcomes show that the proposed system can detect and suppress (or mitigate) the PIO oscillations in real time before it reaches high amplitudes.

Keywords: adaptive control, digital Fly-By-Wire, oscillations suppression, PIO

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Authors: Elena Carbone, Chiara Meneghetti, Ivan Innocenti, Monica Musicanti, Paola Volpe, Francesca Pazzaglia

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Promoting environmental sustainability is becoming a priority for organizations. Little is known, however, on the extent to which green workplace behaviors are linked, alongside organizational determinants, and also to various employees’ individual characteristics. The BE-GREEN research project, in collaboration with Eni S.p.A., aimed at investigating the relationship between the adoption of green workplace behaviors and various employees’ job-related and broader individual characteristics as well as organizational determinants. A sample of 513 Eni employees was administered a survey assessing the adoption of green workplace behaviors and the management of events (e.g., near-miss, unsafe conditions, weak signals) that could anticipate the occurrence of incidents with a harmful environmental impact. The survey also assessed employees’ job-related (e.g., proneness toward behaving pro-environmentally at work) and general (e.g., soft skills, connectedness to nature and environmental awareness) characteristics and perceived organizational support (e.g., environmental culture, leadership). Results showed that the adoption of green workplace behaviors was associated with employees’ proneness toward behaving pro-environmentally at work, and these factors were, in turn, influenced by broader individual characteristics related to soft skills as well as a connectedness to nature and environmental awareness, along with perceived organizational support. The management of events potentially anticipating the occurrence of incidents with a harmful environmental impact was mainly associated with perceived organizational support. These findings highlight how, alongside organizational determinants, different employees’ individual characteristics influence their adoption of green workplace behaviors, with important implications for the development of interventions tailored to promote environmental sustainability in organizations.

Keywords: green workplace behaviors, soft skills, connectedness to nature, environmental awareness.

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Authors: Omaymah Al-Otoom, Rajesh Mehta

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Introduction: Migration is an established risk factor in the development of schizophrenia and other forms of psychosis. The exposure to different social adversities, including social isolation, discrimination, and economic stress, is thought to contribute to elevated rates of psychosis in immigrants and their children. We present a case of resistant schizophrenia in an immigrant adolescent. Case: The patient is a 15-year-old male immigrant. In October 2021, the patient was admitted for irritability, suicidal ideations, and hallucinations. He was treated with Fluoxetine 10 mg daily for irritability. In November 2021, he presented with similar manifestations. Fluoxetine was discontinued, and Risperidone 1 mg at bedtime was started for psychotic symptoms. In March 2022, he presented with commanding auditory hallucinations (voices telling him that people were going to kill his father). Risperidone was gradually increased to 2.5 mg twice daily for hallucinations. The outpatient provider discontinued Risperidone and started Olanzapine 7.5 mg and Lurasidone 40 mg daily. In August 2022, he presented with worsening paranoia due to medication non-adherence. The patient had limited improvement on medications. In October 2022, the patient presented to the ED for visual hallucinations and aggression towards the family. His medications were Olanzapine 10 mg daily, Lurasidone 60 mg daily, and Haloperidol 2.5 mg twice daily. In the ED, he received multiple as-needed medications and was placed in seclusion for his aggressive behavior. The patient showed a positive response to a higher dose of Olanzapine and decreased dose of Lurasidone. The patient was discharged home in stable condition. Two days after discharge, he was brought for bizarre behavior, visual hallucinations, and homicidal ideations at school. Due to concerns for potential antipsychotic side effects and poor response, Lurasidone and Olanzapine were discontinued, and he was discharged home on Haloperidol 5 mg in the morning and 15 mg in the evening. Clozapine treatment was recommended on an outpatient basis. He has no family history of psychotic disorders. He has no history of substance use. A medical workup was done, the electroencephalogram was normal, and the urine toxicology was negative. Discussion: Our patient was on three antipsychotics at some point with no improvement in his psychotic symptoms, which qualifies as treatment-resistant schizophrenia (TRP). It is well recognized that migrants are at higher risk of different psychiatric disorders, including posttraumatic stress disorder, affective disorders, schizophrenia, and psychosis. This is thought to be related to higher exposure to traumatic life events compared to the general population. In addition, migrants are more likely to experience poverty, separation from family members, and discrimination which could contribute to mental health issues. In one study, they found that people who migrated before the age of 18 had twice the risk of psychotic disorders compared to the native-born population. It is unclear whether migration increases the risk of treatment resistance. In a Canadian study, neither ethnicity nor migrant status was associated with treatment resistance; however, this study was limited by its small sample size. There is a need to implement psychiatric prevention strategies and outreach programs through research to mitigate the risk of mental health disorders among immigrants.

Keywords: psychosis, immigrant, adolescent, treatment resistant schizophrenia

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Authors: C. W. Kan

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Cotton is the most commonly used material for apparel purpose because of its durability, good perspiration absorption characteristics, comfort during wear and dyeability. However, proneness to creasing and wrinkling give cotton garments a poor rating during actual wear. Resin finishing is a process to bring out crease or wrinkle free/resistant effect to cotton fabric. Thus, the aim of this study is to illustrate the proper application of resin finishing to cotton fabric, and the results could provide guidance note to the students in learning this topic. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: learning materials, resin, textiles, wrinkle

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Authors: Silsila Sherzad, Hazrat Ali Khan, Tabasum Sherzad, Hazratullah, Sanaullah

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Objective: To study the prevalence of common Mental health disorders among forcibly displaced people and to compare with the common mental health disorders among host community members. Study design: Analytical Study. Place of study: Balochistan institute of psychiatry and behavioral sciences, Quetta, Baluchistan, Pakistan. Methodology: Data from the Outpatient department were analyzed to numerate both the host community and refugees. Out of 4120, 354 refugee patients were identified using their proof registration (POR) card and for 3776 of the host community using their computerized national identity card (CNIC), data was analyzed for the prevalence of mental health disorders among them. Results: This study states that Afghan Refugees presented to OPD services of Balochistan institute of psychiatry and behavioral sciences, 47% were diagnosed as Major depressive disorder with/without psychosis, 19% with Generalized anxiety disorder, 5% were diagnosed as Bipolar Affective disorder, 5% With schizophrenia, 4% as Post-traumatic stress disorder, 3% as migraine, 3% conversion disorder, 2% Obsessive-compulsive disorder, 1% somatoform disorder and 10% of them presented with other psychiatric disorders, while in host community 21% were diagnosed as Major depressive disorder with/without psychosis, 24% as Generalized anxiety disorder, 12% as somatoform disorder, 10% as Obsessive-compulsive disorder, 8% as migraine, 7% as conversion disorder, 4% as Bipolar Affective disorder, 3% as schizophrenia, 3% as Mental and behavioral disorder due to substance misuse and rest of 7% presented with other psychiatric disorders. Conclusion: The conclusion of this study states that mental health disorders are more common among refugees than in other populations. The result of this study shows that there is a big difference in the prevalence of mental health disorders among displaced people and the rest of the population. Some Mental health disorders are present in a higher percentage among displaced people rather than among the host community, while some other disorders are present in a lower percentage among displaced people rather than among the host community. This study also highlights that further studies are needed to determine risk and protective factors within the host community.

Keywords: forced displacement, mental health, Afghan refugees, depression

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Authors: Jamileh Ahmed, Helena Hernandez, Gabriel De Erausquin

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H1N1 virus susceptibility of iPSC-derived DA neurons from schizophrenia patients and controls will compared. C57/BL-6 fibroblasts were reprogrammed into iPSCs using a lenti-viral vector containing SOKM genes. Pluripotency verification with the AP assay and immunocytochemistry ensured iPSC presence. The experimental outcome of ISPCs from DA neuron differentiation will be discussed in the Results section. Fibroblasts from patients and controls will be reprogrammed into iPSCs using a sendai-virus vector containing SOKM. IPSCs will be characterized using the AP assay, immunocytochemistry and RT-PCR. IPSCs will then be differentiated into DA neurons. Gene methylation will be compared for both groups with custom-designed microarrays.

Keywords: schizophrenia, iPSCs, stem cells, neuroscience

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Authors: O. Atli Eklioglu

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Atypical antipsychotics such as quetiapine, olanzapine, and risperidone have been frequently and chronically used to treat psychiatric disorders accompanied by psychosis mainly schizophrenia. Since these drugs are commonly used in male patients of reproductive age, it is required to determine the possible effects of them on the reproductive system. In this study, it was aimed to evaluate the possible toxic effects of quetiapine, olanzapine and risperidone, which are the most frequently prescribed and chronically used psychiatric drugs, on sperm parameters. For this purpose, quetiapine (10, 20 and 40 mg/kg), olanzapine (2.5, 5 and 10 mg/kg), and risperidone (1.25, 2.5 and 3 mg/kg) were administered to male rats for 28 consecutive days. At the end of this period, sperm concentration, motility, and morphology were investigated by a computer-assisted sperm analysis system. According to the results, sperm parameters were negatively affected by antipsychotic use.

Keywords: quetiapine, olanzapine, risperidone, sperm count, motility, sperm morphology, computer-assisted sperm analysis

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Authors: Memnun Seven, Aygül Akyüz

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Having a baby, giving birth and being a mother are generally considered happy events, especially for women who have had a history of infertility and may have suffered emotionally, physically and financially. Although the transition from the prenatal period to the postnatal period is usually desired and planned, it is a developmental and cognitive transition period full of complex emotional reactions. During this period, common mood disorders for women include maternity blues, postpartum depression and postpartum psychosis. Postpartum depression is a common and serious mood disorder which can jeopardize the health of the mother, baby and family within the first year of delivery. Knowing the risks factors is an important issue for the early detection and early intervention of postpartum depression. However, knowing that a history of infertility may contribute to the development of postpartum depression, there are few studies assessing the effects of infertility during the diagnosis and treatment of depression. In this review, the effects of infertility on the development of postpartum depression and nurse/midwives’ roles in this issue are discussed in light with the literature.

Keywords: infertility, postpartum depression, risk factors, mood disorder

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Authors: Kadhim Alabady

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Background: Mental illnesses after childbirth are common. After childbirth, women may experience a variety of postpartum complications such as developing depression during pregnancy and after childbirth. Postpartum depression might increases the risk of developing major depression in the future. The most common is postnatal depression also known as postpartum depression that is believed to affect between 10% – 15% of mothers and the most serious, puerperal psychosis (affecting less than 1%). Purpose: This research simply applies the predictions to the population of Dubai, without any adjustment for local conditions. It is intended to help stakeholders to discuss the scale of the issue locally. Method: Applying the above rates of postnatal depression prevalence (10%–15%) to the number of total live births in Dubai 2014. Setting: Birth registry for Dubai 2011/14. Key findings: it is estimated there would be approximately 2,928–4,392 mothers suffering from postnatal depression in 2014 of which 858–1,287 were nationals and 2,070–3,105 were non–nationals. These figures are likely to fluctuate depending on the number of mothers who have twin births, and these estimates of the level of postnatal depression do not take into account related factors such as the age of the mother and education. Recommendations: To establish mother-infant psychiatric care to target women suffering from depression during pregnancy and puerperium.

Keywords: post natal depression, women, mental health, birth

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Authors: Ruchika Malhotra, Megha Khanna

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The development of change prediction models can help the software practitioners in planning testing and inspection resources at early phases of software development. However, a major challenge faced during the training process of any classification model is the imbalanced nature of the software quality data. A data with very few minority outcome categories leads to inefficient learning process and a classification model developed from the imbalanced data generally does not predict these minority categories correctly. Thus, for a given dataset, a minority of classes may be change prone whereas a majority of classes may be non-change prone. This study explores various alternatives for adeptly handling the imbalanced software quality data using different sampling methods and effective MetaCost learners. The study also analyzes and justifies the use of different performance metrics while dealing with the imbalanced data. In order to empirically validate different alternatives, the study uses change data from three application packages of open-source Android data set and evaluates the performance of six different machine learning techniques. The results of the study indicate extensive improvement in the performance of the classification models when using resampling method and robust performance measures.

Keywords: change proneness, empirical validation, imbalanced learning, machine learning techniques, object-oriented metrics

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Authors: Chloe T. Cohen, Sarah Johnson

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Psychoanalytic literature has traditionally focused on the theoretical explanations of psychological phenomena rather than empirical research to support those ideas. Many clinicians assume a lack of empirical verification of the theories that underpin psychoanalytic treatment disqualifies psychoanalytic psychotherapy as an effective clinical technique. One such theory is Lacan’s ‘Name of the Father’, which extended Freud’s idea of the importance of a successful resolution of the Oedipal problem, situating it even earlier in psychological development. Lacan posited that the Name of the Father construct (establishing psychological structure and preventing psychosis) was best represented in language use, metaphor, and linguistic structure. However, no study to date has empirically examined the Name of the Father construct. The current study attempts to measure Lacan’s ‘Name of the Father’ construct through linguistic structure and metaphor use and to compare it with Freud’s ‘original introject’. We will then investigate whether they relate to adult personality functioning (measured using the Rorschach Inkblot Test). We aim to contribute to the empirical study of psychoanalytic concepts by operationalizing and validating the Name of the Father empirically. We also aim to examine the relationship of the Name of the Father construct to Freud’s concept of the original introject and to adult pathology. We hypothesize that measures of the original introject will mediate the pathway between linguistic indicators of Lacan’s Name of the Father construct and personality functioning.

Keywords: Lacan, Name of the Father, original introject, personality functioning, psychoanalysis

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Authors: Shringika Soni, Utkarsh Jain, Nidhi Chauhan

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Aptamers are recently discovered ~80-100 bp long artificial oligonucleotides that not only demonstrated their applications in therapeutics; it is tremendously used in diagnostic and sensing application to detect different biomarkers and drugs. Synthesizing aptamers for proteins or genomic template is comparatively feasible in laboratory, but drugs or other chemical target based aptamers require major specification and proper optimization and validation. One has to optimize all selection, amplification, and characterization steps of the end product, which is extremely time-consuming. Therefore, we performed asymmetric PCR (polymerase chain reaction) for random oligonucleotides pool synthesis, and further use them in Systematic evolution of ligands by exponential enrichment (SELEX) for anti-psychotic drugs based aptamers synthesis. Anti-psychotic drugs are major tranquilizers to control psychosis for proper cognitive functions. Though their low medical use, their misuse may lead to severe medical condition as addiction and can promote crime in social and economical impact. In this work, we have approached the in-vitro SELEX method for ssDNA synthesis for anti-psychotic drugs (in this case ‘target’) based aptamer synthesis. The study was performed in three stages, where first stage included synthesis of random oligonucleotides pool via asymmetric PCR where end product was analyzed with electrophoresis and purified for further stages. The purified oligonucleotide pool was incubated in SELEX buffer, and further partition was performed in the next stage to obtain target specific aptamers. The isolated oligonucleotides are characterized and quantified after each round of partition, and significant results were obtained. After the repetitive partition and amplification steps of target-specific oligonucleotides, final stage included sequencing of end product. We can confirm the specific sequence for anti-psychoactive drugs, which will be further used in diagnostic application in clinical and forensic set-up.

Keywords: anti-psychotic drugs, aptamer, biosensor, ssDNA, SELEX

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Tanakrit Doltanakarn

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Introduction: These days, cannabis is being accepted in many countries due to the fact that cannabis could be use in medical. The medical cannabis is used to treat and reduce the pain many diseases. For example, neuropathic pain, Parkinson, autism disorders, cancer pain reduce the adverse effect of chemotherapy, diabetes, and migraine. Active ingredients in cannabis that modulate patients' perceptions of their conditions include Δ9‐tetrahydrocannabinol (THC), cannabidiol (CBD), flavonoids, and terpenes. However, there is an adverse effect of cannabis, cardiovascular effects, psychosis, schizophrenia, mood disorder, and cognitive alternation. These effects are from the THC and CBD ingredients in the cannabis. The metabolize processes of delta-9 THC to 11-OH-delta 9 -THC (inactive form), THC were cause of adverse effects. Interestingly, the distributions of CYP2C9 gene (CYP2C9*2 and CYP2C9*3, poor metabolizer) that might affect incidences of adverse effects in patients who treated with medical cannabis. Objective: The aim of this study we want to investigate the association between genetic polymorphism of CYP2C9 frequency and Thai patients who treated with medical cannabis. Materials and Methods:We recruited sixty-five unrelated Thai patients from the College of Pharmacy, Rangsit University. DNA were extracted using Genomic DNA Mini Kit. Genotyping of CYP2C9*2 (430C>T, rs1799853) and CYP2C9*3 (1075A>C, rs1057910) were genotyped by the TaqMan Real-time PCR assay. Results: Among these 31 medicals cannabis-induced ADRs patients, they were diagnosed with 22 (33.85%) tachycardia and 3 (4.62%) arrhythmia. There were 34 (52.31%) medical cannabis-tolerant controls who were included in this study.40 (61.53%) Thai patients were female, and 25 (38.46%) were male, with median age of 57 (range 27 – 87) years. In this study, we found none of the medical cannabis-induced ADRs carried CYP2C9*2 variant along with medical cannabis-tolerant control group. CYP2C9*3 variant (intermediate metabolizer, IM) was found just only one of thirty-one (3.23%) in the medical cannabis-induced ADRs and two of thirty-fourth (5.88%) in the tolerant controls. Conclusions: Thus, the distribution of CYP2C9 alleles offer a comprehensive view of pharmacogenomics marker in Thai population that could be used as a reference for worldwide to investigate the pharmacogenomics application.

Keywords: medical cannabis, adverse effect, CYP2C9, thai patients

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Authors: Veronika Sharok

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Research relevance on psychological determinants of risky behaviors is caused by high prevalence of such behaviors, particularly among youth. Risky sexual behavior, including unprotected and casual sex, frequent change of sexual partners, drug and alcohol use lead to negative social consequences and contribute to the spread of HIV infection and other sexually transmitted diseases. Data were obtained from 302 respondents aged 15-35 which were divided into 3 empirical groups: persons prone to risky sexual behavior, drug users and alcohol users; and 3 control groups: the individuals who are not prone to risky sexual behavior, persons who do not use drugs and the respondents who do not use alcohol. For processing, we used the following methods: Qualitative method for nominative data (Chi-squared test) and quantitative methods for metric data (student's t-test, Fisher's F-test, Pearson's r correlation test). Statistical processing was performed using Statistica 6.0 software. The study identifies two groups of factors that prevent risky behaviors. Internal factors, which include the moral and value attitudes; significance of existential values: love, life, self-actualization and search for the meaning of life; understanding independence as a responsibility for the freedom and ability to get attached to someone or something up to a point when this relationship starts restricting the freedom and becomes vital; awareness of risky behaviors as dangerous for the person and for others; self-acknowledgement. External factors (prevent risky behaviors in case of absence of the internal ones): absence of risky behaviors among friends and relatives; socio-demographic characteristics (middle class, marital status); awareness about the negative consequences of risky behaviors; inaccessibility to psychoactive substances. These factors are common for proneness to each type of risky behavior, because it usually caused by the same reasons. It should be noted that if prevention of risky behavior is based only on elimination of external factors, it is not as effective as it may be if we pay more attention to internal factors. The results obtained in the study can be used to develop training programs and activities for prevention of risky behaviors, for using values preventing such behaviors and promoting healthy lifestyle.

Keywords: existential values, prevention, psychological features, risky behavior

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Authors: Afshan Channa, Sameeha Aleem, Harim Mohsin

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First rank symptoms (FRS) are considered to be pathognomic for Schizophrenia. However, FRS is not a distinctive feature of Schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. The presence of FRS in Mania leads to misdiagnosis of psychotic illness, further complicating the management and delay of appropriate treatment. FRS in Mania is associated with poor clinical and functional outcome. Its existence in the first episode of bipolar disorder may be a predictor of poor short-term outcome and decompensating course of illness. FRS in Mania is studied in west. However, the cultural divergence and detriments make it pertinent to study the frequency of FRS in affective disorder independently in Pakistan. Objective: The frequency of first rank symptoms in manic patients, who were under treatment at psychiatric services of tertiary care hospital. Method: The cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. One hundred and twenty manic patients were recruited from November 2014 to May 2015. The patients who were unable to comprehend Urdu or had comorbid psychiatric or organic disorder were excluded. FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool. Result: The mean age of the patients was 37.62 + 12.51. The mean number of previous manic episode was 2.17 + 2.23. 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a p-value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness. 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity. 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception. Conclusion: The study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders. Being married had no protective effect on the presence of FRS.

Keywords: first rank symptoms, Mania, psychosis, present state examination

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Authors: Anjana Aggarwal, Sheilja Walia

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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.

Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements

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Authors: Valeria Abreu Minero, Edward Barker, Hannah Dickson, Francois Husson, Sandra Flynn, Jennifer Shaw

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Purpose – The purpose of this paper is to identify offender typologies based on aspects of the offenders’ psychopathology and their associations with crime scene behaviours using data derived from the National Confidential Enquiry into Suicide and Safety in Mental Health concerning homicides in England and Wales committed by offenders in contact with mental health services in the year preceding the offence (n=759). Design/methodology/approach – The authors used multiple correspondence analysis to investigate the interrelationships between the variables and hierarchical agglomerative clustering to identify offender typologies. Variables describing: the offender’s mental health history; the offenders’ mental state at the time of offence; characteristics useful for police investigations; and patterns of crime scene behaviours were included. Findings – Results showed differences in the offender’s histories in relation to their crime scene behaviours. Further, analyses revealed three homicide typologies: externalising, psychosis and depression. Analyses revealed three homicide typologies: externalising, psychotic and depressive. Practical implications – These typologies may assist the police during homicide investigations by: furthering their understanding of the crime or likely suspect; offering insights into crime patterns; provide advice as to what an offender’s offence behaviour might signify about his/her mental health background; findings suggest information concerning offender psychopathology may be useful for offender profiling purposes in cases of homicide offenders with schizophrenia, depression and comorbid diagnosis of personality disorder and alcohol/drug dependence. Originality/value – Empirical studies with an emphasis on offender profiling have almost exclusively focussed on the inference of offender demographic characteristics. This study provides a first step in the exploration of offender psychopathology and its integration to the multivariate analysis of offence information for the purposes of investigative profiling of homicide by identifying the dominant patterns of mental illness within homicidal behaviour.

Keywords: offender profiling, mental illness, psychopathology, multivariate analysis, homicide, crime scene analysis, crime scene behviours, investigative advice

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Authors: Rady A., Elsheshai A., Elsawy M., Nagui R.

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Background and Aim: Metabolic syndrome affect around 20% of general population , authors have incriminated antipsychotics as serious risk factor that may provoke such derangement. The aim of our study is to assess metabolic syndrome in patients presenting psychotic features (delusions and hallucinations) whether schizophrenia or mood disorder and compare results in terms of drug naïf, on medication and healthy control. Subjects and Methods: The study recruited 40 schizophrenic patients, half of them drug naïf and the other half on antipsychotics, 40 patients with mood disorder with psychotic features, half of them drug naïf and the other half on medication, 20 healthy control. Exclusion criteria were put in order to exclude patients having already endocrine or metabolic disorders that my interfere with results obtain to minimize confusion bias. Metabolic syndrome assessed by measuring parameters including weight, body mass index, waist circumference, triglyceride level, HDL, fasting glucose, fasting insulin and insulin resistance Results: No difference was found when comparing drug naïf to those on medication in both schizophrenic and psychotic mood disorder arms, schizophrenic patients whether on medication or drug naïf should difference with control group for fasting glucose, schizophrenic patients on medication also showed difference in insulin resistance compared to control group. On the other hand, patients with psychotic mood disorder whether drug naïf or on medication showed difference from control group for fasting insulin level. Those on medication also differed from control for insulin resistance Conclusion: Our study didn’t reveal difference in metabolic syndrome among patients with psychotic features whether on medication or drug naïf. Only patients with Psychotic features on medication showed insulin resistance. Schizophrenic patients drug naïf or on medication tend to show higher fasting glucose while psychotic mood disorder whether drug naïf or on medication tend to show higher fasting insulin. This study suggest that presence of psychotic features themselves regardless being on medication or not carries a risk for insulin resistance and metabolic syndrome. Limitation: This study is limited by number of participants and larger numbers in future studies should be included in order to extrapolate results. Cohort longitudinal studies are needed in order to evaluate such hypothesis.

Keywords: schizophrenia, metabolic syndrome, psychosis, insulin, resistance

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Authors: Satendra Pal Singh, Dalip Kr. Kakru, Jyoti Mishra, Rajesh Thakur, Tarana Sarwat

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COVID-19 is still an intrigue as far as morbidity or mortality is concerned. The rate of recovery varies from person to person, & it depends upon the accessibility of the healthcare system and the roles played by the physicians and caregivers. It is envisaged that with the passage of time, people would become immune to this virus, and those who are vulnerable would sustain themselves with the help of vaccines. The proposed study deals with the severeness of COVID-19 is associated with some specific biomarkers linked to correlate age and gender. We will be assessing the overall homeostasis of the persons who were affected by the coronavirus infection and also of those who recovered from it. Some people show more severe effects, while others show very mild symptoms, however, they show low CT values. Thus far, it is unclear why the new strain of Covid has different effects on different people in terms of age, gender, and ABO blood typing. According to data, the fatality rate with heart disease was 10.5 percent, 7.3 percent were diabetic, and 6 percent who are already infected from other comorbidities. However, some COVID-19 cases are worse than others & it is not fully explainable as of date. Overall data show that the ABO blood group is effective or prone to the risk of SARS-COV2 infection, while another study also shows the phenotypic effects of the blood group related to covid. It is an accepted fact that females have more strong immune systems than males, which may be related to the fact that females have two ‘X’ chromosomes, which might contain a more effective immunity booster gene on the X chromosome, and are capable to protect the female. Also specific sex hormones also induce a better immune response in a specific gender. This calls for in-depth analysis to be able to gain insight into this dilemma. COVID-19 is still not fully characterized, and thus we are not very familiar with its biology, mode of infection, susceptibility, and overall viral load in the human body. How many virus particles are needed to infect a person? How, then, comorbidity contribute to coronavirus infection? Since the emergence of this virus in 2020, a large number of papers have been published, and seemingly, vaccines have been prepared. But still, a large number of questions remain unanswered. The proneness of humans for infection by covid-19 needs to be established to be able to develop a better strategy to fight this virus. Our study will be on the Impact of demography on the Severity of covid-19 infection & at the same time, will look into gender-specific sensitivity of Covid-19 and the Operational variation of different biochemical markers in Covid-19 positive patients. Besides, we will be studying the co-relation, if any, of COVID severity & ABO Blood group type and the occurrence of the most common blood group type amongst positive patience.

Keywords: coronavirus, ABO blood group, age, gender

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