A wide variety of countries are seeking to attract international medical students. International students are quite distinct from local students with respect to ethnicity, race, social and cultural norms, customs, nationality and physical appearance. Medical students are more predisposed to mental disorders, including depression due to several factors, such as: individual personality characteristics, chronic exposure to stressors from an occupation that deals with pain and death and trouble with the teaching-learning process. In the host country, international medical students meet a lot of stressful situations as: language barriers, academic demands, homesickness and lack of social support.

To evaluate the prevalence of anxiety and depression in Romanian and international medical students studying medicine in Romania. To assess the relationship between symptoms of anxiety, symptoms of depression and big-five personality dimensions in medical students.

Overall, 230 first year medical students (90 from English section, 70 from French section and 70 from Romanian sections studying at the University of Medicine and Pharmacy “Iuliu Hatieganu”, Romania, were evaluated for symptoms of anxiety and depression using the STAI and BDI and for personality using the NEO FFI.

Symptoms of anxiety and symptoms of depression were prevalent in medical students (43% and 14%, respectively).

Symptoms of anxiety and depression are prevalent in medical students. Severity of symptoms of anxiety and symptoms of depression in medical students are negatively related to emotional stability. Special attention should be paid to those students who have high levels of depression and low levels of emotional stability.

The authors have not supplied their declaration of competing interest.

Social, political and health related effects of “European migrant crisis” are challenging our Old Continent, not always capable to address immigrants’ needs.

Our main purpose is to estimate the prevalence of post-traumatic stress disorder among asylum seekers arriving in Italy.

We designed a cross-sectional study for prevalence estimation in a reception centre where asylum seekers stay for their first period in Italy. They are given hospitality until the possibility of their permanence is verified. We created a survey asking for general information. Participants also received PTSD Checklist (PCL-C). In our analysis, we adopted 45 as cut-off for diagnosis. Questionnaires have been delivered house-to-house and collected when completed.

In this pilot study, we collected 61 questionnaires. The majority of answers came from male subjects (46). The prevalence of PTSD was 44% (47% among men and 53% among women, not statistically different).

So high rate of PTSD depicts a reality that cannot be left apart. Our attention toward immigrants must focus also on their mental health. European Union should consider new solutions to take care of these critical aspects of those.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Approximately one in every five Singaporean households employs Foreign Domestic Workers (FDWs) (Humanitarian Organization for Migration Economics [Home], 2015). Mental health problems, especially depression, are prevalent among FDWs in Singapore (HOME, 2015). Yet, there is a lack of empirically-supported interventions to address their mental health needs.

To train FDWs as mental health paraprofessionals with selected CBT skills for depression, which may enable them to provide basic assistance to their fellow domestic workers with depressive symptoms.

To present and assess the effectiveness and acceptability of a 4 weekly 3-hour group CBT-based paraprofessional training program for FDWs.

Participants were randomized into either an intervention or a wait-list control group. Participants in the wait-list group received the training after the intervention group completed the training. Both groups completed questionnaires assessing attitudes towards seeking psychological help; stigma towards people with depression; self-confidence in delivering CBT; general self-efficacy; knowledge of depression and CBT before, immediately after, and two months following the training.

Thirty-eight out of 40 participants completed the program. Both groups did not differ on changes in any of the outcome variables. However, within-group analyses showed improved attitudes towards seeking professional health for mental health issues; greater depression literacy; and CBT knowledge following the training. These changes were sustained at 2-month follow-up. All participants indicated high level of satisfaction with the program.

These preliminary results highlight the potential effectiveness and feasibility of implementing the training as a stepped-care mental health service to address the high rate of depression among the FDW community.

The authors have not supplied their declaration of competing interest.

Given the results of multiple epidemiological studies showing a greater incidence of schizophrenia in migrants, especially in second-generation migrants, many researchers tried to investigate which factors could be associated to these findings, in order to have a better understanding of the migration process itself and simultaneously to contribute to improve knowledge about schizophrenia. In line with the research suggesting that social factors are important contributors to psychological suffering and vulnerability to psychosis, several authors pointed cultural identity as a possible mediator between migration and psychosis.

To review different perspectives on the current literature about the relationship between cultural identity and psychosis.

Non-systematic review searching on the database MEDLINE and additional searches through secondary references.

Concepts like identity clarity and identity value attributions are closely related to psychological well-being and may influence vulnerability or resilience to severe mental illness. Simultaneously, these concepts are also regarded as closely linked to social and cultural identity. Feelings of uncertainty between multiple existential positions that may arise for migrants (especially if hierarchical and unequal relationships of power are established) could compromise the sense of meaning and coherence of the self and compromise identity structure, thereby predisposing to psychotic experiences.

Even taking into account the heterogeneity of the reviewed articles, there seems to be some consensus regarding the importance of culture on how individuals experience themselves and others and that preservation of a solid and coherent cultural identity may be a crucial aspect to take into account when studying resilience against severe mental diseases.

The authors have not supplied their declaration of competing interest.

Arnold Chiari Malformation (ACM) is a disorder of embryologic development that is characterized of herniation of the cerebellar structures through the foramen magnum by four types. ACM type 1 (ACM 1) consists in cerebellar tonsil herniation, which is sometimes associated with other abnormalities, including syringohydromyelia, hydrocephalus and skull base alterations. To date, five cases of psychiatric disorders comorbid with ACM-I have been reported. We here present an apathetic patient have delayed diagnosis ACM-I and severe hydrocephalus and comorbid major depressive disorder.

A 36-year-old, male patient who is married and two children, was admitted to hospital with don’t want to make anything, despondency, thoughts of have an incompetency, uselessness and want to death, tiredness, weakness complaints which are increased day by day last 2 months. He was diagnosed with major depression after the psychiatric evaluation and hospitalised. He has unwillingness, tiredness and headache complaints which are started when he was 20 years old and he used antidepressant, anxiolytic, and low dose anthipsycotic drugs under psychiatrist control at this years. In radiologic evaluation, Arnold Chiari type 1 and severe hydrocephalus was detected in brain magnetic resonance imaging.

ACM 1 is related to hydrocephalus as a result of posterior fossa hypoplasia and causes spinal injury by obstruction to cerebrospinal fluid (CSF) flow at the foramen magnum. Apathy is a common yet often overlooked symptom in hydrocephalus. This symptom may be a significant obstacle for cognition and quality of life and is associated with increased level of depression.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Recent developments in neuroimaging have revolutionized medicine and aided in our understanding of how biological abnormalities may contribute to clinical presentation. While such advances have begun to enhance our knowledge about the timing of abnormalities, it remains unclear at this time how neuroimaging impacts the clinical course of the patient. In addition, much debate exists regarding the clinical necessity of neuroimaging for psychiatric conditions, and there are contradictory reports and guidelines for the application of conventional brain imaging (MRI and CT) in the evaluation of patients with mental illness.

We aim to review the clinical utility of neuroimaging in an acute psychiatric setting, and hypothesize that there will be no significant differences between the outcome of neuroimaging and clinical course for patients.

We conducted a retrospective chart review of adult patients who were diagnosed and treated for psychiatric conditions on an inpatient psychiatric service over a period of 36 months July 1, 2013–June 30, 2016.

While imaging advances have added to our understanding of biological abnormalities and can aid in ruling out organic causes of psychiatric illness, at this time it is not guiding clinical management for patients.

The authors have not supplied their declaration of competing interest.

The cerebellum plays a critical role in cognition and behavior. Altered function of the cerebellum has been related to schizophrenia and psychosis but it is not known how this applies to spontaneous resting state activity in young people with familial risk for psychosis.

We conducted resting-state functional MRI (R-fMRI) in 72 (29 male) young adults with a history of psychosis in one or both parents (FR) but without their own psychosis, and 72 (29 male) similarly healthy control subjects without parental psychosis. Both groups in the Oulu Brain and Mind Study were drawn from the Northern Finland Birth Cohort 1986. Participants were 20–25 years old. Parental psychosis was established using the Care Register for Health Care. R-fMRI data pre-processing was conducted using independent component analysis with 30 and 70 components. A dual regression technique was used to detect between- group differences in the cerebellum with p b 0.05 threshold corrected for multiple comparisons.

FR participants demonstrated statistically significantly increased activity compared to control subjects in the anterior lobe of the right cerebellum in the analysis with 70 components. The volume of the increased activity was 73 mm3. There was no difference between the groups in the analysis with 30 components (Fig. 1).

The finding suggests that increased activity of the anterior lobe of the right cerebellum may be associated with increased vulnerability to psychosis. The finding is novel, and needs replication to be confirmed.

The authors have not supplied their declaration of competing interest.

Developmental language disorder (DLD) is common, yet the neurobiology of DLD is poorly understood. A key hypothesis suggests atypical functional lateralization of language, which might be accompanied structurally by a deficit in inter-hemispheric connectivity of language-related regions. Indeed, aberrations of the corpus callosum have been associated with language deficits in children with frank neurological lesions and/or born pre-term. In contrast, studies examining the corpus callosum in children with DLD remain elusive.

We aimed to expand this largely understudied field by comparing callosal morphology between 17 children with DLD and 17 typically developing children carefully matched for sex and age.

We analyzed high-resolution structural magnetic resonance imaging data applying a well-validated computational approach, which captures the thickness of the corpus callosum with a high regional specificity at 100 equidistant points.

As shown in Fig. 1, we observed a significantly thinner corpus callosum, particularly in the splenium, in children with DLD compared to typically developing controls (DLD < CTL).

These findings indicating pronounced aberrations in the brain's largest whiter matter tract make an important contribution to an understudied field of research and support the theory that DLD is accompanied by atypical lateralization of language function.

The authors have not supplied their declaration of competing interest.

Especially the behavioral variant of Frontotemporal Dementia (FTD) may present with impulsivity, social disinhibition or depressive symptoms and these symptoms may create a clinical profile very similar to Bipolar Disorder (BD). In clinical practice, this similarity at symptom level creates substantial diagnostic confusion and often errors. As the treatment approach to the two disorders differ significantly, it is essential to make a reliable differential diagnosis.

In this study we aimed to identify EEG differences between FTD and BD.

For this aim we recruited 22 patients with FTD and 32 patients with BD. Patients in both groups were evaluated with a standardized neuropsychological battery and structural MRI. All patients were evaluated with resting EEG. There were no significant age and gender differences between groups.

EEG power analysis showed that FTD group had increased frontal and temporal theta as compared to the BD group. There were no consistent group differences for other bands.

Based on this result we conclude that quantitative EEG may help differentiating BD from FTD and may eliminate diagnostic uncertainty.

The authors have not supplied their declaration of competing interest.

ADHD is a neurodevelopmental disorder comprising brain structural and functional alterations, especially in default mode network (DMN), as MRI studies have recently shown. However, it is not clear in which extent medication for ADHD may influence the activity of these networks.

The main purpose is to look up published evidence about the effects of ADHD medication on the connectivity of DMN in patients as measured with functional-MRI.

A review was conducted with Pubmed, using search terms ‘default mode network’+ ‘ADHD’ + ‘medication’/‘methylphenidate’/‘atomoxetine’/‘stimulant’/‘lisdexanfetamine’. Original research studies in English using f-MRI to assess DMN connectivity in ADHD patients were included in a more comprehensive review.

The searches found 124 articles, 8 meeting the review criteria. A total size of 146 ADHD patients was comprised (mean size: 18.25 patients). Three studies used specific resting-state f-MRI. Seven were drug trials, 3 of them short-term, randomized and controlled ones. Six included methylphenidate, 2 atomoxetine, 1 lisdexanfetamine and 3 amphetamines. Two also assessed drugs clinical effects. Evidence seems heterogeneous, but mostly consistent with normalizing drug effects on DMN in patients (in some studies also compared with healthy controls), associated with a measured clinical improvement in one study with amphetamines and one with atomoxetine. One trial found little differences on DMN activity.

Psychostimulant drugs and atomoxetine are clinically effective medications; DMN connectivity may partially explain their action mechanisms and constitute a potential response predictor. Further f-MRI studies might more deeply assess the imaging-clinical relationships for each drug.

The authors have not supplied their declaration of competing interest.

The aim of this study was the analysis of dynamics of motor cortex metabolite in the norm and in early stage of schizophrenia in period of BOLD response to event related single stimulus.

The patients group consisted of 9 mails of 16–28 years old in initial stage of schizophrenia and in remission. The group of 9 age matched healthy mails was used as a control.

Phillips Achieva 3.0 T scanner was used for the study. Volume of interest in motor cortex was localized on the base of fMRI. 1Н МR spectra were run using synchronization of FID signals acquisition (PRESS, TE = 30 ms TR = 3000 ms) with dynamics of BOLD response at the same paradigm.

The BOLD signal in both groups demonstrated maximum at the 6th s after target stimulus, however its value was reliably lover in schizophrenia in comparison with the control. The only [NAA] in normal motor cortex was changed after stimulation. The stable values of [NAA], [Cr] and [Cho] were observed in dynamic of resting state as well. [NAA] in normal cortex statistically significantly decreased at the 12th s after stimulus presentation and returned to initial value at the 15th s.

Different behavior of [NAA] in the norm and schizophrenia might be related with a difference in location (or activity) of aspartoacylaze (ASPA). Decreased expression of glutamate transporters in schizophrenia could also reduce consumption of NAA as a source of acetate in synthesis of AcCoA which is used for restoration of ATP.

The authors have not supplied their declaration of competing interest.

Normal pressure hydrocephalus (NPH) occurs in 0.5% of persons over 65 years old. The etiology of NPH is still unknown. Clinically NPH is characterised by cognitive deterioration, gait impairment and urinary incontinence. NPH is a possible reversible cause of dementia. Neuroimaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) allow to assess typical brain changes in this disorder.

The objectives are to present the typical findings of NPH on CT and MRI and to demonstrate differences between NPH and central brain atrophy in neuroimaging.

The imaging features of NPH include: supratentorial ventriculomegaly with callosal angle less than 90o, tight sulci at the vertex and considerable out of proportion enlargement of Sylvian fissures. In case of central brain atrophy there may be a predominance of ventriculomegaly and/or widened sulci without crowding of the gyri at the vertex and callosal angle greater than 90o. In both entities, the decrease of density in periventricular region may be seen: in NPH could be a sign of transependymal oedema or in brain atrophy as an accompanying leukoaraiosis. Additionally, it is possible to assess changes in flow of cerebrospinal fluid (CSF) on MRI: in NPH an increased pulsatile CSF circulation in aqueduct as flow void sign may be observed.

Correct diagnosis of NPH on CT or MRI in relation to clinical data is very important. Treatment with ventriculoperitoneal shunt or third ventriculostomy may partially improve the quality of life in some patients with cognitive impairment due to NPH.

The authors have not supplied their declaration of competing interest.

Childhoods in urban or rural environments may differentially affect risk for neuropsychiatric disorders. Here, we leveraged on dramatic urbanization and rural-urban migration since the 1980s in China to explore the hypothesis that rural or urban childhoods may differentially influence memory processing and neural responses to neutral and aversive stimuli.

Explore the underlying mechanisms of childhood environment effect on brain function and neuropsychiatric risk.

We examined 420 adult subjects with similar current socioeconomic status and living in Beijing, China, but with differing rural (n = 227) or urban (n = 193) childhoods. In an episodic memory paradigm scanned in a 3 T GE MRI, subjects viewed blocks of neutral or aversive pictures in the encoding and retrieval sessions.

Episodic memory accuracy for neutral stimuli was less than for aversive stimuli (P < 0.001). However, subjects with rural childhoods apparently performed less accurately for memory of aversive but not neutral stimuli (P < 0.01). In subjects with rural childhoods, there was relatively increased engagement of bilateral striatum at encoding, increased engagement of bilateral hippocampus at retrieval of neutral and aversive stimuli, and increased engagement of amygdala at aversive retrieval (P < 0.05 FDR corrected, cluster size > 50).

Rural or urban childhoods appear associated with physiological and behavioural differences, particularly in the neural processing of aversive episodic memory at medial temporal and striatal brain regions. It remains to be explored the extent to which these effects relate to individual risk for neuropsychiatric or stress-related disorders.

The authors have not supplied their declaration of competing interest.

Chloroquine, a 4-aminoquinoline derivative, has long been used for the treatment of malaria and rheumatological disorders, including rheumatoid arthritis and systemic lupus erythematosus. Accumulating evidence now suggests potential use of chloroquine as a neuroprotectant. Studies have shown that nitric oxide (NO) pathway is involved in the chloroquine actions. Considering the fact that nitrergic neurotransmission plays a crucial role in the central nervous system functioning, in the present study we evaluated whether nitrergic system is involved in the anticonvulsant effects of chloroquine in a model of clonicseizure in mice.

Clonic seizure threshold was determined by infusion of pentylenetetrazole (PTZ, 0.5%) at a constant rate of 1 mL/min into the tail vein of male Swiss mice (23–29 g). Minimal dose of PTZ (mg/kg of mice weight) needed to induce clonicseizure was considered as an index of seizure threshold.

Chloroquine (5 mg/kg, acutely 30 min before test, intraperitoneally), i.p significantly increased the seizure threshold. Acute co-administration of a non-effective dose of the non-selective NO synthase (NOS) inhibitor, L-NAME (L-NG-Nitro-L-arginine methyl ester hydrochloride,5 mg/kg, i.p.) or the selective inhibitor of neuronal NOS, 7-NI (7-nitroindazole, 40 mg/kg, i.p.) with an effective dose of chloroquine (5 mg/kg) inhibited its anticonvulsant effects. Co-administration of a non-effective dose the selective inducible NOS inhibitor, aminoguanidine (100 mg/kg, i.p.) with chloroquine 5 mg/kg did not alter its anticonvulsant effects.

Chloroquine increases the PTZ-induced clonic seizure threshold in mice. We demonstrated for the first time that nitric oxide signaling probably through neuronal NOS could be involved in the anticonvulsant effects of chloroquine in this model of seizure in mice.

The author has not supplied his/her declaration of competing interest.

The association between the neurocognitive impact of cannabis use and deficits in working and declarative memory is well documented. Studies with cannabis users suggest that recognition memory is particularly susceptible to cannabinoid acute intoxication. Studies carried out in the 1970s using free memory tests, showed that cannabis users not only named fewer words having also a tendency to evoke intrusive memories. Interestingly, a recent study has exposed an association between cannabis consumption and increased likelihood of creating fake memories.

The main objective of this work is to do literature revision, framing old data with recent works, exposing the relationship between cannabis consumption and memory confabulation/intrusion.

Literature review, comparison and description of empirical data [1].

Recent studies show that both cannabis users and abstinents are more susceptible to create false memories, not being able to identify trap stimuli as events that never occurred.

Changes in perception and memory deficits are two common consequences of acute marijuana intoxication. The fact that these deficits remain during drug abstinence demonstrates the relevance of better understanding the mechanisms by which cannabinoids alter such cognitive functions. Reductions in the activation of brain areas comprised in the lateral and temporal lobe and in frontal cortex zones involved in the processes of attention and performance monitoring may be a possible explanation.

The authors have not supplied their declaration of competing interest.

Schizophrenia is a debilitating psychiatric disorder which places a significant emotional and economic strain on the individual and society-at-large. Unfortunately, currently available therapeutic strategies do not provide adequate relief and some patients are treatment-resistant. Therefore there is urgent need for the development of mechanistically different and less side effect prone antipsychotic compounds. Recently, the endocannabinoid system has emerged as a potential therapeutic target for pharmacotherapy that is involved in a wide range of disorders, including schizophrenia. Modulation of this system by the main psychoactive component in cannabis, Δ9tetrahydrocannabinol (THC), induces acute psychotic effects and cognitive impairment. However, the non-psychotropic, plant-derived cannabinoid agent cannabidiol shows great promise for the treatment of psychosis, and is associated with fewer extrapyramidal side effects than conventional antipsychotic drugs.

The aim of this review is to analyse the involvement of the endocannabinoid system in schizophrenia and the potential role of cannabidiol in its treatment.

There is still considerable uncertainty about the mechanism of action of cannabidiol as well as the brain regions which are thought to mediate its putative antipsychotic effect. Further data is warrant before this novel therapy can be introduced into clinical practice.

The authors have not supplied their declaration of competing interest

This paper is a review of literature about the relation in some cases between psychotic symptoms and NMDA antibodies. Most of these cases are early observed and treated by psychiatry, observing torpid evolution and symptoms that are rarely observed in Psychiatry patients, like visual hallucinations or rapid fluctuations of symptoms.

Make a review of psychotic symptoms and NMDA antibodies, to think about other options when we are in front of some unusual cases in psychiatry, and it seems that “nothing is working”

Systematic review of pub med literature, applying the keywords: “psychotic” and “NMDA antibodies” of last 5 years.

We found that in most of cases the patients presents Opisthotonus, catatonia, and rhythmic and non-rhythmic involuntary movements of the mouth and jaw, and most of them had a psychiatric evaluation for those symptoms. There was no response to antipsicotic treatment. The treatment with corticoids and rituximab was effective.

In psychiatry we have to think in some cases that maybe “the patient could have something else than a psychiatric disease”, most when we found that the symptoms has a rare presentation and the treatment is not effective.

We encourage our colleagues to “think outside the box” when something like this occurs, and hesitate about our own valuations of the patients, when the case is atypical strange.

The authors have not supplied their declaration of competing interest.

Charles-Bonnet Syndrome (CBS) is a clinical entity characterized for visual hallucinations in patients with severe vision impairment and preserved cognitive state. Its pathogeny is still unknown, limiting management options. For diagnosis neurological and psychiatric disorders must be discarded. Treatment is based in three pillars: explaining to the patient the origin and nature of the symptoms, treating the visual deficit when possible, and pharmacotherapy with anti-psychotics.

To outline the main characteristics and etiopathogenic theories of the CBS, so as to improve diagnosis and treatment.

Basing on a case followed in mental health consults, we made a systematic review of the articles published in Medline (PubMed) in the last 5 years, with the following keywords, Charles-Bonnet Syndrome, hallucinations, deafferentation, visual impairment.

We found that all our case and the reported ones had in common the nature and characteristics of the hallucinations, the presence of a trigger, usually a new medicament, and the functional MRI patrons of activity; those patrons located the loss of input prior to the association cortex, which appeared hyper-excitable in functional MRI.

Although the aetiology and pathogeny of CBS is still unclear, present data suggests that the key mechanism may be a dysregulation in the homeostatic adaptation of the neural pathway when it is left without external input, traducing a hyper-function of a physiological process, probably mediated by acetylcholine, as opposed with other neuropsychiatric pathologies, in which the cortex is the primary affected area.

The authors have not supplied their declaration of competing interest.