Our findings indicating increased brain serotonin synthesis capacity in migraine patients are consistent with previous reports of systemic alteration of serotonin metabolism in patients without aura. Our results also suggest that the mechanism of action of beta-adrenergic antagonists for migraine prophylaxis may involve regulation of serotonin synthesis.

Background To date, very little knowledge is available with regard to the way in which mental health systems worldwide are facing the current global health emergency. The present paper reports the data emerging from a survey conducted to study the impact of the current emergency on the functioning of the Italian Departments of Mental Health (MHD). Methods Heads of MHDs received a 40-item multiple choice questionnaire relating to Community Mental Health Centres (CMHC) and related facilities, and a 30-item questionnaire focused on General Hospital Psychiatric Wards (GHPW). Statistical analysis was carried out by means of Chi Square test with Yates correction or the Fisher Exact test, as needed. Results: 71 questionnaires returned from the 134 MHDs (52.9%) and 107 of the 318 (32.6%) GHPWs. Less than 20%of CMHCs have been closed; approximately 25% have restricted access hours. The usual mode of operation in CMHCs changed substantially. Urgent psychiatric consultations are continuing as usual, in the same way as interventions for compulsory treatments, and prison consultations. All other activities have been reduced to some extent. Remote contacts with users have been set up in approx. 75% of cases. Cases of COVID positivity were reported amongst both staff members (approx. 50 % of CHMCs), and facility users (52% of CHMCs). 20% of CMHCs reported cases of increased aggressiveness or violence, among community patients, although only 8.6% regarding severe cases. Major issues in the supply of personal protective equipment (PPE) for staff members were reported. A reduced number of GHPWs (-12%), beds (approx.-30%) and of admissions was registered (87% of GHPWs). 8% of GHPWs reported an increase in compulsory admissions, and an increased rate of violence toward self or others among inpatients. Patient swabs were carried out in 50% of GHPWs. 60% of GHPWs have reported the admission of symptomatic, COVID+ psychiatric patients to General COVID-19 Units; severely ill and noncollaborative COVID+ patients are generally admitted to speci c "COVID-19" GHPWs, or to purposeadapted isolated areas of the wards. Conclusions The COVID-19 pandemic has heralded a radical change in the mental health system of Italy, and a consequent series of challenging issues.

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The care of mentally ill people at home is being encouraged nowadays. As a result, the family members feel an increased burden of care and find it difficult to cope with the care of a schizophrenic patient at home. We interviewed the relatives of 62 schizophrenics systematically regarding the behaviour of the patients that was perceived to be distressful. This was done using the Scale for Assessment of Family Distress. It was noted that behaviours related to activity and self-care were perceived to be most distressful, and not aggressive or psychotic behaviour. Distress was more often reported by younger relatives and those with more education. The findings have implications in planning appropriate family intervention methods.

The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu) pandemic is believed to be the legacy of the influenza pandemic (1918-19). The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine ‘PUBMED’ to search for published articles with different MeSH terms using Boolean operator (AND). Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson's disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

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Alexithymic characteristics were examined in a sample of 30 patients fulfilling the DSM-III criteria for psychogenic pain disorder using an interviewer-rated scale (Beth Israel Hospital Psychosomatic Questionnaire), a self-rated scale (Toronto Alexithymia Scale) and a projective technique (Thematic Apperception Test). The findings were compared with a control group of healthy subjects matched on sociodemographic variables. Pain patients were found to be more alexithymic in contrast to the control group as evidenced by the interviewer-rated and self-rated scales. The correlations among the three measures were in the expected direction.