Nurses are among the health professionals that are confronted with burnout due to workload demands. The dominance of females in the profession reinforce the prevailing notion that the caring professions such as nursing are relegated to women. This gives the study its gender perspective.

To determine the interaction between situational, factors, role stressors, hazard exposure and personal factors in the largest tertiary hospital in the Philippines.

This was a cross-sectional study, which aimed to determine the interaction between situational, factors, role stressors, hazard exposure and personal factors among 246 nurses consisting most of females (78.5%) from the different wards and units in the Philippines General Hospital (PGH).

Almost half (49.6%) of the respondents reported being ill due to work in the past year, and 56.1% missed work because of an illness. Correlation statistics using the Spearman's rho showed organizational role stressors was most significant in burnout among nurses in the Philippine's largest tertiary hospital. Organizational role stressors consisted of ten dimensions, namely:

– inter-role distance (IRD);

– role stagnation (RS);

– role expectation conflict (REC);

– role erosion (RE);

– role overload (RO);

– role isolation (RI);

– personal inadequacy (PI);

– self-role distance (SRD);

– role ambiguity;

– resource inadequacy (RIn).

The contribution of the study is in advancing new concepts in the already existing framework of burnout, and thus, can assist nurses and hospital administration on how to control this problem.

The author has not supplied his declaration of competing interest.

Common mental disorders (CMD) have a 12-month prevalence over 7% in the Italian population. Only 16,9% of people are treated by the health services, despite the high cost in disability and loss of productivity.

To improve access to low-intensity CBT (LI-CBT) treatments in primary care.

To organize a clinical pathway in which general practitioners (GPs) identify the early signs of CMD and promote a collaborative care with a team of mental health practitioners (MHPs).

A small team of MHPs outlined and implemented, in collaboration with a group of 9 GPs, a clinical pathway to treat CMD in stepped care. Guided self-help was the first and main intervention. Group and individual CBT were offered–when needed–as a second and third step. If the user opted for drug treatment, a psychiatrist conducted one or two sections of consultation to the GP. The MHP team was fully integrated within the community mental health center (CMHC). PHQ-9 and GAD-7 were rated at each appointment.

With a mean of 5,3 appointments, 90 persons were treated in 1 year. 68% reached recovery (both PHQ-9 and GAD-7 < 10), a result in line with the best performing English Clinical commissioning groups in the IAPT project.

A small multi-professional team of MHP can build with GPs a simple clinical pathway able to reach high standards of care with relatively small resources offering LI-CBT integrated with drug treatment and high intensity care.

The authors have not supplied their declaration of competing interest.

Refugee children, particularly unaccompanied refugee minors, present with disproportionately high prevalence of mental health and emotional difficulties. However, the mental health service access and treatment engagement of this vulnerable group has been consistently shown to be poorer than the general population. Despite of this, so far there hasn’t been much research to explore the possible underlying reasons or barriers for these young people to access mental health service in their host countries.

This research aims to understand unaccompanied refugee children's barriers to access and utilize mental health services. To explore any potential characteristics in the service provision that can be linked with the observed poor treatment engagement and service access is also an objective of this study.

The study was conducted by using semi-structured interviews with 15 unaccompanied asylum seeking minors and their carers to elicit their views, perceptions and beliefs based on their experience of receiving treatment from a specialist mental health service in the UK.

The interview transcripts were analysed using thematic analysis. The main findings were categorised into two broad themes, the participants’ perceptions of the intervention received, and perception of the professionals involved. The different elements and pertinent issues within these two broad areas were discussed.

Findings will help stimulate further exploratory research gaining better understanding of the barriers for these young people to access treatment, and contribute in developing innovative services that are more efficient in engaging this vulnerable group and suitable to meet their specific needs.

The authors have not supplied their declaration of competing interest.

From a life-span developmental perspective, retirement can be considered a life event that entails a complex psychological challenge, including leaving one's professional life and organizing/enjoying the newly available free time. The literature about retirement identifies different stages and patterns of transition/adaption associated with time spent in retirement.

To analyze the association between time spent in retirement and subjective measures of mental health, depressive symptomatology, loneliness and satisfaction with life.

Quantitative cross-sectional study with 641 participants (M = 74,86). The instruments included: sociodemographic questionnaire; mental health inventory (MHI-5); geriatric depression scale (GDS); UCLA loneliness scale; satisfaction with life scale (SWLS).

Statistically significant differences in all the health and well-being variables addressed were found between subgroups of time spent in retirement (MHI-5: P = 0.001; GDS: P < 0.001; UCLA: P = 0.038; SWLS: P = 0.022). Mental health and satisfaction with life increases in the first year after retirement, but during the second year, they decrease to the levels found in pre-retirement. Loneliness and depressive symptomatology follow an inverted pattern. With the passing of years, loneliness and depression tend to increase; mental health and satisfaction with life tend to decrease.

The results provide support to the hypotheses of honeymoon and disenchantment phases in the recently retired and to the existence of different patterns of transition/adaptation associated with time spent in retirement. They also highlight the relevance of devising intervention strategies that enable individuals to maintain the satisfaction levels with life and mental health achieved during the first phase of retirement.

The authors have not supplied their declaration of competing interest.

In the UK, almost 50% of illness diagnosed among working age adults is mental distress, depression and chronic anxiety being the two most prevalent illnesses. However, only 24% of those diagnosed receive appropriate interventions within the National Health Service (NHS). In light of this, third sector organisations, such as MIND, are left to fill the gap in providing therapeutic care. This paper reports on an evaluative study of what Mind offers as opposed to statutory services from a service user perspective.

An exploration of the differences in mental health care between statutory and non-statutory organisations.

To identify how service users experienced MIND's counselling service. To establish the benefits and disadvantages of mental health care within statutory and non-statutory services. To identify the impact of mental health care from non-statutory services.

This qualitative research project, adopted a case study approach. Using one to one narrative interviews, data from 12 participants, five males and seven females were collected. Following transcription, each narrative was analysed individually, with thematic analysis being used across all 12 interviews.

Six themes were identified; mindful of the gap; easing like sunday morning; magic moments; love is in the air; lighting up a future and changing the status quo.

Mind plays a significant role in enabling those with psychological problems to move towards building a better future. Findings suggest statutory services can learn important lessons from non-statutory organisations not least how best to provide cohesive, collaborative and compassionate mental health care for those in distress.

The authors have not supplied their declaration of competing interest.

Migration with its long-term changes and the resulting task to adjust to the new environment has been associated with an increased risk for mental health problems. This study aims to gain further insight on the relationship between the fours acculturations strategies (integration, assimilation, separation, marginalization) and severity of depression.

A total of n = 79 first generation Vietnamese outpatients from a psychiatric outpatient clinic for Vietnamese migrants in Germany were investigated regarding self-reported depressive symptoms (patient health questionnaire-9) and acculturation (Stephenson multigroup acculturation scale; SMAS).

Patients with an integration acculturation strategy reported lower severity of depression compared to marginalized patients, who reported the highest severity of depression.

The results implicate that the integration of both the mainstream society and the ethnic society might serve as a resource, whereas the rejection of both societies might increase the risk of depression.

The authors have not supplied their declaration of competing interest.

Vietnamese migrants under the influence of migration-related stressors (MRS) represent a vulnerable group within the mental health care system in Germany.

First study examining the relationship between the quantity of experienced MRS and the severity of self-reported symptoms of depression in a Vietnamese outpatient-sample.

137 first-generation Vietnamese migrants diagnosed with depression were asked to complete the BDI-II and 24 questions about stressful experiences related to the migration process. Linear regression models was performed to examine the influence of the MRS-quantity on BDI-II total score and on BDI-II subscales (Buckley et al., 2001).

A higher number of experienced MRS was found to be related to a higher BDI-II total score, as well as to a higher score on the cognitive subscale in particular. Regarding the cognitive depression-dimension the BDI-II items pessimism, past failure, guilt feelings, punishment feelings and suicidal thoughts were positively related to the MRS-quantity.

A dose-response-relationship was found, with a higher number of MRS being related to a higher severity level of self-reported depressiveness as well as to a higher level of cognitive depression-symptoms in particular. The increase in suicidal ideations in the light of MRS-exposure is in line with findings from other migrant populations. Therapeutic interventions may focus (more) on depressive cognitions as a result of recurring MRS-experiences. Special attention should be placed on suicidal thoughts being boosted by MRS.

The authors have not supplied their declaration of competing interest.

Equal access to health care treatment is a highly prioritized goal in most OECD countries. Timely access has become a priority too; in Denmark now with a 4-week deadline from referral to diagnosis. When mental health services become more centralized and allocation of patients to treatment further away from home become more common, it could have a negative impact on the goal of equal access.

To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.

A nationwide, Danish, register based, follow-up study on frequencies of contacts to out-patient psychiatric services, psychologist consultations supported by public funding and therapeutic talks by general practice.

Outpatient-psychiatric services were reached more often by patients in low SEP measured by income, but their frequencies of visits were less. Contacts to psychologists were less than half for patients in low SEP and less frequent too. Mental health service by GP showed low SEP associated with low contact. No difference in use of emergency or inpatient psychiatric services was found. Distance to provider showed interaction with SEP and contact to psychologist and frequencies of contact to outpatient psychiatrists. When distance increased by 5 km, contact to psychologist fell by 11% among lowest income group and frequencies of visits to outpatient psychiatrist fell by 5%.

Lower SEP is associated with lower mental health care utilization. Increased distance to provider increases inequity in mental health service utilization.

The authors have not supplied their declaration of competing interest.

Homeless people are more likely to have higher prevalence of psychotic disorders than general population. However, we know less about the prevalence of psychotic symptoms in this group.

To estimate the lifetime and current prevalence of psychotic symptoms and their correlates among homeless people living in the Paris metropolitan area.

We analysed data from 839 homeless randomly selected for the “Samenta” survey that studied mental health and addiction problems in this population. The mini-international neuropsychiatric interview was used to assess psychotic symptoms. Separate multivariate logistic regression analyses were conducted to estimate the associations of sociodemographic characteristics (age, gender, education level and migrant status), early life experiences (sexual abuse, physical and psychological violence, substance use) and psychiatric disorders.

The lifetime prevalence of psychotic symptoms was 35.4% (95% CI = 28.1–43.5) and the prevalence of current symptoms was 14,0% (95% CI = 9,8–19,6) with no significant difference between migrant and native groups, after exclusion of subjects with a diagnosis of psychotic disorder (n = 145). In multi-adjusted models, childhood sexual abuse was associated with an increased risk of lifetime or current psychotic symptoms (OR > 4, P < 0.05). Early life psychological violence was strongly associated with the risk of lifetime psychotic symptoms in natives (OR = 6.33; 95% CI = 2.10–19.0), whereas alcohol misuse in adolescence was related to lifetime or current psychotic symptoms in migrants (OR = 3.34; 95% CI = 1.20–9.37).

Homeless people are at higher risk of psychotic symptoms compared to the general population in France. Our findings are consistent with the hypothesis that childhood abuse is an important risk factor of the psychosis continuum.

The authors have not supplied their declaration of competing interest.

The admission experience survey (AES) is a reliable tool for measuring perceived coercion in mental hospital admission. We developed the Italian AES through translation back-translation and administered it to acutely hospitalized psychiatric patients.

To verify psychometric characteristics of the Italian AES. To Examine the AES factor structure.

n = 156 acutely hospitalized patients (48% women, 69% voluntary) were recruited in two university hospitals in Rome (Umberto I Policlinic, Sant’Andrea Hospital) and were administered the Italian AES. We conducted a principal component analysis (PCA) with equamax rotation.

Socio-demographic and clinical characteristics of the sample are reported in Table 1. The Italian AES had good internal consistency (Cronbach's alpha = 0.90); Guttmann split-half reliability coefficient was 0.90. AES total score significantly differed between voluntary and involuntary patients (5.08 ± 4.1 vs. 8.1 ± 4.9, P < 0.05). PCA disclosed a three-factor solution explaining 59.3 of the variance. Significant correlations emerged between AES total score and clinical variables (Table 2). Pearson's correlation coefficient disclosed a significant correlation between perceived coercion and psychiatric symptoms severity (BPRS total score).

The Italian version of AES and proposed new factor structure proved reliable.

The authors have not supplied their declaration of competing interest.

Sexual dysfunctions are more common in individuals with psychotic disorders and has a major impact on both quality of life and compliance.

The purpose of this study is to investigate whether a relationship between sexual dysfunction and level of treatment compliance in individuals with psychotic disorders.

The sample group of the study consisted of 173 in-patients who agreed to participate were selected by random sampling method. The permission was obtained from the hospital's ethics committee. In this study, to assess the sexual functionality Golombok-Rust inventory of sexual satisfaction male and female form and to assess the treatment compliance; medical treatment compliance rate scale is used.

When sexual problems and treatment compliance compared to gender, subscales of satisfaction (t = 4,423, P = 0.000), avoidance (t = 3.348, P = 0.001), touch (t = 2.165, P = 0.032) and overall total (t = 4.015, P = 0.000), although a statistically significant difference was found, there were no differences in treatment compliance. Aditionally, there is no relation between sexual problems and treatment compliance in men. It is also found that there is a weak negative statistical relation amongst treatment compliance and communication (r = −0.244, P = 0.027), avoidance (r = −0.270, P = 0.014), anorgasmia (r = −0.253, P = 0.022) and overall total (r = −0.249, P = 0.024) in women. According to these findings while sexual problems increase, treatment compliance decreases.

The level of compliance to the treatment and subscales of sexual problems; satisfaction, avoidance, and touch mean scores differ from each other. There was a weak negative correlation in between Women's compliance and sexual problems.

The authors have not supplied their declaration of competing interest.

War in Syria and related refugee crisis has caught worldwide attention for the past few years. The war is still continuing by the time of the writing of this abstract. War is one of the reasons of posttraumatic stress disorder (PTSD). Syrian people experience many traumatic events like witnessing death, torture and rape.

The aim of this research is to screen for PTSD among Syrian war victims.

A total of 150 (women = 52, men = 98) war victims between 18–65 years, inhabiting a Syrian camp near the Turkish border were screened with trauma response checklist for PTSD between March 11 and April 11 2015.

Significant amount of the interviewed participants were found to show symptoms of PTSD. Seventy-six percent (n = 114) of the participants had experienced a traumatic event. In total, 80.6% (n = 121) were experiencing distress. Seventy-eight percent (n = 117) had avoidance. Eighty-four percent (n = 126) had negative interfering thoughts. Eighty-eight percent (n = 132) were experiencing trauma associated disturbance. Answers from 78.6% (n = 118) of the participants indicated that they should be further referred to a specialist. The findings were not affected by gender or age.

We have found that most of the participants showed signs of PTSD. Our findings highlight the psychological impact of war on Syrian people. A definite diagnosis of PTSD can be made with detailed psychiatric examination, however given the amount of victims and available staff a brief screening instrument may help identify potential cases to be further evaluated. PTSD has life-long consequences and trauma can be passed through generations. International support for war victims should include psychological support and interventions.

The authors have not supplied their declaration of competing interest.

Children are at greater risk than adults for weight gain and metabolic disorders including hyperlipidemia and diabetes with newer antipsychotics. A web-based safety-monitoring program using a prior documentation model required submission of patient safety data (prior documentation) for insurance coverage at the pharmacy point of sale. This program launched in April of 2011, covering all NC Medicaid and Health Choice recipients under age 18. Clinical monitoring parameters and interactive educational features were developed with pediatric psychiatric experts and key mental health stakeholder groups.

Using a four-year run in period and a full 9 months of post implementation claims data, evaluate the rates of antipsychotic prescribing and safety monitoring before and after the implementation of the A + KIDS program.

Implementation of this program was associated with a consistent monthly decrease in overall antipsychotic use and increases in patient monitoring of glucose and lipid (Figure. 1, Table 1).

The prior documentation registry was effective in decreasing antipsychotic use and increasing safety monitoring. The impact of changing to more traditional prior authorization on the same clinical endpoints is currently under evaluation.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

It is commonly accepted that in most patients with schizophrenia external factors act on genetic predisposition to produce active psychotic symptoms. In fact, we showed that patients with schizophrenia have an abnormal brain activation and peripheral autonomic response to psychological stress. We sought to characterize the brain connectivity networks of such response in schizophrenia.

We studied the pattern of brain connectivity in relation to mental arithmetic stress paradigm in 21 patients and 21 healthy subjects aged 18 to 50 years, using 3T-fMRI. A period of 6 minutes of resting state acquisition (PRE) were followed by a block design with three 1-minute CONTROL task (one digit sum), 1-minute STRESS task (two digit subtraction) and 1-minute rest after task (POST). Pairwise Pearson correlations were calculated between 90 regions of interest. Data were analyzed with MATLAB and SPSS software.

Patients with schizophrenia showed a lower connectivity network between fronto-temporal limbic areas compared with control subjects during control and stress task. Moreover, we observed a great variability of link density during resting state in patients but not in controls, and it diminishes in response to task.

Patients present abnormalities in networks related to stress response showing an alteration in fronto-temporal connectivity, and a poor and random modulation of these networks at rest. Current and previous findings suggest abnormal fronto-temporal connectivity that ultimately would lead to psychotic symptoms emergency in response to an environmental stressor and, even, could be related to hypervigilance and misattribution feeding into the paranoid cognition characteristic of patients with schizophrenia.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Apathy is usually defined as a lack of goal-directed behavior. Although it is observed in about 30% of depressed patients, neurovascular mechanisms underpinning apathy remain little-known.

The main objective of this study was to compare the cerebral perfusion of apathetic depressed patients with non-apathetic depressed patients by arterial spin labeling (ASL), a quantitative and non-invasive perfusion magnetic resonance imaging (MRI) technique. The secondary objectives were to study their clinical profile and their correlation with cerebral perfusion data.

This study was conducted from a cohort of depressed patients in Rennes, France. Eighty-three depressed patients were included, of whom 22 were apathetic (AES≥42), 61 non-apathetic (AES < 42). Everyone got a clinical evaluation with scale screenings, especially for apathy (AES), anxiety (STAI) and anhedonia (SHAPS) as well as a cerebral MRI, including a pseudo-continuous ASL sequence.

Apathetic depressed patients were significantly less anxious and less anhedonic. Apathetic perfused better than non-apathetic in the inferior frontal gyrus (P = 0.022). We found a significant positive relationship between apathy and perfusion of the left frontal inferior gyrus (P = 0.05, r = 0.21). State-anxiety was positively correlated with perfusion of the cingulate cortex, the insula and the left amygdala. Anhedonia was positively correlated with the perfusion of the ventromedial prefrontal cortex, the cingulate cortex and the insula.

We have shown that the clinical and perfusional profiles of apathetic depressed and non-apathetic differ. This study suggests the existence of two distinct neurobiological networks for depressed patients; one involving motivational networks for apathetic patients, and another one involving emotional networks for more anhedonic patients.

The authors have not supplied their declaration of competing interest.

Although some magnetic resonance imaging (MRI) studies have investigated the existence of a relationship between clinical severity and neuroanatomical alterations in patients with schizophrenia (SCZ), the biological signature associated with illness severity in schizophrenia is still uncertain.

This study aims to investigate structural brain abnormalities in SCZ with particular regards to the identification of potential deficits associated to the severity of illness.

1.5 T MRI data were acquired for 61 subjects with SCZ and 59 matched healthy controls (HC). The patient group was divided in two subgroups based on clinical severity, one composed by 34 mild-to-moderately ill patients and the other one by 27 severely ill patients, and compared with matched HC.

The whole group of patients with SCZ had significantly reduced gray matter (GM) volumes in left inferior and middle temporal gyrus compared to HC (P < 0.05, pFWE corrected). Furthermore, compared to HC, patients with mild-to-moderate illness showed decreased GM volumes in inferior temporal gyrus (P < 0.05, pFWE corrected) whereas those with severe illness had reduced right cerebellum (P < 0.05, cFWE corrected). No differences were observed between the two subgroups of patients.

Our results showed significant GM volume reductions in left inferior and middle temporal gyrus in patients with SCZ compared to matched HC, confirming the role of this region in the pathophysiology of SCZ. Furthermore, we identified specific cerebellar gray matter volume reductions in patients with severe illness, which may contribute to stratify patients with SCZ according to their clinical phenotype expression, ultimately helping in guiding targeted therapeutic/rehabilitation interventions.

The authors have not supplied their declaration of competing interest.

Empathy is evolutionary preserved in social organisms and emotional face processing is one of its measures. Systems possibly active during empathic processing include perspective-taking, basic emotional contagion “mirroring” and “theory of mind” systems.

fMRI studies help clarifying neural correlates of empathic face processing; ALE meta-analysing fMRI studies allows identification of brain area activation/deactivation during empathy.

To identify brain areas most consistently involved in empathy.

We carried ALE meta-analysis of original studies focusing on cerebral activations during empathic face processing tasks and reporting data on Talairach or MNI space coordinates, converting the former in the latter. An 11-April-2016 PubMed search, using as keywords terms like empathy combined with functional magnetic resonance imaging (fMRI), produced 124 records of which 23 were finally included (568 participants, 247 males and 321 females; mean age 32.2 years). We followed the PRISMA statement. Whole-brain data were meta-analysed; significance was set at P = 0.0001, uncorrected.

ALE meta-analysis of data from 21 experiments (totalling 527 foci) on empathic face processing during experimental task conditions showed that emotional vs. neutral/control conditions significantly correlated with activations of left anterior cingulate cortex (BA 32), right precentral gyrus (BA 6), left amygdala, right superior frontal gyrus (BA 9), left middle occipital gyrus (BA 37), right insula (BA 13), left putamen, and left posterior cingulate cortex (BA 31).

Empathy is a complex process correlating with activation of different brain areas, which have been involved in emotional cue processing, self-other/same-different discrimination, perspective-taking, mirror neuron activation, emotional arousal and decision-making.

The authors have not supplied their declaration of competing interest.

Internet gaming disorder (IGD) is a type of behavioral addiction characterized by abnormal executive control, leading to loss of control over excessive gaming. Attention deficit and hyperactivity disorder (ADHD) is one of the most common comorbid disorders in IGD, involving delayed development of the executive control system, which could predispose individuals to gaming addiction. We investigated the influence of childhood ADHD on neural network features of IGD.

Resting-state functional magnetic resonance imaging analysis was performed on 44 young, male IGD subjects with and without childhood ADHD and 19 age-matched, healthy male controls. Posterior cingulate cortex (PCC)-seeded connectivity was evaluated to assess abnormalities in default mode network (DMN) connectivity, which is associated with deficits in executive control.

IGD subjects without childhood ADHD showed expanded functional connectivity (FC) between DMN-related regions (PCC, medial prefrontal cortex, thalamus) compared with controls. These subjects also exhibited expanded FC between the PCC and brain regions implicated in salience processing (anterior insula, orbitofrontal cortex) compared with IGD subjects with childhood ADHD. IGD subjects with childhood ADHD showed expanded FC between the PCC and cerebellum (crus II), a region involved in executive control. The strength of connectivity between the PCC and cerebellum (crus II) was positively correlated with self-reporting scales reflecting impulsiveness.

Individuals with IGD showed altered PCC-based FC, the characteristics of which might be dependent upon history of childhood ADHD. Our findings suggest that altered neural networks for executive control in ADHD would be a predisposition for developing IGD.

The authors have not supplied their declaration of competing interest.