IntroductionAccess to mental health (MH) services is unequal worldwide and changes are required in this respect.ObjectivesOur aim was to identify the delay to the first psychiatry consult and to understand patients’ characteristics and perspectives on the factors that may influence the delay, among a sample of participants from three Southeastern European Countries.Materials and methodsThe WHO Pathway Encounter Form questionnaire was applied in 400 patients “new cases” and a questionnaire on the factors influencing the access was administered to the same patients, as well as to their caretakers and MH providers.Result and discussionsThe average profile of the patient “new case” was: married female older than 40 years, with an average economic status and no MH history. The mean delay was up to 3 months and the most important factors that were influencing the delay were stigma and lack of knowledge regarding MH problems and available current treatments.ConclusionsFuture policies trying to improve the access to psychiatric care should focus on increasing awareness about MH problems in the general population.

No abstract

No abstract

Alzheimer�s disease (AD) is a complex neuropsychiatric condition characterized by progressive cognitive symptoms.The social and psychological costs associated with the care of AD patients are very high; therefore, significant funds for research in this field are being invested worldwide. The accuracy of medical methods for establishing the diagnosis of AD with specific neuropathology is very important. Biomarkers can detect AD in their pre-clinical stage, monitor the disease progression, and detectmore objectively the treatment response. We performed a retrospective study of 100 patients admitted to the Gheorghe Preda Psychiatric Hospital of Sibiu with the diagnosis of Mild Cognitive Impairment and Alzheimer�s Dementia. The diagnosis was established according to the Diagnostic and Statistical Manual Disorders-4th edition criteria and the severity of the condition was determined by the Mini Mental State Examination. Our retrospective study revealed that in a certain period of time, most hospitalized patients with AD had the most days of hospitalization; they were patients in severe stage, due to the needs of multidisciplinary care and the multiple possibilities offered by medical staff. At present, AD research, in addition to finding therapeutic remedies in the clinical stages of AD, also aims at primary and secondary prevention strategies, including the detection of biomarkers in the pre-clinical stage of AD.

Hyperdopaminergia has been identified at impulsive or psychotic patients, the polymorphism of COMT or other enzymes that metabolize dopamine could be involved. The deficiencies of the serotoninergic system in suicidal behaviour has been mentioned by many studies that indicate the reduction of 5-HT, 5-HIAA in CSF or 5-HTT polymorphism. Young patients with psychotic or depression symptoms manifest, frequently, aggressive and self-harm behaviour. Besides the association between the young age and the aggressivity of the patients with serious mental disorders, our study shows gender differences and this matter is sustained by hormonal factors. The study was conducted at the Gheorghe Preda Psychiatric Hospital in Sibiu. The study comprises 52 patients aged between 18 and 35 who were diagnosed with the diagnosis of Schizophrenia, Bipolar Affective Disorder, Depressive Episode and Major depressive disorder according to the DSM-5 criteria. Evaluation of the severity of psychiatric and depressive symptomathology were assessed with Brief Psychiatric Rating Scale and Beck Depression Inventory; aggression and self-aggression in the patients with Schizophrenia, respectively with Bipolar disorder, depressive episode and Major depression disorder were assessed with Buss Perry Aggression Questionnaire and Suicide Intent Scale. Regarding the severity of aggression in the young patients from our study (Buss Perry scale score), male gender is higher than female gender: higher percentages in males (35% and 10%) than in females (16 and 0%). Determining aggression in schizophrenia is possible due to COMT polymorphism that lead to impulsivity or psychotic symptoms. The study show a significant positive correlation between the severity of symptoms of schizophrenia and aggression. From the analysis of the severity of depression in young patients (SIS score) it is noted that its severity is higher in the female gender. Women had higher scores of moderate depression (58%) and severe (26%) than men (37 and 25%, respectively). This relationships could be possible due to the polymorphism of the gene encoding the 5-HTT serotonin transporter related with serotonin deficiency.The study do not show a significant positive correlation between the severity of the depressive symptomatology and the degree of the suicide intent.

The Hepatitis C Virus (HCV) infection often associates medical and mental health conditions which lead to increased levels of distress. Our study aimed at assessing the level of perceived stress on a sample of 90 HCV infected patients treated with Direct-Acting Antiviral (DAA) agents for 12 weeks, and its possible correlations with clinical and evolutionary elements. The evaluation was conducted in three phases: before administration of the DAAs (BSL), at the End of the Treatment (EOT), and 24 weeks after the BSL (Sustained Viral Response—SVR). The perceived stress was measured using the Perceived Stress Scale (PSS). The efficiency of the DAA treatment reduced the levels of stress (98.99% moderate and high stress at BSL to 70.00% at SVR). It was observed, for the entire study period (BSL to SVR), that the decrease in the perceived stress severity was significantly associated with demographic items such as gender (p < 0.01), urban environment (p < 0.001), the age of the subjects (p < 0.05), and clinical data such as F4 degree of fibrosis (p = 0.001) and overweight or obesity class II (p < 0.01). The perceived stress is directly associated with the severity of the HCV infection, and it could be significantly lowered by an efficient therapeutic approach, as DAAs are nowadays.

In this paper, we describe an actuator-based EMDR (eye movement desensitization and reprocessing) virtual assistant system that can be used for the treatment of participants with traumatic memories. EMDR is a psychological therapy designed to treat emotional distress caused by a traumatic event from the past, most frequently in post-traumatic stress disorder treatment. We implemented a system based on video, tactile, and audio actuators which includes an artificial intelligence chatbot, making the system capable of acting autonomously. We tested the system on a sample of 31 participants. Our results showed the efficiency of the EMDR virtual assistant system in reducing anxiety, distress, and negative cognitions and emotions associated with the traumatic memory. There are no such systems reported in the existing literature. Through the present research, we fill this gap by describing a system that can be used by patients with traumatic memories.

No abstract