Causes Of Mental Illness Research Articles

Perceptions and Beliefs Towards Mental Health and Mental Illness: A Qualitative Study among University Students in Malaysia

Introduction: University students’ perspectives on mental health issues remain scarce despite the growing prevalence of mental illness among this population. Therefore, this study aimed to explore university students’ perceptions and beliefs about mental health and mental illness. Methods: Virtual in-depth interviews were conducted from December 2021 to March 2022. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Sixteen informants from a Malaysian university were interviewed. Four major themes emerged: (1) understanding of mental health and mental illness; (2) perceived causes of mental illness; (3) attitudes towards mental illness; (4) strategies to maintain good mental health. Most informants related mental health to an individual’s thoughts, emotions and behaviours, while a minority equated ‘mental health’ with ‘mental illness’. The majority of informants cited socio-environmental factors as the primary cause of mental illness. Unexpectedly, informants did not view religious factors as a cause of mental illness, although it was thought to be deeply rooted in the older generation. Nearly all informants expressed positive attitudes and willingness to help people with mental illness. However, some informants decided to cover up their mental health problems to avoid the likelihood of experiencing negative emotions. Most informants believed that living a fulfilling and balanced life, staying optimistic and being religious could help them to maintain good mental health. Conclusion: To mitigate the deterioration of students’ mental health, it is necessary to understand their perceptions and beliefs about mental health and mental illness as these may influence their help-seeking behaviours. The study findings showed that university students have a basic understanding of mental health and mental illness and most of them are supportive in handling people with mental illness.

Exploring Mental Health Awareness: A Study on Knowledge and Perceptions of Mental Health Disorders among Residents of Matsafeni Village, Mbombela, Mpumalanga Province.

The global rise in mental health disorders has significant social, economic, and physical impacts. Despite advancements in support, cultural beliefs attributing mental illnesses to spiritual causes persist, fostering discrimination and stigmatization. The study aims to explore the understanding and perceptions of mental health in Matsafeni Village, acknowledging the complexity of mental health issues. A qualitative method and a descriptive exploratory design were employed, enabling the researcher to describe, examine, and explore the knowledge and perceptions regarding mental health. Data collection was conducted through unstructured, open-ended interviews, with 15 participants selected through convenience sampling. The data were analyzed through thematic analysis. Measures of rigor were ensured through credibility, transferability, confirmability, and dependability. Participants demonstrated knowledge of mental health disorders, recognizing disruptions in thought patterns and diverse symptoms. They highlighted key signs and behaviors, emphasizing the need for spotting indicators such as untidiness. Perceptions of the causes of mental illness varied, including witchcraft and genetics. Participants unanimously advocated for seeking help from traditional healers, medical facilities, and therapies. Community members shared their views of mental health, covering their understanding, recognition of signs, personal interactions, and observations of behaviors in individuals with mental health conditions. Reported symptoms align with existing research, emphasizing the complexity of managing safety concerns in severe mental illnesses. The study highlights the need for community education to reduce stigma, considering cultural factors in mental health perceptions. Recommendations include early interventions, enhanced mental health services, and collaboration between western and traditional approaches for a holistic and culturally sensitive approach to mental health.

The 'social' in psychiatry and mental health: quantification, mental illness and society in international scientific networks (1920s-1950s).

The post-World War II international mental health movement placed significant emphasis on the concept of the 'social environment', a true paradigm shift in thinking about the causes of mental illness. Rather than focusing on individual risk factors, experts and policy-makers began to consider the interplay between social context and mental health and illness. Also, during this period, quantification gained prominence within the expanding field of Western psychiatry. Eventually, the concept of the 'social' became fragmented into quantifiable social determinants that could be correlated with mental illness and subjected to systematic neutralization. This trajectory paved the way for the prevailing biomedical psychiatric epidemiology. This broader inquiry challenges us to redefine our understanding of the 'social' in the context of mental health research and practice.

Children with Mental Illness and Their Families: Problems and Implications for Social Work

This paper aims to assess the situation of children’s mental health as well as the problems that their families are facing. The results show that, currently, children in the study are facing many types of mental illness with different levels from light to serious mental health problems. Attention deficit hyperactivity disorder is the highest rate among mental health types. The causes of mental illness are quite diverse, including psychological and social causes. With such a situation, their families are also facing different issues and difficulties such as stress in the family; economic decline; being discriminated against; lack of childcare knowledge. Based on the study findings on the child mental health situation and the problems encountered by the family, the article has provided some information and discussions about solutions in general as well as emphasized on the implications of social work in intervening and supporting the problems that the research has discovered.

Indigenous Knowledge and Perception Toward Mental Illnesses Within Goma City in Democratic Republic of Congo

Background: Prevailing wars for more than two decades have been associated with the increased burden of mental illnesses (MIs) in North-Kivu province (NKP), in Democratic Republic of Congo (DRC). The community perception of this claim has, however, not been fully documented. Aims: To assess the knowledge and perception of Goma city residents on MI and their associated factors. Methods: Cross sectional study, was conducted among 610 selected community residents including key informants of Goma city from April to July 2021. Quantitative data from semi-structured interviews was analyzed using descriptive statistics and binary logistic regression, while data from Focus group discussions (FGDs) were analyzed using qualitative thematic analysis. Results: Among residents of Goma city, rates of correct recognition of MIs namely schizophrenia, anxiety, depression and neurodevelopment disorders varied: 96.6%, 29.7%, 39.5% and 14.3%, respectively. The major causes of MIs perceived by respondents were spiritual (67.5%) and substance abuse (56.7%). Qualitative data from FGD’s revealed three major themes for poor perception of MI among residents as indigenous names of various MIs, reason of preferring traditional medicine versus conventional medicine (CM) and challenges faced in management of MIs using CM. Furthermore, demographic factors such as education, religion, occupation and age were not statistically significant (p˃0.05) in predicting one’s odds of MI perception among Goma city residents. Conclusion: The findings revealed that residents of Goma city have poor knowledge and perception on MIs regardless of education, religion, occupation and age.

Problems of diagnostic psychiatry—and the search for a way forward

The recent history of psychiatry is one of diagnostic expansion. Since the etiological model of mental illness was superseded by the symptom model around 1980, new diagnoses have continuously been added to the reigning manuals of psychopathology, most recently with DSM-5 and ICD-11. This article unfolds some of the criticism that has recently been directed at diagnostic psychiatry with a focus on two quite different lines of critical thought: One represented by a neuroscientific approach known as RDoC, which argues that psychiatry must move beyond symptoms and find the causes of mental illness in the brain (Insel et al., 2010), and another represented by a contextual approach known as PTMF, which argues that mental distress is by and large understandable in light of what happens to people (Boyle & Johnstone, 2020). These oppositional perspectives stand out as prototypical, and each contain valuable insights but also limitations. The article ends by arguing that the limitations can be overcome if the perspectives are united by a hybrid theory stating that mental illness is always a property of a relation between a person and an environment. Two such theories are introduced and discussed (Gannik, 2002; Wakefield, 1992).

New Technologies to Diagnose and Treat Mental Health Problems

This article introduces three novel approaches and technologies to the field of mental health and psychiatry, these are: digital sensors, neural network computing, and neuromodulation pacemakers to the brain. Sensors built into devises such as smartphones and smart watches can monitor and diagnose mental disorders. Neural computing simulate how the brain may function in health and disease, thus offering valuable information about possible causes for these disorders. Finally therapeutic interventions can be achieved with brain-pacemakers technologies. Have you ever wondered what technologies such as smartphones could have to do with mental health? When we talk about mental health problems, we are usually referring to difficulties with emotions and thoughts that can affect our daily functioning. There are three new technologies that are revolutionizing how we diagnose and treat mental disorders. The first is the smartphone. Smartphone-based technology enables continuous monitoring of a patient’s mental state and allows doctors to diagnosis, evaluate, and even treat patients from afar. The second technology is neural computing, which seeks to understand the physical, brain-based causes of mental illnesses. Finally, brain pacemaker technologies may make it possible to cure mental illnesses in the same way that pacemakers currently cure heart problems. Keep reading to hear the details of each of these fascinating advances in mental healthcare!

Altered Inhibitory Control Mechanism of Internet Addiction: An Electroencephalogram Study of Brain Oscillations and Connectivity.

The development of the Internet has changed people's lives and has resulted in a new type of addictive behavior. In the past decade, Internet game addiction has been identified as a mental illness. Considering internet game addiction as the only cause of mental illness is limited in its view, as internet games, social platforms and other internet multimedia are also widely used. Thus, other internet-related behaviors, that maybe addictive, should also be included. Previous neuroimaging studies have reported a role of alteration in brain's inhibitory control mechanism in addiction. However, the results are still diverse with inconsistent findings. In this study, we used an Internet-related stop signal task with EEG signals recorded to study the relationship between internet addiction through brain oscillations and functional connectivity. We also compared the differences in the brain connectivity between addicted and non-addicted participants using phase lag index. We found that the brain connectivity in participants addicted to the internet is significantly greater than that of nonaddicted users.Clinical Relevance- In this study, we assessed brain functional networks of participants with Internet Gaming Disorder and internet addiction.

A method of mental disorder recognition based on visibility graph

The causes of mental disorders are complex, and early recognition and early intervention are recognized as effective way to avoid irreversible brain damage over time. The existing computer-aided recognition methods mostly focus on multimodal data fusion, ignoring the asynchronous acquisition problem of multimodal data. For this reason, this paper proposes a framework of mental disorder recognition based on visibility graph (VG) to solve the problem of asynchronous data acquisition. First, time series electroencephalograms (EEG) data are mapped to spatial visibility graph. Then, an improved auto regressive model is used to accurately calculate the temporal EEG data features, and reasonably select the spatial metric features by analyzing the spatiotemporal mapping relationship. Finally, on the basis of spatiotemporal information complementarity, different contribution coefficients are assigned to each spatiotemporal feature and to explore the maximum potential of feature so as to make decisions. The results of controlled experiments show that the method in this paper can effectively improve the recognition accuracy of mental disorders. Taking Alzheimer's disease and depression as examples, the highest recognition rates are 93.73% and 90.35%, respectively. In summary, the results of this paper provide an effective computer-aided tool for rapid clinical diagnosis of mental disorders.

Identifying emotional causes of mental disorders from social media for effective intervention

Identifying the emotional causes of mental illnesses is key to effective intervention. Existing emotion-cause analysis approaches can effectively detect simple emotion-cause expressions where only one cause and one emotion exist. However, emotions may often result from multiple causes, implicitly or explicitly, with complex interactions among these causes. Moreover, the same causes may result in multiple emotions. How to model the complex interactions between multiple emotion spans and cause spans remains under-explored. To tackle this problem, a contrastive learning-based framework is presented to detect the complex emotion-cause pairs with the introduction of negative samples and positive samples. Additionally, we developed a large-scale emotion-cause dataset with complex emotion-cause instances based on subreddits associated with mental health. Our proposed approach was compared to prevailing CNN-based, LSTM-based, Transformer-based and GNN-based methods. Extensive experiments have been conducted and the quantifiable outcomes indicate that our proposed solution achieves competitive performance on simple emotion-cause pairs and significantly outperformed baseline methods in extracting complex emotion-cause pairs. Empirical studies further demonstrated that our proposed approach can be used to reveal the emotional causes of mental disorders for effective intervention.

Ketamine and the Disinhibition Hypothesis: Neurotrophic Factor-Mediated Treatment of Depression.

Ketamine is a promising alternative to traditional pharmacotherapies for major depressive disorder, treatment-resistant depression, and other psychiatric conditions that heavily contribute to the global disease burden. In contrast to the current standard of care medications for these disorders, ketamine offers rapid onset, enduring clinical efficacy, and unique therapeutic potential for use in acute, psychiatric emergencies. This narrative presents an alternative framework for understanding depression, as mounting evidence supports a neuronal atrophy and synaptic disconnection theory, rather than the prevailing monoamine depletion hypothesis. In this context, we describe ketamine, its enantiomers, and various metabolites in a range of mechanistic actions through multiple converging pathways, including N-methyl-D-aspartate receptor (NMDAR) inhibition and the enhancement of glutamatergic signaling. We describe the disinhibition hypothesis, which posits that ketamine's pharmacological action ultimately results in excitatory cortical disinhibition, causing the release of neurotrophic factors, the most important of which is brain-derived neurotrophic factor (BDNF). BDNF-mediated signaling along with vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF-1) subsequently give rise to the repair of neuro-structural abnormalities in patients with depressive disorders. Ketamine's efficacious amelioration of treatment-resistant depression is revolutionizing psychiatric treatment and opening up fresh vistas for understanding the underlying causes of mental illness.

Assessing Mental Health Crisis in Pandemic Situation With Computational Intelligence

Covid-19 pandemic has created huge emotional distress and increased the risk of psychiatric problems. This happened owing to imposition of necessary stringent healthcare measures that infringed personal space, emotional freedom, and caused financial loss. Our physical well-being is directly associated with mental fitness and health. From analysis it has been found that feature like struggling in concentration and memory, visionary issues, and arthritis are customary symptoms in patients suffering from mental crises. Our proposed research work aims to find out the reasons behind mental illness and ways to improve mental disorders using supervised approach. The main focus is to develop a smart computationally intelligent model to assist healthcare practitioners in analysing and diagnosing severe mental illness. Our proposedmodel assists in analysing causes of mental disorder and aids in reducing total medicinal cost along with reduced mental illness rate. Additionally, a recommendation system is also developed for diagnosing depressive patients.

The prevalence and correlates of depression among older adults in greater Kumasi of the Ashanti region

BackgroundApproximately two million Ghanaians suffer from mental disorders including depression. The WHO defines it as an illness characterized by constant sadness and loss of interest in activities that a person usually enjoys doing and this condition is the leading cause of mental disorders; however, the burden of depression on the aged population is fairly unknown. A better appreciation of depression and its predictors is necessary to design appropriate policy interventions. Therefore, this study aims to assess the prevalence and correlates of depression among older people in the Greater Kumasi of the Ashanti region.MethodsA cross-sectional study design with a multi-stage sampling approach was employed to recruit and collect data from 418 older adults aged 60 years and above at the household level in four enumeration areas (EAs) within the Asokore Mampong Municipality. Households within each EAs were mapped and listed by trained resident enumerators to create a sampling frame. Data was collected electronically with Open Data Kit application over 30 days through face-to-face interaction using the Geriatric Depression Scale (GDS). The results were summarized using descriptive and inferential statistics. A multivariable logistics regression using a forward and backward stepwise approach was employed to identify the predictors of depression in the study sample. All analyses were performed using STATA software version 16, and the significance level was maintained at a p-value < 0.05 and presented at a 95% confidence interval.ResultsThe study achieved a response rate of 97.7% from the estimated sample size of 428 respondents. The mean age was 69.9 (SD = 8.8), and the distribution was similar for both sexes (p = 0.25). The prevalence of depression in this study was 42.1% and dominated by females, older adults (> 80 years), and lower economic class respondents. The rate was 43.4% for both consumers of alcohol and smokers with a history of stroke (41.2%) and taking medication for chronic conditions (44.2%). The predictors of depression in our study were being single, low class [aOR = 1.97; 95% CI = 1.18–3.27] and having other chronic conditions [aOR = 1.86; 95% CI = 1.59–4.62], and the inability to manage ones’ own affairs [aOR = 0.56; 95% CI = 0.32–0.97].ConclusionThe study provides data that can inform policy decisions on the care of the elderly with depression in Ghana and other similar countries, confirming the need to provide support efforts towards high-risk groups such as single people, people with chronic health conditions, and lower-income people. Additionally, the evidence provided in this study could serve as baseline data for larger and longitudinal studies.

Policy Recommendations to Improve Mental Health in Polish Prisons

Context: Mental health is a central aspect of public health and social development, as such it corresponds to target 3.4 of the Sustainable Development Goals. This target aims to promote mental health and well-being, making it especially necessary to address this matter in environments such as prisons where exposure to risk factors is high. Incarceration itself is a cause of mental illness. Central and Eastern European countries hold some of the highest prison populations in the region and Poland numbers in this regard are 50% higher than the average in the European Union (EU) (about 179 inmates per 100,000 inhabitants). In Polish prisons, the chance of receiving adequate psychiatric and psychological care is limited due to a shortage of trained personnel and scarce infrastructure. However, data on mental health in Polish prisons is not routinely reported from official sources. Article 150 of the Polish Penal Code attempts to protect the mental health of inmates; yet, in reality, there is no legal enforcement to apply these measures, a feature shared with most of its neighbouring countries. The aim of this policy brief is to offer recommendations to lower recidivism rates, up-scale prison staff and create spill-over effects on (mental) healthcare and security in Polish prisons.Policy Options: The World Health Organization (WHO) European Framework for Action on Mental Health 2021-2025 should be adapted to the Polish Prison System. Best practices focus on a collaborative approach centred on healthcare services, labour policies, well-being and rehabilitation. Ideally, incarceration provides inmates with the possibility to be included and active, to see their relatives, to vote, to be engaged and maintain contact with the outside society. These best practices statistically reduce mental illnesses, lower recidivism and promote inclusion and rehabilitation. Recommendations: To tackle mental health challenges that prisoners in Poland experience, it is recommended to adapt a new approach with the following components: improving methodological quality of data collection as well as routine reporting to enable good governance structures, promoting collaborative efforts among stakeholders, and strengthening existing resources through capacity building which has been convincingly demonstrated as the most cost-effective type of interventions.

How does the public understand the causes of mental disorders? An analysis of Irish news media before and during the COVID-19 pandemic.

Public perceptions of the determinants of mental illness have important implications for attitudes and stigma, but minimal previous research has explored how causal attributions are spontaneously invoked in everyday public discourse. This study investigated how causal explanations for mental illness are disseminated in popular Irish news media, in the two years before and after the onset of the COVID-19 pandemic. Keyword searches of a news media database identified 1,892 articles published between March 2018 to March 2022 that mentioned one of six categories of mental disorders: anxiety disorders, mood disorders, substance-related disorders, personality disorders, eating disorders, and psychotic disorders. Overall, 25% of the identified articles contained a causal explanation for mental illness. Inductive content analysis revealed the content and prevalence of eight types of causal explanations for mental disorders. Overall, attributions to life events/experiences, the cultural/societal environment, interpersonal relations, and health and lifestyle factors occurred more frequently than attributions to biological or psychological determinants. Life events/experiences were the most common explanation for anxiety and personality disorders, cultural/societal environment for eating disorders, and health/lifestyle factors for mood and psychotic disorders. Interpersonal factors in mental illness aetiology became more salient following the COVID-19 pandemic. The findings emphasise the need for theory and research on lay explanations of mental disorders to account for diversity, both in the range of attributions invoked, and in how attributional patterns shift across time and mental disorders category.

Ethnographic study of mental illness in Enugu-Ezike town, Nigeria

Enugu-Ezike community stands out in the Southeast of Nigeria as regards the practice of traditional medicine. Their traditional healers have been making remarkable success in the area of healing mental illness through indigenous knowledge. The acclaimed success has been made possible through different methods and practices. This research is focused on mental illness in Enugu-Ezike, Nigeria as it seeks to document the different types of mental illness and examine the causes and methods of diagnosing the ailment and cure. The study also sought to determine the active ingredients found in traditional herbs used in the treatment of mental illness. The study was conducted using both qualitative and quantitative methods of data collection. A semi-structured interview was conducted for the key informants, which include traditional healers and elders with rich cultural knowledge about the mental health system. Information from individuals healed from mental illness and their caregivers corroboratedthe data from the traditional healers and elders. Two sets of instruments were used for data collection, namely: a structured questionnaire and an interview guide. A participant as an observer was also used to gather data. Data analysis was mostly descriptive, relying on generated data from both qualitative and quantitative methods. The result of the study emanates from all the data generated, including the chemical analysis of roots/herbs used in mental treatment. The results showed that violating taboos,anger toward ancestral spirits, and stealing are the causes of mental illness. Divination, sacrifices, and physical observation are the commonest methods of diagnosis. Treatment of mental illness takes different forms such as the administration of herbs and roots, sacrifices to appease the angered spirits, and rituals. Chemical analysis reveals that active metabolites found in plants used by healers in the treatment of mental illness in other places were also found in herbs used by traditional healers in the study area.

Use of a Two-Eyed Seeing Approach to Increase Client Satisfaction with Psychiatric Services Among an Indigenous Population

IntroductionPsychiatry has historically had difficult relationships with Indigenous people, tending to dismiss their views on mental health and illness as superstitious or primitive. Indigenous people have responded by refusing to come for services, missing appointments, and dismissing treatment offered. Canadian Mi’qmak elder Albert Marshall introduced the term, etuaptmumk, to highlight the idea that Indigenous Knowledge and Practice has equal value to contemporary psychiatry. While translated as two-eyed seeing, the term refers to explanatory pluralism and invites a respectful dialogue among cultures as equals.ObjectivesWe implemented a two-eyed seeing research in Indigenous communities to explore the differences of some Indigenous North American cultures in their view of mind and mental health from conventional Euro-American psychiatry and how their cultural practitioners negotiated those differences. We wondered how perception of services would change if mental health practitioners were aware and were more respectful of those differences.MethodsWe engaged in a series of discussions with traditional knowledge keepers about their views on mind and mental health. We used constructivist grounded theory methods to identify what was common among these views. We developed a training program to engage mental health clinicians in understanding and responding to these differences. We engaged community members receiving services in a discussion about their perception in the change in the quality of the services. We summarized their responses.ResultsDifferences between Indigenous views and those of conventional psychiatry included (1) greater emphasis on the role of community and socio-environmental influences on mental health, (2) inclusion of spirituality and spiritual beings in their expectation for cause of problems and treatment, (3) greater emphasis on inter-generational trauma and historical trauma in addressing mental health. After inclusion of practitioners in the mental health services who had been oriented to these differences and integration of ceremony into the mental health services, ninety-four percent of respondents asked if the service had improved responded in the positive. Attendance at scheduled appointments increased from 56% to 81%. Adherence to recommendations increased from 27% to 67%, which were significant.ConclusionsAwareness of cultural differences in beliefs about causes of mental illness and acceptable types of treatment increased client satisfaction with services offered, improved attendance rates, and improved adherence rates to treatments offered among Indigenous people. These results could generalize to other populations who hold different views than those of conventional psychiatry. The concept of two-eyed seeing, or explanatory pluralism, holds heuristic value for psychiatry by allowing multiple points of view to be true at the same time.Disclosure of InterestNone Declared

Preferences for Health Care and Its Determinants Among Mentally Ill Patients of the West Shoa Zone Community, Oromia, Ethiopia.

Over 9 million people die from mental diseases each year, making them the second highest cause of mortality and the primary cause of disability worldwide. To explore the preferences for health care and its determinants among mentally ill patients in the West Shoa Zone Community in Oromia, Ethiopia, from July 11-September 20, 2022. The preference for health care and its determinants among mentally ill patients in the West Shoa Zone community were explored using an ethnographical study. Purposefully, a total of 16 FGD participants and 10 unstructured interview subjects, who had pertinent experiences and perspectives, were carefully selected from the urban and district levels. Data was collected utilizing two approaches in a triangulated manner and then coded, findings were contextualized, and a thematic plot was developed for thematic analysis. In this study, in response to the questions, three main findings were thematized according to the causes, and six sub-themes were framed under the themes according to the preferences for treatment among mentally ill patients. The themes that emerged from the data were; 1. Supernatural causes, 2. Traditional non-spiritual beliefs and practices; and 3. Medico-surgical problems. The majority of the participants responded that residents preferred religious spiritualists the most (46%), followed by traditional counselors (Wabeka) (19%), traditional spiritualists (15%), institutional care (12%), herbalists (4%), and psychologists (4%). In this study, the most commonly perceived causes of mental illnesses were bad spirits, devilish activity, and engaging in actions that violated social norms and regulations. Religious spiritualists were the study's first choice for mental health care. This study advises collaboration and a shared strategy between health care professionals and traditional and religious stakeholders.

Rituximab for treatment-resistant schizophrenia and/or obsessive-compulsive disorder (OCD): functional connectivity and cytokines associated with symptomatic improvements

IntroductionImmunological mechanisms may contribute to the causation of mental illness. Autoimmunity is most convincingly shown for anti-NMDA-R encephalitis and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS); disorders that overlap clinically with schizophrenia and OCD. Altered inflammatory cytokine production, glial activation and auto-antibodies have also been associated with schizophrenia and OCD. In these disorders, however, the treatment results with anti-inflammatory or immunomodulating drugs have hitherto been limited and inconsistent. Yet other targets within the immune system may still be effective and new options are warranted for treatment-resistant patients. Rituximab targets B-lymphocytes and is often used in autoimmune disorders such as rheumatoid arthritis, multiple sclerosis and anti-NMDA-R encephalitis.ObjectivesWe aimed to investigate whether rituximab is clinically effective, safe and tolerable as add-on therapy in markedly ill, treatment-resistant adult psychiatric patients with schizophrenia or OCD. We also wanted to identify putative mediating mechanisms in treatment responders, such as cytokine changes and functional connectivity (FC).MethodsIn an open pilot study, adults (18-39 years) with treatment-resistant schizophrenia and/or OCD were included. They received an intravenous infusion of rituximab 1000 mg, once at baseline, in addition to their regular psychiatric medication and were followed for 1 year. The main outcome measures were the Positive and Negative Syndrome Scale (PANSS) or Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impression-Improvement scale (CGI-I) and the Personal and Social Performance scale (PSP). Treatment response was defined as ≥ 40 % decrease in PANSS or ≥ 35 % decrease in Y-BOCS, and much improved according to CGI-I. Resting-state fMRI was applied at baseline and after 5 months. Plasma cytokines were measured at 0, 3 and 5 months. Cognitive tests and the recently developed PsychoNeuroinflammatory Related Signs and Symptoms Inventory (PNISSI) were used to identify and measure symptoms related to neuro-inflammation and cognitive function.ResultsNineteen patients were treated with rituximab. 3-5 months after treatment, 6/9 patients with schizophrenia and 1/10 with OCD responded. One schizophrenia patient continues with rituximab every 6 months and has reportedly done well for almost 3 years. No severe side effects were reported apart from recurrent abdominal pain in a schizophrenia patient and one case of post-COVID-19 syndrome. Significant changes of FC were detected in responders only and correlated with PSP changes.ConclusionsAberrant B-cell activities may contribute to treatment-resistant schizophrenia and be amenable to treatment with rituximab. However, the results of this pilot study need confirmation in placebo-controlled trials.Disclosure of InterestNone Declared

On the Impact of Environmental Design on Mental Disorders in Adolescents

High prevalence of attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, tic disorder, obsessive-compulsive disorder and separation anxiety disorder in the population aged 6 to 11 years is becoming an increasingly urgent social problem, in order to solve which various methodologies have been raised, but all of which have been proved that negative effects coexist with the expected results. This passage is going to solve the dilemma that no perfect solution is precedent and available. In this passage, a new mitigation method which is asserted to be both efficient and harmless is raised. This passage indicates the potential causes of mental disorders occurring among adolescents, which are biological reasons, endocrine functions, physical causes, family factors and parental rearing methods. Traditionally utilized methodologies, which are drug therapies, sensory deprivation laws, room restriction laws, however, have been proved to be equipped with certain disadvantages. Therefore, it is anticipated that the validity of the mechanism raised in the passage can be overhauled by professionals and that the methodology itself can be generalized and utilized in order to solve the serious problem that adolescents are suffering from mental disorders which the entire society is willing to and eager for certain actions to be taken.