Psychiatry and Psychopathology

Fraternal incest, due to its transgressive nature, is a form of sexual abuse with severe psychological
repercussions. This study aimed to explore the relationships between post-traumatic stress disorder
(PTSD), dissociative symptoms, and attachment styles among female victims of fraternal incest in
Tunisia. Seventy adult women with a history of fraternal incest participated in the study. PTSD
symptoms were assessed using the Post-Traumatic Stress Disorder Checklist -DSM-5 (PCL-5),
dissociative experiences with the Dissociative Experiences Scale -Second Edition (DES-II), and
attachment styles with the Experiences in Close Relationships Revised (ECR-R16). The results
indicate a substantial mental health impact of Sibling Incest. Nearly three-quarters of participants
met the clinical threshold for post-traumatic stress, and a substantial proportion exhibited insecure
attachment patterns and notable dissociative symptoms. Significant positive correlations were found
between PTSD symptoms, dissociative experiences, and insecure attachment. Age and duration of abuse
were significantly associated with higher PCL-5 scores, while no significant effects were observed
for DES-II or ECR-R16. Younger participants and those exposed for more than two years had higher
PCL-5 scores. These findings emphasise the interconnected roles of PTSD, dissociation, and insecure
attachment among survivors of sibling incest, highlighting the need for integrative, trauma-informed
approaches and for further research specifically on sibling incest to better understand its dynamics.
Key words: sibling incest, attachment, dissociative experiences, Post-Traumatic Stress Disorder.
How to cite this paper: Saadi SE (2025). Psychological Consequences of Fraternal Incest. International
Journal of Psychology & Psychological Therapy, 25, 3, 301-308.

Recent advances in the understanding of the neural substrates of goal-directed behaviour have created new interest in unlocking the mystery behind those disorders that are characterized by poverty of thought and action. In this review, various studies will be considered which proffer converging evidence that the dopaminergic brain circuitry running from ventral tegmental areas in the midbrain, via nucleus accumbens in the forebrain, to the frontal cortex, tends to produce aboulia when its restitutive function fails. Such aboulic deficits occur in various neurological and psychiatric disorders in which they have profound implications for the patients' management, rehabilitation and social interactions. We begin by examining the consequences of dopamine agonism and antagonism in pre-clinical studies and draw on the inferences that can be made from studies in humans. We then go on to discuss aboulic features in neuropsychiatric conditions, focusing on clinical manifestation, animal models, abnormal dopamine activity and pharmacological interventions.

For seventy-nine years, the United Nations has claimed to embody the universality of humanity. Yet under its blue flag hides a hierarchy of power that perpetuates colonial continuities (Mazower, 2009). Five permanent members hold veto power that dictates the fate of the world, while Africa—the cradle of humanity, home to 1.4 billion people, and the continent most weakened by external interventions—remains voiceless in the corridors of decisive power (Adebajo, 2021).
From a Coafrwological perspective, this is not a simple oversight. It is the deliberate perpetuation of what decolonial thinkers call epistemicide: the silencing of African sovereignty in global decision-making (de Sousa Santos, 2014). From the CEADA lens—the Existential Condition of Africans and People of African Descent in the World—the exclusion of Africa from permanent membership on the Security Council is not only unjust; it is an existential threat to the dignity, survival, and flourishing of African peoples worldwide (Mpékè-Ntonga, 2024).
Thus arises a radical but necessary question: what if Africa withdrew from the UN to found—or join—another world organization more equitable?

Шизофрения остается одним из самых стигматизированных и непонятых психических расстройств. За видимыми симптомами — бредом и галлюцинациями — скрывается глубокое нарушение базовых когнитивных процессов. Данная статья рассматривает шизофрению через призму современных психологических концепций: теории ментализации, метапознания, когнитивных искажений и нарушения исполнительных функций. Мы попытаемся понять, как рушится внутренний мир человека, и как психологическая наука находит точки воздействия, чтобы помочь ему восстановить связь с реальностью.

This article introduces and defines Spiritopsychopathology as a new Coafrwological discipline. Emerging from the Pan-African science of Coafrwology-founded upon the principles of order, justice, restoration, and global African renaissance-Spiritopsychopathology names the psychospiritual pathology underlying Western systems of domination, including colonialism, slavery, racism, and neocolonialism. Unlike Western psychology, which focuses primarily on the disorders of the individual mind, Spiritopsychopathology diagnoses the collective, civilizational disorders that animate structures of oppression against Africans and their descendants. Drawing upon the work of Fanon (1952; 1961), Ani (1994), Mbembe (2001), Wynter (2003), and others, this article situates the concept historically, outlines its theoretical foundations, and presents its diagnostic and therapeutic functions within the broader Coafrwological project.

Political lying constitutes a structural dimension of modern regimes of power. While Western democracies base their legitimacy on transparency and truthfulness, their leaders often resort to falsified narratives to justify their actions. The case of Emmanuel Macron, denying any colonial heritage in France's gold reserves, fits into a long tradition: Nicolas Sarkozy asserting that Africa had "not sufficiently entered history" (2007), Tony Blair and George W. Bush justifying the Iraq War based on non-existent weapons of mass destruction (2003), and Barack Obama and Hillary Clinton legitimizing military intervention in Libya (2011) with humanitarian rhetoric that led to chaos.

CEADA-la Spiritopsychopathologie, la LocalStrategie et d'autres concepts paradigmatiques et socio-ethniques panafricains. Directeur de l'Institut d'études sur le monde africain contemporain (IEMAC/ICAWS) Résumé : Le religionisme, dans une perspective Coafrwologique, est l'imposition de l'adhésion religieuse-par coercition, pression systémique ou manipulation-avec pour objectif principal de maintenir le contrôle social et d'aliéner les individus de leur autonomie, de leur identité culturelle et de leur esprit critique. Cet article introduit la spiritopsychopathologie, un cadre conceptuel capturant les perturbations psychologiques et spirituelles résultant d'une religion imposée ou subie de force. La spiritopsychopathologie s'étend sur cinq domaines interconnectés : cognitif, émotionnel, comportemental, spirituel et social, offrant une approche systématique pour comprendre les impacts individuels et sociétaux du religionisme. En intégrant les idées de Marx, Foucault et Fanon aux recherches contemporaines sur le traumatisme religieux et les abus spirituels, cette étude propose une typologie et un cadre méthodologique pour la recherche de terrain en Coafrwologie-l'étude de la religion en tant qu'outil de contrôle, d'aliénation et de gouvernance sociale.

Abstract:
Religionism, in a Coafrwological perspective, is the imposition of religious adherence—through coercion, systemic pressure, or manipulation—with the primary aim of maintaining social control and alienating individuals from autonomy, cultural identity, and critical reasoning. This article introduces Spiritopsychopathology (Mpeke-Ntonga 2024), a conceptual framework capturing the psychological and spiritual disturbances resulting from coerced or imposed religion. Spiritopsychopathology spans five interrelated domains: cognitive, emotional, behavioural, spiritual, and social, providing a systematic approach to understanding the individual and societal impacts of religionism. Integrating insights from Marx, Foucault, and Fanon with contemporary research on religious trauma and spiritual abuse, this study proposes a typology and methodological framework for field research in Coafrwology (2007-2025)—the study of religion as a tool of control, alienation, and social governance.

Individuals with borderline personality disorder (BPD) experience extreme interpersonal conflict, crippling their ability to sustain successful relationships. Consequently, clinicians within the psychological field face difficulty in devising treatments plans which can assist these individuals with suffering minimal relationship loss. The purpose of this study was to understand how current technological methods of social interaction affect individuals who suffer from BPD to improve treatment outcomes. This research was guided by the principles of attachment theory and social baseline theory. A quantitative correlational design using social network analysis and multiple regression analysis was used to examine data from surveys. Participants were solicited using the social media platforms Facebook, Instagram, and Twitter. The final sample included six males, 64 females, and four individuals who identified as other. The standardized instruments used to examine the relationship between ...

This paper applies the Sentient-Consciousness Projection Network (SCPN) to clinical neuroscience by modelling Traumatic Brain Injury (TBI) as a cascading, multi-scale system failure. The TBI cascade is described through the Triad of Pathology: Decoherence (collapse of the quantum-biological substrate at Layer 1), Dyscritia (network shift away from quasicriticality at Layer 4), and Dissonance (massive accumulation of variational free energy at Layer 5). The analysis then extends to pharmacological intervention, specifically morphine. Morphine is modelled as an analgesic that reduces the precision of nociceptive prediction errors, thereby alleviating Dissonance (suffering), but at the risk of exacerbating Dyscritia by pushing the brain further into subcriticality, threatening coma and respiratory depression. The SCPN thus provides a formal, ethical framework to weigh therapeutic benefits against systemic risks.

This paper introduces a first-principles framework for psychopathology derived from the Sentient-Consciousness Projection Network (SCPN). Instead of describing mental illness through symptom clusters, it defines systemic modes of failure within a multi-scale architecture of consciousness. The model identifies a Triad of Pathology: (1) Dissonance—disorders of prediction leading to sustained variational free energy accumulation; (2) Dyscritia—deviation from the quasicritical operating regime (σ≈1), manifesting as subcritical rigidity or supercritical chaos; and (3) Decoherence—failures in Multi-Scale Quantum Error Correction (MS-QEC) that protect the system’s integrity. These three failure modes provide a transdiagnostic lens to reinterpret conditions such as schizophrenia, depression, and Alzheimer’s disease, grounding psychiatric pathology in physics, computation, and biology.

The history of serological investigations of the blood of the insane is traced from the initial such study in 1854 by a solitary Scottish asylum physician, who counted the blood cells of his lunatic patients under a weak microscope, to the January 2005 announcement by an international team of geneticists of the development of a genomic blood test that can differentially diagnose schizophrenia and bipolar disorder. The story of the first claim of the development of a blood test for madness in 1912 -the Abderhalden defensive ferments reaction test -is related in detail. Studies of the blood of the insane have followed four general methodological paradigms: the corpuscular richness paradigm (1854); the metabolic paradigm (c. 1895); the immunoserodiagnostic paradigm (1906); and the medical genomics paradigm (2005).

ENIGMATIC SPEECH (ON THE POETICS OF DELUSION)                                                    I. Zislin, Psychiatrist, Independent Researcher.Jerusalem. Israel.                                                                    In his renowned 1978 work, “The Semantic Structure of the Riddle,” Yu. I. Levin wrote: “It is precisely in the example of the riddle that one can clearly discern all the capriciousness of human thinking, particularly linguistic thinking, and its reluctance to fit into defined frameworks and categories” (Levin Yu. 1978). From this perspective, the philological position can be compared with the psychiatric one. This paper proposes to examine certain aspects of the structure and dynamics of the riddle and delusion based on their common features: the absence of semantic invariants and their metaphorical nature. Both the riddle and delusion, due to their fundamentally occasional nature (though not arbitrariness) and openness, lack semantic invariants. Here, ‘openness’ implies the potential for virtually any text to be transformed into a riddle or a delusion.It is precisely due to this occasionality that, unlike a proverb, the riddle lacks a universal quantifier. However, both the riddle and delusion contain a transformation operator: “The advantage (of the transformation operator) lies precisely in its universality: it is assumed that anything can turn into anything else (while not everything is similar to everything else)” (Tsivyan T. 1994).T. Tsivyan’s thesis can be expanded, making it possible to speak not of one, but of two types of transformation operators: 1) an internal transformation operator (within the riddle, anything can turn into anything), and 2) an external transformation operator, the essence of which is the potential to turn any text into a riddle. Both such operators are embedded in the structure of delusion.The absence of semantic invariants is perhaps one of the reasons why, to this day, there is no satisfactory definition and, consequently, classification for either the riddle or delusion. In this sense, the modern classification of delusion is analogous to the classification of riddles adopted as far back as the 19th century (Sadovnikov D. 1876), which is based primarily on “themes.” The shortcomings of such a system (its inherent incompleteness, overlapping categories, vagueness of basic concepts, etc.) are quite clear but remain insurmountable for now. The commonly accepted thesis concerning the metaphorical nature of the left part of a riddle (the description) can and should be questioned. One basis for this view is the fact that, in essence, any metaphor can be transformed into a riddle (again, as part of an occasional, subjective procedure). However, the left part of the riddle itself is not a metaphor per se as long as it is detached from its denotatum (the answer). It can be characterised as a visual-metonymic structure. It is precisely in the left part that the poser of the riddle consciously constructs a deceptive image through the enumeration of features or negations. The narrative of a persecutory delusion, for example, is constructed in much the same way. For both delusion and the riddle, it is possible to identify a causation mechanism linking the left part of the riddle (the description) to the answer (the solution). By examining the formation of persecutory delusions and comparing them to the riddle, it becomes possible to analyze two causation mechanisms – hypersemiotic and motivational.

Domestic violence/intrapersonal violence (DV/IPV), inclusive of physical, sexual, emotional,
psychological, or economic consequences, negatively affects victims and child witnesses. The
impact of DV/IPV on the family system and society is far-reaching. DV/IPV is experienced by
10 million adults and 3.3 million child witnesses in the United States; additionally, 35% of
women worldwide fall victim annually. This systematic review was conducted to examine
empirical literature on DV/IPV victimization, DV/IPV’s influence on women victims’ mental
health, and child witness mental health comorbidities. The primary research question was, how
do barriers to mental healthcare access have detrimental effects on victims’ health and how do
these barriers continue to contribute to the avoidance of help-seeking behaviors? The analysis
guided by PRISMA 2020 revealed three interrelated themes: stigma and mental health access;
cultural differences; psychological control, low self-esteem, and hopelessness. Additionally,
DV/IPV exposure has long-lasting effects on child witnesses, including a risk for future DV/IPV
perpetration. Considering the sociocultural context in which DV/IPV occurs, the costly burden
involves a multiplicity of public services that contribute to individual and family financial strain.
The problem of DV/IPV is compounded by various political, cultural, legal, and economic
factors, requiring a crucial necessity to understand its etiology. Therapists should remain aware
of social and legal sanctions that can inform clinical interventions and prevention strategies and
treat underlying root causes of the DV/IPV perpetration. Future research is needed to improve
behavioral health interventions and develop overall policies to protect affected women and child
witnesses.

Borderline Personality Disorder (BPD) is defined within psychiatry as a mental health condition that is characterised by unstable emotions, impulsive behaviours, intense and unstable relationships, and a fragile sense of self (Leichsenring et al., 2024). Prevalence estimates vary, ranging from 0.7% to 5.9% in the general population, and rising to as high as 15% to 28% among psychiatric inpatients. But the diagnosis is controversial: Concerns about the validity, the overlap with other conditions, and the stigmatisation of those diagnosed bring into question whether it is helpful to relate to BPD as a distinct disorder. While recognising the intersections of race, class, gender identity, and culture, this essay centres on heteronormative women within Western sociocultural contexts.

Interleukin-1 beta (IL1β) is primarily produced by monocytes in the periphery and the brain. Yet, IL1β protein levels have to date been investigated in major depressive disorder (MDD) and antidepressant response using either plasma or serum assays although with contradictory results, while mononuclear cell assays are lacking despite their extensive use in other contexts. In this pilot study, we comparatively assessed IL1β in mononuclear lysates and plasma in depressed MDD patients over treatment and healthy controls (HC). We recruited 31 consecutive adult MDD inpatients and 25 HC matched on age, sex, and BMI. Twenty-six patients completed an 8-week follow-up under treatment. IL1β was measured in both lysates and plasma in patients at baseline (T0) and at study end (T1) as well as in HC. We calculated ΔIL1β(%) for both lysates and plasma as IL1β percent changes from T0 to T1. Seventeen patients (65.4% of completers) were responders at T1 and had lower baseline BMI than non-responders...

Bibliotherapy has long remained a significant tool in deLing cases with subtle affect disorders as well as dealing with periodic mental illnesses. However it's role in dealing with cases of psychiatric disease entities like Major Depressive Disorder is largely restricted.In this case report, an young adult female suffering from multiple self harm attempts, severely depressed receiving antidepressants, mood stabilizers and augmenting antipsychotics with concurrent Cognitive Behaviour Therapy was also encouraged with Bibliotherapy, and in course of time, the intervention seemed to be effective with follow up visits and subsequent observation.The case confirms that Bibliotherapy indeed can be an effective annexture in a few selective cases along with conventional psychopharmacotherapy.

Submission Response by Dr Alex Burns to the Inquiry Into the Recruitment Methods and Impacts of Cults and Organised Fringe Groups for the Legislative Assembly Legal and Social Issues Committee, Parliament of Victoria, Australia on 31st July 2025.

Cet article s'attache à faire le point sur le stress à partir des mécanismes psychobiologiques et des interactions multiniveaux qui le sous-tendent et qu'il génère. Cet abord fait intervenir plusieurs systèmes et champs théoriques. Le lecteur y trouvera un point de vue à la fois intégré et précis pour une compréhension des mécanismes physiologiques du stress au regard des données actuelles. Il cible des questions d'importance pour les recherches à conduire. Il intègre l'histoire du stress chez l'individu dans une démarche intégrative, démarche indispensable à toute prise en charge systémique. Enfin, il déstigmatise la réponse de stress en resituant le stress dans sa fonction de vie et d'adaptation nécessaire à la survie de l'homme. Le stress est bien une réponse normale et essentielle de l'organisme, face à des modifications de l'environnement, pour assurer sa survie. © 2025 Elsevier Masson SAS. Tous droits réservés, y compris ceux relatifs à la fouille de textes et de données, à l'entraînement de l'intelligence artificielle et aux technologies similaires.

The history of religions is, in many ways, the history of erasure. For thousands of years, entire cultures centered around the worship of the Goddess were gradually replaced by theological systems dominated by masculine, hierarchical, and authoritarian figures. This suppression of the sacred feminine happened not only through war or inquisitorial fire but also through language — in how symbolic experience was structured: what was
written, what was silenced, what one could imagine, and what was condemned as “idolatry,” “fetish,” or “demon.” In this essay, I examine this process through the lenses of three radical thinkers: The Alphabet vs. the Goddess (1998) by Leonard Shlain; Moses and Monotheism (1939) by Sigmund Freud; The Myth of the Goddess (1991) by Anne Baring and Jules Cashford.

This study examines the demographic factors and severity of pornography addiction in India, analysing the impact of age, relationship status, co-morbid conditions, and socio‑cultural norms on addiction patterns and treatment outcomes.
Methods: A retrospective, observational, cross-sectional study was conducted with 589 participants (583 males, 6 females) aged 18 and older, diagnosed with pornography addiction as per ICD‑11 Compulsive Sexual Behavior Disorder criteria. Participants sought treatment through Allo Health’s online and offline platforms. Data on demographics, clinical diagnoses, and treatment outcomes were extracted from electronic health records and analysed using SPSS‑14. Treatment options included pharmacological interventions (SSRIs, bupropion) and psychotherapy (cognitive‑behavioural therapy, motivational interviewing, relapse prevention).
Results: The majority (374) were under 30 (mean age 28.98). Most were single (287), followed by married (167), in relationships (112), and divorced (6). Sexual orientation: 568 heterosexual, 15 bisexual, 2 homosexual, 4 undisclosed. Younger age was significantly associated with higher addiction severity (p = 0.004), suggesting early exposure and digital overuse lead to compulsive consumption. Singles had significantly higher severity than those in relationships or married (p < 0.001), likely due to limited sexual expression. Treatment: 338 received medication only, 207 therapy only, 42 a combination. Younger individuals were more likely to undergo therapy. Two participants were ineligible for treatment.
Conclusion: The study highlights the complexity of pornography addiction in India, showing strong links between age, relationship status, and addiction severity. Younger individuals face higher vulnerability due to early exposure, poor coping mechanisms, and digital engagement. Socio-cultural factors and stigma further influence addiction and help-seeking. Findings emphasize the need for culturally sensitive interventions, digital literacy programs, and public health initiatives. Future research should explore longitudinal trends, gender disparities, and the impact of emerging digital technologies.

This article explores two very different forms in which immoral conduct was problematized over the course of the 19th century. It does this by contrasting the sexual purity politics of the Vice Society and the medicalization of morality as 'moral insanity'. Early in the century the Vice Society promoted coercive legislation with the aim of 'suppressing vice'. From mid-century, moral insanity theories sought to grapple with vice by disaggregating 'moral' from other forms of insanity. These two movements had quite distinct and incompatible lines of development; and they never overtly engaged with each other. The article makes its key argument by demonstrating the way in which such dissimilar trajectories came together towards the end of the century in the 'moral hygiene' movement, mobilizing discourses of 'degeneration' (and 'feeblemindedness') with projects promoting sexual purity.

In spite of the success of cognitive behavioral therapy for social phobia in research studies, it remains unclear whether interventions will remain successful in the routine of clinical practice, where patients might differ from those in research samples. This study investigates the possibility that higher effect sizes are achieved under typical research conditions. Thirty studies testing treatment effects for social phobia are re-examined by categorizing them according to the quality and amount of applied sample restriction and laboratory study characteristics. The results indicate that even accumulation of sample restriction, such as excluding patients with comorbid disorders or being outside a certain age range, does not have any predictive value for treatment effect. However, there was a relevant tendency for studies applying a row of laboratory treatment conditions, such as recruiting patients by advertisements, applying treatment in university settings, and using specifically trained therapists, to achieve higher effect sizes.

It has been widely suggested that depression negatively affects patients with cardiovascular disease. There are several pathophysiological mechanisms as well as behavioral processes linking depression and cardiac events. Improvements in nursing and medical care have prolonged survival of this patient population; however, this beneficial outcome has led to increased prevalence of depression. Since mortality rates in chronic heart failure patients remain extremely high, it might be as equally important to screen for depression and there are several valid and reliable screening tools that healthcare personnel could easily employ to identify patients at greater risk. Consultation should be provided by a multidisciplinary team, consisting of cardiologists, psychiatrists, and hospital or community nurses so as to carefully plan, execute, and evaluate medical intervention and implement lifestyle changes. We aim to systematically review the existing knowledge regarding current definitions, ...

Ethical dilemmas frequently arise in the treatment of clients with eating disorders, and clinicians regularly encounter an array of ethical challenges related to whether or not overt and covert coercive tactics should be implemented. In this paper, the authors provide an overview of perplexing ethical questions relevant to medical, nutritional and psychological treatment of clients with eating disorders including imposed treatment, enforced feeding, the duty to protect minors and adults, the determination of competence and capacity among medically comprised clients, and the effectiveness of coercive treatment for clients with eating disorders. The processes of ethical decision‐making in terms of ethical principles, professional codes of conduct, the existing empirical literature and the use of a decision‐making framework are explored. Taking a collaborative and client‐sensitive approach, the authors outline and apply an integrative ethical decision‐making model to facilitate clinici...

In this report we examined the reliability and structural validity of the Chilean version of the Social Phobia and Anxiety Inventory, SPAI, (Turner, Beidel, Dancu y Stanley, 1989), using a sample of 1040 non clinical Chilean adolescents (range of age between 13 and 18 years). The structural validity analysis indicated the existence of two, clearly differentiated, subscales (Social Phobia and Agoraphobia) that explained 43.4% of the variance. The alpha reliability coefficients were very high in each one of the subscales. In spite of finding significant differences, for sex in both scales, the effect size was small. On the other hand, the age variable was significant in the social phobia scale but not in the agoraphobia one, but again the effect size was small. In general the results offer empirical evidence in support of the reliability and validity of the Chilean version of the Social Phobia and Anxiety Inventory.

Among the great philosophers of the twentieth century, Karl Jaspers occupies a special position, first, because he never completed a regular training in philosophy, and second, because he did not come to philosophy from mathematics, physics or biology, as many others did, but from psychiatry. The importance of his psychiatric experience to his philosophical work is unmistakable, not only because of the many references to psychopathological phenomena to be found in his later writings but also because of the existential depth of his thought, to which Jaspers's early confrontation with limit situations (Grenzsituationen) in psychiatry undoubtedly contributed. The study of Jaspers as a psychiatrist is, therefore, of interest not just from a history-of-psychiatry perspective, but also if we wish to fully grasp his philosophy. This is underlined by the fact that, in the fourth edition of his General Psychopathology (1944), Jaspers himself included a comprehensive outline of his existential philosophy as it stood at the time. Throughout his life, he remained attached to psychiatry and psychopathology, and in his late autobiography he writes of his General Psychopathology: "The book remained an essential part of my life over the decades" (Jaspers 1967a, 168). "To the work of my youth I remained faithful. I never became indifferent to Psychopathology" (ibid., 170). The following account of Jaspers's psychiatric work is, therefore, not concerned with a merely initial, let alone marginal preoccupation, but with a matter foundational to his thought. I first briefly trace Jaspers's professional development as a psychiatrist, then describe his psychopathological work in detail, including consideration of the significance of his concept of limit situations to psychiatry.

Typical antipsychotic agents have shown little efficacy in the treatment of acute psychoses in patients whose clinical picture is characterized by concurrent substance abuse. Substance-related issues usually not only remain unimproved while being treated with atypical antipsychotics but very often show an increase in severity. The fact that they have no quick or global effectiveness on psychotic phenomena is especially troubling because abused substances oftentimes have the effect of reinforcing and maintaining psychotic symptoms. In this observational study, we compared the discharge rate in 30 cannabis-abusing patients and in 26 nonabusers, who were males, treatment-resistant psychotic bipolar inpatients, treated with clozapine. Discharge rates 30 days after the start of treatment were 23.1% for nonabusers and 53.3% for abuser patients (P = 0.04). Discharge rates at 60 days were 80.8% for nonabusers and 83.3% for abuser patients. We submit the hypothesis that underactivity of the meso-limbic pathway by treatment with typical antipsychotics makes cannabis abuse more likely, and as such, treatment with Clozapine is more effective.

MaterIals and Methods We evaluated for research in Google Scholar and MEDLINE/ PubMed applying the keywords 'NAC', AND 'N-acetylcysteine', AND 'Psychiatric disorders', AND 'Psychological illness', as well as terms specific to each condition. A search by hand was conducted through the listed studies' references. Studies published before December 2024 were mentioned. Research work on specific psychiatric disorders and N-acetylcysteine (NAC) is becoming more and more popular medication in the management of mental health conditions. NAC antiinflammatory, antioxidant and glutamate transmission properties, currently being explored for the therapeutic intervention of neurological conditions, e.g. anxiety, depressive disorders, post-traumatic stress disorder, obsessive-compulsive disorders, bipolar disorders and schizophrenia. Clinical studies for many psychiatric diseases have yielded contradictory findings, despite the fact that there is a wealth of preliminary data and intellectual support for the application of NAC in the treatments of many of these illnesses. The most of the research studies have proven insufficient and too briefly explored. More research are required to established NAC efficacy, appropriate indication and adverse drug reactions.

The Mental Status Examination (MSE) is a structured and systematic assessment tool used to evaluate a patient’s current cognitive, emotional, and behavioral functioning. Though historically rooted in psychiatry, the MSE has evolved into a cornerstone of clinical evaluation in family medicine, emergency care, internal medicine, and neurology. This paper provides a comprehensive examination of the MSE, elaborating on its components—appearance, behavior, motor activity, speech, mood, affect, thought process, thought content, perceptions, cognition, insight, and judgment—and their clinical relevance. Special attention is given to the diagnostic value of the MSE in differentiating between psychiatric and organic disorders, monitoring treatment responses, and evaluating the severity and trajectory of mental illness.
The MSE is inherently interpretive and subject to variability depending on the clinician’s training, cultural awareness, and interaction with the patient. Challenges in accurate assessment arise when evaluating patients with intellectual disabilities, language barriers, or altered consciousness. Furthermore, the paper discusses how the MSE can be enhanced through interprofessional collaboration and continuous observation by allied healthcare providers. Cultural competence, contextual understanding, and awareness of social determinants of health are essential for a nuanced and equitable application of the MSE. The role of the MSE in clinical decision-making, its implications for patient safety, and the necessity of interprofessional training are underscored to reinforce its value in modern medicine.

This chapter provides an explorative analysis of self-illness ambiguity in personality disorders. Self-illness ambiguity refers to the difficulty in distinguishing one’s self from a mental disorder or diagnosis. Personality disorder diagnoses may invoke a specific type of self-illness ambiguity, for the characteristics of personality disorders (i.e., maladaptive personality traits) seem more closely related to “who one is” than to a disorder. Our analysis focuses on the concept of trait maladaptivity. We use three characteristics of trait maladaptiveness (temporality, severity, and attitude) to compare such maladaptivity in personality disorders with other cases of trait maladaptivity. Aside from some similarities, we argue that managing one’s traits in the context of personality disorders is distinct in that it may involve a distancing or disidentification with the maladaptive trait, which sometimes leads to the development of a subsidiary (or “as if”) self. In a further step, people with a personality disorder may start to experience what we call “self–self-ambiguity,” where they struggle to determine whether a particular action is part of their default or subsidiary self. Finally, we discuss how people with a personality disorder implicitly relate to their maladaptive personality traits using the concept of self-relating.

Scholars of perfectionism have proposed significant modifications to DSM-5&#39;s alternative model of personality disorders (AMPD), such that (1) perfectionism be expanded beyond the inclusion of a singular trait—rigid perfectionism—and (2) perfectionistic traits be specified as trait descriptors of personality disorders (PDs) other than obsessive-compulsive PD. In this study, we evaluate these proposals by examining the degree to which (a) perfectionistic traits are already instantiated in Section II and Section III models of personality pathology; and (b) perfectionistic traits meaningfully augment the construct validity of AMPD PDs. We conducted these approaches in a large sample (N =3D 435) from an Iranian undergraduate population that is atypically found in the literature. Results showed that perfectionistic traits are already fairly well instantiated in Section III Criterion B. Perfectionistic traits minimally improved the construct validity of OCPD, but did not meaningfully d...

This reflection contends that much of the mental dysfunctionality prevalent in African communities originates from the deep historical imposition of Arab and Western religious systems. These religious colonisations disrupted African cosmologies, generated prolonged cognitive dissonance, and gradually led to the formation of narcissistic personality structures and fragmented identities. The analysis is framed through an Afrocentric and Coafrwological perspective, integrating insights from decolonial theory, transpersonal psychology, and African philosophy. Healing requires a re-rooting of African minds in Indigenous spiritual, cultural, and epistemic orders.

Among the various instruments used in literature, the Big Three Perfectionism Scale (BTPS) is designed to meet the need for a comprehensive and current tool for the measurement of perfectionism and the assessment of personal tendencies. The present study adapts and examines the psychometric properties of the Turkish versions of both the BTPS-45 and BTPS-16, based on the responses of 427 Turkish community adults who were recruited for the purpose. All of the respondents were assessed with the two popular perfectionism scales, and for dark personality features and psychological problems, while 109 re-completed the BTPS-45 and BTPS-16 scales for the evaluation of test-retest reliability 2 weeks later. The results of the confirmatory factor analysis conducted to test the various models with different factor structures showed that the models comprising the three main and 10 sub-dimensions of the BTPS-45 and three main dimensions of the BTPS-16 showed the best fit. The significant relationships found between the BTPS factors, the scores recorded from the other perfectionism scale, the dark triad and the psychopathology symptoms all supported the validity of both the BTPS-45 and the BTPS-16. The findings further indicated that the structures of these forms had acceptable internal consistency and demonstrated satisfactory test-retest reliability. The reliability and validity of the Turkish versions of the long and short forms of the BTPS were thus established, supporting their use in further empirical studies and psychological interventions.

À l’époque du darwinisme, de la sociologie naissante, de la neurologie psychiatrique et de la criminologie, le remords est au centre d’un renouveau romanesque et d’une controverse philosophique. Ce concept clé de la morale, vieux de plus de deux-mille ans (les Grecs païens s’en servaient bien avant le christianisme), jure avec l’eudémonisme moderne et semble apporter un démenti à Sade au profit d’un retour en force de la culpabilité. Mais ce ne sont pas toujours des spiritualistes qui le relancent : dans Thérèse Raquin, Zola remet au goût du jour une expérience douloureuse de la faute et tente de l’expliquer avec des arguments matérialistes. Puis il revient sur la psychopathologie du criminel dans La Bête humaine. Dans l’intervalle entre ces deux romans, Crime et châtiment est traduit en français et soulève une controverse philosophique dans lequel les chrétiens, les darwinistes, les kantiens et les schopenhaueriens se battent, chacun voulant démontrer que le roman de Dostoïevski leur donne raison. Ce livre est centré sur un moment précis du débat moderne autour du crime, mais il remonte, pour l’éclairer, à la tradition doctrinaire du remords chrétien, que les « nouveaux remords » antispiritualistes cherchent à remplacer. La longue durée de ce débat fait signe également vers les enjeux de la faute, de la responsabilité et de la réparation dans les sociétés d’aujourd’hui.

Background: Research has established a relationship between psychosis and physical harm in the early course of psychosis. However, little is known about the relationship between specific psychosis symptoms, such as hearing voices, and physical harm. Objective: This study aimed to determine the prevalence and typology of physical harm related to hearing voices, as well as what aspects of the voice-hearing experience retrospectively predicted incidents of harm within an Early Intervention in Psychosis Service (EIPS). We conducted a quality improvement project in a single EIPS. We reviewed case notes of patients and extracted information on the cognitive-phenomenological features of the voices patients heard, as well as any incidents of physical harm that were causally linked to these voices. Results: It was found that 32.2% of EI patients had an actual incident of physical harm in their case notes that was causally linked to hearing voices. The most common type of physical harm was neglect. In terms of cognitive phenomenological binary correlations that retrospectively predicted physical harm in the case notes, patients were 20 and 7 times more likely to have harmed themselves if they heard self-harm commands (i.e., directions to harm themselves physically) and perceived the voice as omnipotent, respectively. Patients were 6 times more likely to have harmed someone else if they heard violent commands. Verbal auditory hallucinations commonly influence physical harm in the early course of psychosis. Hearing commands and/or believing the voice to be omnipotent are strong retrospective-correlative predictors that may aid in the assessment and therapeutic intervention.

Background: Postpartum depression (PPD) is a significant public health concern, particularly in lowresource settings where access to mental health care is often limited. The condition can adversely affect maternal health, infant development, and family dynamics, necessitating effective identification and management strategies. Aim: The study aimed to investigate the prevalence of postpartum depression and assess the effectiveness of management strategies in low-resource settings. Methods: This prospective observational study was conducted at Civil Hospital Kahuta Rawalpindi from October 2023 to September 2024. A total of 80 postpartum women were recruited using purposive sampling. Participants were screened for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and those with positive findings were assessed further through clinical interviews. Management strategies, including counseling and pharmacotherapy, were implemented based on the severity of symptoms, and outcomes were monitored over a six-months period. Results: The prevalence of postpartum depression in the study population was found to be 45%, with a higher occurrence among women with limited social support and financial constraints. Counseling was provided to all diagnosed cases, while 33% required additional pharmacological intervention. After four weeks of management, 75% of participants reported significant improvement in depressive symptoms, with better outcomes observed in those who adhered to the recommended treatment protocols. Conclusion: Postpartum depression was prevalent in a substantial proportion of women in low-resource settings. Tailored management strategies, combining counseling and pharmacotherapy, proved effective in alleviating symptoms. The findings underscore the need for integrating mental health services into maternal care programs in low-resource settings to ensure early detection and intervention for PPD.

Background: This syndrome known as Metabolic syndrome (MetS) including obesity, diabetes, and hypertension are being increasingly implicated in the causation of several urological disorders such as renal stones, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS). These metabolic disturbances of MetS including insulin resistance and chronic inflammation advanced in this disease may play a key role in the development and progression of these disorders. Aim: The purpose of this present research was twofold: to review and determine the relationship between MetS and urological disorders/ diseases and to examine the possible pathophysiological relationship between MetS components and urological health consequences. Method: A cross sectional study; therefore, the sample of the population included people characterized by their metabolic status. The study also included clinical measurements of MetS and its components such as BMI, fasting blood glucose and blood pressure in addition to diagnostic tests for kidney stones, ED, and LUTS. Correlation and risk factors were done by regression models/statistical tests. Results: MetS was associated with a higher prevalence of kidney stones, ED and LUTS than no MetS. Overweight/obesity was positively related to the prevalence of kidney stone disease and LUTS while diabetes and hypertension had positive association with ED. The results of statistical models showed that the risk of urological diseases with MetS through Insulin resistance and vascular dysfunctions are increased. Conclusion: The finding has captured the significant relationship between MetS and urological disorders hence posturing that if the MetS complications are managed by lifestyle changes and medication, then the above illnesses could be addressed. MetS management should be included as a part of routine urological practice to recommend patient education and cooperation of urologist with metabolic expert.

Objective: To evaluate the frequency of Pospartum Depression in patients attending Postnatal Clinic in Fauji Foundation Hospital, Peshawar.Material & Methods: This descriptive, cross-sectional study was conducted in Gynaecology, Psychiatry and Medical OPD of Fauji Foundation Hospital from January 2011 to June 2012. A sample of 139 women attending the postnatal clinic within 6 weeks of their delivery were included using consecutive, non-probability sampling and screened through the Urdu version of Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of 11. Data was analyzed using SPSS version 16.Results: Out of 139 participants, 51 (36.69%) were found to be suffering from Postnatal Depression. Of the total participants, 88 (63.3%) were from age group 18-35 years. We found that class 8 students 18 (35.3%) is showing the maximum EPDS score. 32 (62.7%) participants having &gt;11 score have delivered their babies through spontaneous vaginal delivery and 35 (68.6%) participants...

Background: Breast cancer remains one of the leading causes of morbidity and mortality among women globally. Early detection and awareness of associated risk factors are essential to improve prognosis and reduce disease burden, particularly among females of reproductive age. Aim: The study aimed to determine the prevalence, identify the risk factors, and assess the effectiveness of early detection practices for breast cancer among females of reproductive age. Methods: A cross-sectional study was conducted at Allied Hospital Faisalabad. The study population comprised 100 females of reproductive age. Data were collected between February 2024 and January 2025 using structured questionnaires, clinical evaluations, and screening tests including breast selfexamination awareness and clinical breast examinations. Demographic variables, family history, lifestyle factors, and reproductive history were assessed. Results: The prevalence of breast cancer in the study population was found to be 7%. Significant risk factors included a positive family history of breast cancer (p<0.01), early menarche (p=0.03), nulliparity (p=0.04), and obesity (p<0.05). Only 38% of participants reported practicing regular breast selfexamination, and just 25% had ever undergone a clinical breast examination. Lack of awareness and cultural stigma were identified as major barriers to early detection. Conclusion: The study highlighted a notable prevalence of breast cancer among reproductive-age females, with several modifiable and non-modifiable risk factors. The low uptake of early detection methods emphasizes the need for public health strategies focused on awareness, education, and accessible screening programs to promote early diagnosis and better outcomes.

There is large consensus across clinical research that feelings of worthlessness (FOW) are one of the highest risk factors for a patient's depression becoming suicidal. In this paper, I attempt to make sense of this empirical relationship from a phenomenological perspective. I propose that there are purely reactive and pervasive forms of FOW. Subsequently, I present a phenomenological demonstration for how and why it is pervasive FOW that pose a direct suicidal threat. I then outline criteria, contingent upon empirical verification, by which clinicians can more confidently identify when a patient's FOW place them at high risk of suicide.

Introdução: O Transtorno de Personalidade Antissocial (TPA) pode ser considerado um problema para a sociedade, pois os portadores deste transtorno não sentem remorso ou culpa, mas sim, prazer em causar sofrimento às vítimas. A cada 25 pessoas, uma sofre do Transtorno de Personalidade Antissocial. Objetivo: O presente artigo tem como objetivo discutir suas características e buscar a relação entre o transtorno e fatores genéticos, biológicos e psicossociais. Método: A metodologia utilizada foi caracterizada por revisão integrativa durante o ano de 2018 no banco de dados do Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Resultados: Os resultados desse estudo concluíram a dificuldade, não somente do cidadão comum, mas também da literatura, em diferenciar com precisão psicopatia e sociopatia, mesmo sendo os dois transtornos prejudiciais ao sujeito. As causas da psicopatia podem ser genéticas (discute-se a sua hereditariedade), biológicas (alterações no lobo pré-frontal responsável por emoções e comportamentos sociais) ou psicossociais (negligência parental, abusos físicos ou mentais, exposição a ambientes negativos e situações conflituosas). Conclusões: Concluiu-se a dificuldade de encontrar tratamento eficaz para o transtorno de personalidade antissocial e visto que os psicopatas não buscam tratamento, não se pôde ainda encontrar uma cura, sendo assim, a necessidade de mais estudos para que o transtorno de personalidade antissocial que vem se tornando um problema de saúde pública seja mais compreendido pela comunidade científica, buscando dessa forma, um prognóstico mais positivo para o tratamento do transtorno.

Este artigo pretende discutir sobre a medicalização da sexualidade cercada pelas questões históricas e sociais, e refletir sobre alguns transtornos presentes nas versões do Manual de Diagnóstico e Estatístico dos Transtornos Mentais (DSM), por meio dos estudos de gênero. Entende-se que a sexualidade constitui um importante dispositivo social de controle sobre as pessoas . O DSM possui uma importância política para a sociedade e denuncia os sujeitos anormais da sociedade. Parte das normas acerca da sexualidade é relacionada ao modo como cada cultura lida com a reprodução, os papéis sociais do masculino e feminino, e com o fim de manter os gêneros e as práticas sexuais presas à diferença sexual. Cumpre à sociedade recusar esse projeto patologizante e se abrir para uma sexualidade fluida e dinâmica.

Generally speaking, BPD is a cognitive-affective disposition that shapes one's conception and experience of herself, and also her experiences of interrelationality. Many BPD symptoms relating to affect regulation are spurred by psychosocial complications that can then exacerbate psychosocial complications in future relationships. One consequence of affective dysregulation due to abuse-induced trauma can be persistent interpersonal breakdowns. Such breakdowns can be caused by the inability of two differently affectively disposed persons to harmonize according to what person each needs based on a set of supposedly shared norms and expectations. Attempting to identify specific ethical issues related to affective disruptions in interrelational harmonizing requires that one pull together the embodied experiences of BPD and the effects of those experiences on interpersonal relationships and then position that distinctive dynamic within an ethico-epistemological framework. I believe that one critical trigger for BPD affective dysregulation comes from the role of abuse-induced trauma in the cultivation of the BPDer's body memory. I offer a description of this phenomenology, which I ground in the philosophy of embodied cognition. The relationship between trauma and the embodied memory matters to ethical conversations about BPD because it is crucial to see how trauma that manifests as a specific kind of affective disposition can influence the ethical harmonizing of interpersonal interactions. I write this analysis from my own first-person experience of someone diagnosed with severe BPD.