Community health workers and promotoras (CHW/Ps) increasingly support research conducted in communities but receive variable or no training. We developed a culturally and linguistically tailored research best practices course for CHW/Ps that can be taken independently or in facilitated groups. The purpose of this study was to evaluate the facilitated training.

CHW/Ps were recruited from communities and partners affiliated with study sites in Michigan, Florida, and California. They participated in virtual or in-person training facilitated by a peer in English or Spanish and then completed a survey about their abilities (i.e., knowledge and skills for participating in research-related work) and perceptions of the training. Linear regression analyses were used to examine differences in training experience across several factors.

A total of 394 CHW/Ps, mean age 41.6 ± 13.8 years, completed the training and survey (n = 275 English; 119 Spanish). Most CHW/Ps were female (80%), and 50% identified as Hispanic, Latino, or Spanish. Over 95% of CHW/Ps rated their abilities as improved after training; 98% agreed the course was relevant to their work and felt the training was useful. Small differences were observed between training sites.

Most CHW/Ps rated the training positively and noted improved knowledge and skills for engaging in research-related work. Despite slight site differences, the training was well received, and CHW/Ps appreciated having a facilitator with experience working in community-based settings. This course offers a standard and scalable approach to training the CHW/P workforce. Future studies can examine its uptake and effect on research quality.

Treatment choice when prescribing antidepressants for major depressive disorder (MDD) is often influenced by safety and tolerability profiles. A transient increase in suicidality following antidepressant treatment initiation is a key concern. Although rare, its unpredictability and consequences make them a significant worry. In 2004, the U.S. Food and Drug Administration (FDA) issued a “black-box” warning regarding a potential increase in suicidality in adolescents receiving antidepressant treatment for depression that was later expanded to include both young adults and a broader range of antidepressants.

The aim of this study is to evaluate the risk of increased suicidality during the treatment with serotonin and norepinephrine reuptake inhibitors (SNRIs) in young adults with MDD.

We conducted a non-systematic literature search on PubMed using the combination of MeSH terms ([Serotonin and Noradrenaline Reuptake Inhibitors] OR [Levomilnacipran] OR [Desvenlafaxine Succinate] OR [Venlafaxine Hydrochloride] OR [Duloxetine Hydrochloride]) AND [Suicide] AND [Young Adult], and the keywords [(“Serotonin and Noradrenaline Reuptake Inhibitors” OR “Levomilnacipran” OR “Desvenlafaxine” OR “Venlafaxine” OR “Duloxetine”) AND (“Suicide” OR “treatment-emergent suicidal ideation”) AND (“Young” OR “Youth”)].

A total of 31 manuscripts were retrieved and 6 were selected, 3 original research and 3 non-systematic reviews of randomized clinical trials. Only studies written in English that provided information about suicidality with SNRIs in young adults with MDD.

Globally, studies show that not only antidepressants decrease the risk of suicide attempt in depressed patients, but also there is no evidence of an increased suicidality in young adults treated with SNRIs.

Interestingly, one study showed that increasing suicidality could be related to side effects of the treatment, such as anxiety, agitation and irritability. The authors found that poor antidepressant response and greater severity of depression during follow-up were associated with treatment increasing suicidal ideation, as it was suggested in another study.

Another study reinforced that there may be an emotional component to the activating effects produced by some antidepressants that could explain their controversial association with rare cases of suicidal ideation and behaviour.

In conclusion, growing evidence shows that antidepressants overall decrease the risk of suicide attempt in depressed patients. Therefore, reducing antidepressant use over the FDA concerns about increased suicidal tendencies in young patients may actually increase suicide risks due to inadequate treatment of depression. Additional studies are essential to further confirm the importance of early treatment for depression.

None Declared

Cognitive control (CC) involves a top–down mechanism to flexibly respond to complex stimuli and is impaired in schizophrenia.

This study investigated the impact of increasing complexity of CC processing in 140 subjects with psychosis and 39 healthy adults, with assessments of behavioral performance, neural regions of interest and symptom severity.

The lowest level of CC (Stroop task) was impaired in all patients; the intermediate level of CC (Faces task) with explicit emotional information was most impaired in patients with first episode psychosis. Patients showed activation of distinct neural CC and reward networks, but iterative learning based on the higher-order of CC during the trust game, was most impaired in chronic schizophrenia. Subjects with first episode psychosis, and patients with lower symptom load, demonstrate flexibility of the CC network to facilitate learning, which appeared compromised in the more chronic stages of schizophrenia.

These data suggest optimal windows for opportunities to introduce therapeutic interventions to improve CC.

Community health workers and promotoras (CHW/Ps) have a fundamental role in facilitating research with communities. However, no national standard training exists as part of the CHW/P job role. We developed and evaluated a culturally- and linguistically tailored online research best practices course for CHW/Ps to meet this gap.

After the research best practices course was developed, we advertised the opportunity to CHW/Ps nationwide to complete the training online in English or Spanish. Following course completion, CHW/Ps received an online survey to rate their skills in community-engaged research and their perceptions of the course using Likert scales of agreement. A qualitative content analysis was conducted on open-ended response data.

104 CHW/Ps completed the English or Spanish course (n = 52 for each language; mean age 42 years SD ± 12); 88% of individuals identified as female and 56% identified as Hispanic, Latino, or Spaniard. 96%–100% of respondents reported improvement in various skills. Nearly all CHW/Ps (97%) agreed the course was relevant to their work, and 96% felt the training was useful. Qualitative themes related to working more effectively as a result of training included enhanced skills, increased resources, and building bridges between communities and researchers.

The CHW/P research best practices course was rated as useful and relevant by CHW/Ps, particularly for communicating about research with community members. This course can be a professional development resource for CHW/Ps and could serve as the foundation for a national standardized training on their role related to research best practices.

Adults diagnosed with Borderline Personality Disorder (BPD) likely have a history of psychological trauma. There has been research about the connection between Complex Post-Traumatic Stress Disorder (c-PTSD) and BPD.

This paper provides a review of the relationship between complex trauma and key features of BPD.

Review of the literature from 2015 to present, using search engines such as Pubmed and Google Shoolar, using the following keywords: borderline personality disorder, complex post-traumatic stress disorder, trauma

Traumatic victimisation and compromised primary caregiving relationships have been hypothesized to be key aetiological factors in the subsequent development of BPD. c-PTSD was defined as a syndrome with symptoms of emotional dysregulation, dissociation somatisation and poor self-esteem, with distorted cognition about relationships, following traumatic interpersonal abuse. It was proposed as an alternative for understanding and treating people who had suffered prolonged and severe interpersonal trauma, many of whom were diagnosed with BPD. Although, the boundaries between c-PTSD and BPD remain vague. Currently, the main difference is the assumption that symptoms of c-PTSD are sequelae of exposure to traumatic stress, which is not inherent in the current DSM-5 definition of BPD. Furthermore, to date, the neurochemistry and neurostructural changes seen in c-PTSD, BPD and PTSD do not clearly differentiate the three conditions.

BPD and PTSD are relatively distinct with regard to the precise qualitative definitions of their diagnostic features, but nevertheless have substantial potential overlap in their symptom criteria.

No significant relationships.

About a decade ago, the idea of a Late-Onset Post Traumatic Stress Disorder (LO-PTSD) emerged, in order to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans.

This paper provides a review of the changes happened during the onset of a late form of PTSD and how can mental health professionals intervene.

Review of the literature from 2015 to present, using search engines such as Pubmed and Google Schoolar, using the following keywords: Late-Onset Post Traumatic Stress Disorder, triggers, prevention, intervention

At first, there was hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. However, recent studies have proposed that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This process can lead positively to personal growth or negatively to increased symptomatology.

Therefore the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life should be reconsidered.

No significant relationships.

The aim of the study was to investigate mental health and conspiracy theory beliefs concerning COVID-19 among health care professionals (HCPs).

During lockdown, an online questionnaire gathered data from 507 HCPs (432 females aged 33.86 ± 8.63 and 75 males aged 39.09 ± 9.54).

A post-stratification method to transform the study sample was used; descriptive statistics were calculated.

Anxiety and probable depression were increased 1.5–2-fold and were higher in females and nurses. Previous history of depression was the main risk factor. The rates of believing in conspiracy theories concerning the COVID-19 were alarming with the majority of individuals (especially females) following some theory to at least some extend.

The current paper reports high rates of depression, distress and suicidal thoughts in the HCPs during the lockdown, with a high prevalence of beliefs in conspiracy theories. Female gender and previous history of depression acted as risk factors, while the belief in conspiracy theories might act as a protective factor. The results should be considered with caution due to the nature of the data (online survey on a self-selected but stratified sample).

There is a lack of accurate screening tools for suicide risk in the patients presenting to emergency departments. The Personality and Life Event (PLE) Scale, a set of the 27 most discriminative items from a collection of questionnaires usually employed in the assessment of suicidal behavior, demostrated an elevated accuracy, sensibility, and specificity in classifying suicide attempters.

To validate the self-administered PLE Scale.

In order to examine its psychometric properties, the PLE scale was administered to 59 suicide attempters, 48 psychiatric controls, and 69 medical patients attending the Puerta de Hierro emergency department. To examine its reliability, we used: 1) Cronbach's coefficient α to evaluate the internal consistency; 2) test-retest reliability to assess if the scale is stable over time. Interrater reliability is not relevant as the PLE is a self-report. To assess its construct validity, we used some of Beck's Suicide Intent Scale (SIS). All analyses were carried out using SPSS v.20 (Macintosh).

The most frequent criteria for suicide attempters were item 4 (‘I often feel empty inside’; 88.1%) and 20 (‘I act on impulse’; 79,7%). Mean (± SD) of the PLE Scale in suicide attempters, psychiatric controls, and medical controls was 74.49 (± 32.44), 57.19 (± 29.63), and 17.48 (± 21.15), respectively. The PLE had an acceptable internal consistency (Cronbach's alpha =0,674).

Our preliminary findings support the reliability, construct validity, and ussefulness of the PLE to identify suicide attempters to those attending to emergency departments.

Sexual dysfunction, such as low libido, erectile dysfunction and anorgasmia, is very common in patients taking serotoninergic antidepressants (SSRIs). These adverse effects persist throughout the treatment period, are not self-limited, and drive many male patients to treatment discontinuation in order to recuperate normal sexual functioning.

The purpose of the present study was to investigate the sexual function of male patients treated with antidepressants for major depression, before initiation of treatment, during treatment and two months following withdrawal of SSRIs.

This observational study comprised 25 male patients (age: 30–50 years) followed-up on an outpatient basis for major depression.

Sexual functioning was assessed with the Arizona Sexual Experience Scale (ASEX) and depressive symptoms with the Hamilton Rating Scale for Depression (HDRS) at three time points: baseline (period free of medication), three months after starting treatment with SSRIs, and two months following antidepressant discontinuation.

Paired samples t-tests were used for comparisons between numeric variables at the three time points and Spearman's correlation coefficients were calculated between factors associated with sexual dysfunction.

Mean values ??(± SD) of ASEX and HDRS scores at the initial, second and final assessment are shown in Table 1.

Correlation coefficients between ASEX, HDRS and age at the three points of evaluation are presented in Table 2.

Antidepressants (SSRIs) have a negative impact on sexual functioning of male depressed patients. Quality of sexual functioning is negatively associated with age and the severity of depressive symptoms before the administration of antidepressant treatment. Sexual functioning significantly improves after discontinuation of antidepressants; this improvement is even superior to the pre-treatment period of sexual functioning.