Abstract Background Situated within a transcultural framework, this article traces the portrayal of psychiatry and mental health in Egyptian cinema, analysing representations of psychiatric disorders, therapeutic practices, and professional roles. It juxtaposes Egyptian productions with films from Europe, North America, India, and elsewhere to identify convergences and divergences in the cinematic depiction of stigma, illness, and care. Early Egyptian films often relied on sensational or comic tropes that mirrored prevailing social misconceptions; by contrast, more recent titles— Bab el Hadid (Cairo Station), Asef ‘ala el Ez‘ag (Sorry for the Disturbance, 2008), and Al Feel al Azraq (The Blue Elephant)—mark a shift towards psychological realism and empathetic engagement. Literary influences, notably Naguib Mahfouz and Ihsan Abdel Quddous, enrich characterisation and deepen the humanistic portrayal of mental suffering. Methodology This narrative review examines selected Egyptian films produced between 1952 and 2014, alongside key international films, to analyse trends in the depiction of mental illness, stigma, and psychiatric care. Films were included if they centrally portrayed psychiatric disorders, therapeutic practices, or professional roles and were culturally or historically significant. Films where mental illness appeared only incidentally or symbolically were excluded. The analysis identifies convergences and divergences across cinematic traditions, situates representations within cultural and historical contexts, and explores narrative, genre, and thematic patterns. Conclusion Ultimately, Egyptian cinema’s evolving representation of mental health presents opportunities for reducing stigma in the psychiatric social discourse. The review ends by arguing that cinema can serve both as a pedagogical resource for psychiatric education and as a vehicle for public engagement. It calls for closer collaboration among filmmakers, psychiatrists, and educators to enhance mental health literacy, and broaden societal understanding of human suffering and associated mental disorders.

Orthorexia nervosa through the eyes of psychiatrists: A large population study.

BackgroundTo investigate whether epidemiological characteristics, including comorbidities, income, and education, have changed over time in people with cluster headache compared to controls.MethodsTrends in cardiopulmonary, neurological, and psychiatric comorbidities, and income and education categories, were assessed using linked data from Norwegian health registries for 2009-2022. Comorbidities were defined based on relevant diagnosis codes from both the primary and the specialist healthcare. Income was categorized based on the national median for each year. Education was assessed based on the International Classification Standard for Education. Each cluster headache case was matched with 20 controls without cluster headache. Prevalence rate ratios were calculated using generalized estimating equations.ResultsPeople with cluster headache had higher prevalence than matched controls without cluster headache in all examined comorbidities, particularly migraine (men: 9.8% versus 0.3%; women: 23.1% versus 1.6%), mood disorders (men: 6.7% versus 2.8%; women: 9.2% versus 4.9%), and pulmonary disorders (men: 3.0% versus 1.8%; women: 4.8% versus 2.3%). Hypertension, coronary heart disease, and psychiatric disorders in specific age- and sex groups increased more in people with cluster headache than in controls during the recording period. Low/medium income was more prevalent in people with cluster headache versus controls (men: 50.2% versus 42.2%; women: 51.4% versus 46.6%). Similarly, low/medium education was more prevalent in people with cluster headache than controls (men: 77.0% versus 65.1%; women: 65.0% versus 55.0%). The prevalence of low/medium education increased in young women during the recording period.ConclusionsPeople with cluster headache have a higher prevalence of comorbidities compared to matched controls, particularly migraine, mood disorders, and cardiopulmonary disease. Multiple comorbidities have increased in prevalence over time. Annual income and years of education were lower in people with cluster headache compared to matched controls. Cluster headache is a complex disease that requires specialist follow-up and individualized therapy.

The structure of undergraduate psychiatric medical education in Nigerian medical schools.

Abstract Background At present, there is a problem of disconnection between theory and practice among psychiatric nursing talents. The insufficient cultivation of psychological intervention skills makes it difficult for nursing staff to meet patients’ demands for psychological interventions such as cognitive behavioral therapy. Computerized cognitive behavioral therapy, which relies on digital technology to achieve standardized intervention processes, has been proven effective in the treatment of depression and anxiety disorders. However, there are still deficiencies in the integration of this therapy in psychiatric nursing education. The existing courses lack a systematic integration framework, and the awareness of computerized cognitive behavioral therapy among teachers and students is low. Based on this, the research proposes a three-stage integrated framework that combines theory, simulation and practice, aiming to address the disconnection between courses and clinical needs through this core approach. Method A total of 360 third-year nursing students from three medical colleges were selected for the study and randomly and equally divided into the integrated group, the traditional group and the control group. The integrated group learning course includes a computerized cognitive behavioral therapy module. The course builds a three-stage integrated framework of “theory-simulation–practice” through interviews with experts and in combination with clinical application guidelines. The traditional group studied regular courses, while the control group only participated in special lectures on computerized cognitive behavioral therapy. Subsequently, the CCBT cognitive questionnaires, nursing skills assessment scores, and course satisfaction scale data of the three groups of students were collected before, during, and after the class. The study was statistically analyzed using SPSS 26.0. Result The comparison results of the three groups in terms of the CCBT cognitive questionnaire score, the pass rate of intervention skills assessment, and the course satisfaction score are shown in Table 1. As shown in Table 1, the score of the CCBT cognitive questionnaire in the integrated group was 89.25 ± 7.56, the pass rate of the CCBT intervention skills assessment was 92.54%, and the course satisfaction score was 85.65 ± 8.33. Compared with the traditional group, the improvement was very significant (p<.01). Although the three core indicators of the traditional group have improved to some extent compared with the traditional group, they are still far inferior to those of the integrated group. Discussion Research has confirmed that the three-stage framework can effectively integrate computerized cognitive behavioral therapy with psychiatric nursing courses. In the future, a collaborative teaching evaluation system between educational institutions and clinical practice can be established in collaboration with medical institutions to promote the in-depth adaptation of psychiatric nursing education to clinical needs.

Abstract Background Major Depressive Disorder (MDD), a mood disorder with high recurrence rates, presents limitations in existing pharmacological treatments regarding improving patients' social functioning and emotional regulation. Music therapy has garnered significant attention due to its direct influence on the limbic system and its capacity to modulate emotional arousal levels. However, existing research on the neuropsychological mechanisms underlying active participatory music intervention for emotional regulation in depression remains lacking in quantitative evidence. Based on self-cognition and neuroplasticity theories, this study investigates the clinical efficacy of piano performance in regulating emotions among patients with mild to moderate depression. The core objective is to validate whether short-term, structured piano learning can serve as an effective medium for emotional catharsis and restructuring, thereby providing evidence-based non-pharmacological strategies for depression recovery. Methods Sixty patients with mild to moderate depression were randomly assigned to an intervention group (n = 30) and a control group (n = 30). Inclusion criteria excluded severe suicidal tendencies or prior professional music training. Experimental process: (1) Baseline period (T0): All participants completed the Hamilton Depression Rating Scale (HAM-D-17) and Positive and Negative Affect Schedule (PANAS) upon enrollment, with clinical baseline data recorded. (2) Intervention period: Control group: Maintained original antidepressant medication regimen with routine psychiatric health education and follow-up. Intervention group: Received an 8-week piano intervention program in addition to the control group's regimen. Sessions occurred twice weekly for 45 minutes each, emphasizing emotional expression through performance. (3) Evaluation phase (T1): HAM-D and PANAS assessments were conducted at the conclusion of the 8-week intervention period for both groups. Results: Baseline comparisons revealed no significant differences between groups in age, disease duration, or HAM-D scores at T0 (p>.05), indicating comparability. Primary outcomes after 8 weeks of intervention are summarized in Table 1: Depression severity significantly decreased, with the intervention group exhibiting a significant reduction in HAM-D scores at T1 compared to baseline (p<.001) and significantly lower scores than the control group at the same time point (10.42 ± 2.85 vs 16.15 ± 3.10, p<.01). Positive affect was significantly improved. PANAS results showed that the intervention group exhibited a significantly greater increase in positive affect scores compared to the control group (Cohen's d = 0.68). Discussion This study confirms that an 8-week structured piano intervention effectively alleviates depressive symptoms in patients with mild to moderate depression through dual pathways of cognitive restructuring and emotional sublimation, while enhancing positive emotional experiences. It may serve as an effective adjunctive therapeutic approach in the field of mental health rehabilitation. Limited by sample size and follow-up duration, future studies should expand sample size, extend follow-up periods, and integrate techniques such as electroencephalography or functional magnetic resonance imaging to further explore the underlying neural circuit mechanisms. Funding No. 2024SJYB0460.

SUMMARY This reflection explores the unique challenges and opportunities in psychiatric medical education in the Middle Eastern region. The variation in aspects of teaching across the region can be explained by the influence of cultural and religious perspectives on the understanding of mental illness. Key barriers include pervasive stigma, shortages of teaching staff and limited clinical placements. Innovations like virtual learning and regional collaboration offer pathways to strengthen curricula, enhance competency-based assessment and further improve the future of psychiatry education.

Cognitive profiles in older adults with psychotic disorders: Results from routine clinical assessments

Rethinking Psychiatric Education.

ObjectiveThis study aimed to explore the hematology-derived relationship between the blood-based indices associated with sarcopenia including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum AST/ALT ratio, and the risk of pneumonia and delirium among hospitalized patients experiencing acute withdrawal from excessive alcohol consumption.Study designFor this retrospective study, patients experiencing acute withdrawal from excessive alcohol consumption who underwent inpatient treatment at a psychiatric teaching hospital in western China between January 1, 2014 and December 31, 2023 were analyzed. Patient-related data were accessed through an electronic medical record database, and logistic regression analyses were used to explore the relationship between the blood-based indices associated with sarcopenia and the risk of developing pneumonia and delirium in this population.ResultThis study enrolled 553 patients. The incidence of pneumonia and delirium in this group of patients was 13.74%. AST/ALT ratios were significantly higher in patients with pneumonia relative to non-pneumonia patients (P<0.001) and in those with delirium versus those with no delirium (P<0.01); compared with the low AST/ALT group, the high AST/ALT group had a higher prevalence of pneumonia (21.90% vs. 11.06%, P<0.01) and delirium (20.44% vs. 11.54%, P<0.05). When the AST/ALT was used as a categorical variable, after adjustment for confounding factors, logistic regression showed that the high AST/ALT group had a higher risk of pneumonia (OR = 1.91, 95%CI: 1.09-3.34) and delirium (OR = 1.92, 95%CI: 1.03-3.58) than the low-AST/ALT group. When the AST/ALT were used as continuous variables, after adjustment for potential risk factors, logistic regression showed that higher AST/ALT was associated with a greater risk of both pneumonia and delirium (pneumonia, OR = 1.48, 95%CI: 1.10-2.00; delirium, OR = 1.58, 95%CI: 1.14-2.19). However, NLR and PLR were not associated with a risk of pneumonia and delirium.ConclusionThese results suggest that in patients with a history of excessive alcohol consumption and hospitalization for acute alcohol withdrawal, the AST/ALT ratio is associated with increased risk of both pneumonia and delirium, while NLR and PLR are not.

Current evidence-based guidelines recommend the use of antipsychotic monotherapy at the lowest effective dose. Nonetheless, high-dose antipsychotics and antipsychotic polypharmacy appear to be common in clinical practice, often deviating from established recommendations. This study aimed to estimate the prevalence and factors associated with high-dose antipsychotic prescribing among adult psychiatric inpatients. The study was conducted at Ibn Rushd Psychiatric Teaching Hospital in Baghdad, Iraq. The medical records of inpatients admitted from 24 April 2023 to 12 September 2023, were retrospectively analysed to extract routinely collected patient-level data and medication details; dosing appropriateness was based on that stated in the British National Formulary. Of the 225 eligible patients, 51.1% were male, aged 18-82 years (mean = 33.9). Altogether, 48.6% of patients received antipsychotic polypharmacy, and 35.6% were prescribed high-dose antipsychotics. No significant associations were found between high-dose antipsychotic prescribing and patients' characteristics, including age, sex, length of hospital stay, and number of admissions. Predictors of high-dose antipsychotics were polypharmacy (adjusted odd ratio [AOR]:12.61; 95% confidence interval [CI]: 1.78, 89.50), first-generation antipsychotics (AOR: 7.049; 95% CI 1.33, 37.44), quetiapine (AOR: 5.66; 95% CI 1.16, 27.53), procyclidine (AOR: 0.17; 95% CI 0.05, 0.55), and antidepressants (AOR: 0.19; 95% CI 0.05, 0.76). Approximately one in three patients received regular high-dose antipsychotic therapy, which contradicts optimal clinical practice and risks patient safety. Targeted educational interventions are warranted to enhance guideline adherence and promote safe and appropriate use of antipsychotics. This is the first study to assess the magnitude and factors associated with high-dose antipsychotic prescription in Iraq.

Abstract Existing research suggests that personal therapy positively contributes to the continued personal well‐being and ongoing professional development of mental health professionals, including psychiatrists. The aim of this research is to examine the use and characterization of personal therapy by consultant and trainee psychiatrists based in Ireland. This included an examination of participants who reported delivering psychotherapeutic interventions and their confidence in these skills. An anonymous survey was designed based on two existing questionnaires used in previous studies. Various recruitment strategies were employed to maximize response. A total of 139 psychiatrists responded to the survey; 44.6% reported having engaged in personal therapy at some point in their lives. Most respondents described their psychotherapy as short‐term, supportive and once weekly. Burnout was listed among the top reasons for seeking therapy. By providing new insights into the status of psychotherapy within contemporary psychiatric practice, this study could thus be of interest to psychiatric educators and curriculum developers. For people who present to psychiatric services, psychotherapy still has a critical role in the treatment of mental distress. Psychiatrists therefore need sufficient exposure to and experience of the differing psychotherapy modalities to confidently treat or appropriately refer their patients. Concerningly, only a minority of the participants in this research had confidence in their psychotherapeutic technique, and many indicated only seeking personal psychotherapy when they had reached a crisis of burnout.

Specialized education in psychiatric nursing is one of the key pillars for improving the quality of mental health services in different societies. This study aimed to review and compare the Master’s programs in psychiatric nursing in Iran and at King’s College London. The findings revealed that Iran’s psychiatric nursing program is relatively new and still in its developmental stage, focusing mainly on clinical care and the management of psychiatric patients. In contrast, King’s College London offers a program with a longer history and a more advanced structure, emphasizing research skills, clinical leadership, interprofessional education, and innovative teaching approaches such as evidence-based and collaborative learning. Significant differences were found in admission criteria, program duration, the balance between theory and practice, and evaluation tools. Drawing on successful international experiences could help enhance psychiatric nursing education in Iran, highlighting the need to adopt innovative teaching approaches, strengthen research and leadership, and ensure a balanced integration of theory and practice. The use of educational technologies and the creation of research opportunities for students are also crucial. Ultimately, the study underscores the importance of continuous revision and adaptation of educational programs to align with international standards while considering local contexts. Such reforms are essential for empowering psychiatric nurses and advancing mental health services. The results can serve as a guide for policymakers and nursing educators to improve the quality and effectiveness of graduate psychiatric nursing programs.

&lt;p&gt;&lt;strong&gt;Context and relevance.&lt;/strong&gt; Modern psychiatry exists in permanent conceptual crisis rooted in the "hard problem of consciousness". This crisis manifests clinically through a progressive decline in phenomenological analysis and the dominance of unreflected reductionism, often masked by pragmatism and clinical consensus. &lt;strong&gt;Purpose:&lt;/strong&gt; To conduct preliminary mapping of worldview positions among practicing psychiatrists regarding key philosophical issues in psychiatry and to develop a methodological framework for their further study. &lt;strong&gt;Methods:&lt;/strong&gt; A cross-sectional anonymous online survey of 120 practicing psychiatrists (including residents and early-career specialists) was conducted using an original questionnaire designed to identify both explicit and implicit attitudes. Analysis included descriptive statistics, hierarchical cluster analysis (Ward's method), and link analysis using Pearson's &amp;chi;&amp;sup2; with Bonferroni correction. &lt;strong&gt;Results:&lt;/strong&gt; The study revealed internal contradictions and eclecticism in worldview positions. While biological reductionist positions dominated (69.1%), a significant proportion of respondents demonstrated contradictory attitudes, particularly widespread implicit functionalism and views incompatible with physicalism (40% of total sample. The research also shows a weak link between philosophical views and clinical attitudes, indicating that clinical decisions are determined not by philosophical reflection but rather by systemic constraints, educational standards, and pragmatic simplified choices. &lt;strong&gt;Conclusions:&lt;/strong&gt; The documented dominance of unreflected reductionism reflects psychiatry's systemic crisis and necessitates intentional integration of philosophical reflection into psychiatric education and clinical practice.&lt;/p&gt;

Psychiatry is undergoing a global reconfiguration driven by social, technological, and environmental transformations. This paper examines the future of psychiatry through a comparative analysis of international frameworks and the current Brazilian context. It highlights the need to integrate neuroscience with social and cultural psychiatry, emphasising ethics, diversity, and the participation of people with lived experience as essential components of education and practice. Although national guidelines provide a structured framework for competency-based training, they remain limited in addressing emerging challenges such as inequality, climate change, migration, and the geopolitical determinants of mental health. To translate these advances into real-world impact, implementation science must guide the adaptation of evidence-based interventions to diverse sociocultural contexts. The paper advocates for an expanded biopsychosocial model that explicitly includes dimensions of social justice and public mental health. Brazil’s complex sociocultural landscape offers a unique opportunity to align psychiatric education and practice with these global perspectives, bridging knowledge and practice to foster a more equitable, humanistic, and context-responsive psychiatry.

Realistic simulation, including standardized patients, virtual reality and hybrid modalities, offers immersive and risk-free environments for psychiatric training, yet its impact on learner outcomes remains unclear. This systematic review assesses how realistic simulation influences knowledge, skills and confidence in psychiatric education for healthcare students and professionals in medicine and nursing. We followed PRISMA 2020 guidelines to search, screen and analyse articles in BVS, Embase, PUBMED and Scopus databases through 15 April 2025. We included quantitative studies with control groups that evaluated active, realistic simulation interventions in psychiatry. Four reviewers independently screened, extracted data and applied the JBI's critical appraisal tools, according to each study design to assess the trustworthiness, relevance and results of the published papers. Of 7690 records, eight studies met the inclusion criteria. Interventions spanned standardized patient encounters, video-based mental status exams, 360° lived-experience immersions, virtual-reality self-harm scenarios and cross-professional OSCEs. Most studies reported significant improvements versus traditional methods in diagnostic reasoning, clinical assessment, communication, empathy and self-reported confidence; one pilot found no between-group differences despite positive learner feedback. All studies clearly described instruments and objectives, 50% employed randomized or matched controls, 100% targeted student learning, 88% discussed limitations and 75% detailed applicability to medical curricula. Realistic simulation enhances multiple competencies in psychiatric education but is hampered by methodological heterogeneity and limited controlled designs. Standardized outcome measures, longitudinal follow-up and exploration of emerging modalities are needed to optimize and validate their role in mental health training.

Mental health literacy (MHL) encompasses both cognitive and cultural dimensions. Low MHL sustains stigma by reinforcing misconceptions, social distancing and discrimination, discouraging help-seeking and adherence to treatment. In education, MHL extends beyond knowledge to empathy, emotional intelligence and inclusivity. Integrating MHL into psychiatry training enhances competence and compassion, cultivating openness toward mental illness. Promoting diversity and inclusion is not only a moral imperative but also vital for effective psychiatric education. Embedding MHL across learning environments fosters understanding, reduces stigma and strengthens psychiatry’s connection to the human experience in all its emotional and cultural depth.

Pediatric primary care providers (PPCPs) often report discomfort with managing behavioral health issues. Child psychiatry access programs (CPAPs) offer psychiatric consultation, education, and referral support. This exploratory, sequential mixed-methods study aimed to identify factors influencing PPCPs' perceived ability to manage behavioral health issues and the impact of these factors on PPCPs' use of psychiatric consultation from California's CPAP. Focus group data from 11 pediatric practices (N=52 PPCPs) were analyzed to identify factors shaping PPCPs' perceived ability to address behavioral health issues. Consultations (N=188) involving the participating practices (March 2022-April 2024) were analyzed for their purpose, patients' demographic and clinical characteristics, and disposition (i.e., ongoing management in primary care or referral to specialty behavioral health care). Logistic regression was used to examine factors associated with disposition. PPCPs felt somewhat capable of managing care for patients with attention-deficit hyperactivity disorder (ADHD), depression, or anxiety and for those receiving psychotherapy, but they felt less capable when patients had multiple psychiatric diagnoses or clinical risk factors such as suicidal ideation. Many PPCPs reported discomfort with initiating or changing psychotropic medications. Seventy percent of consultations were related to medication. Consultations resulted in disposition to primary care management for 72% of patients, and this disposition was positively associated with an ADHD, a depression, or an anxiety diagnosis (adjusted odds ratio [AOR]=4.90) and younger patient age (≤11 years; AOR=2.58) but negatively associated with clinical risk factors (AOR=0.31). Availability of psychiatric consultation via CPAPs may enhance PPCPs' ability to manage behavioral health issues within primary care.

Purpose: This study aimed to explore nursing students' perspectives on the use of artificial intelligence (AI) in psychiatric nursing education through a qualitative meta-synthesis. Methods: The qualitative meta-synthesis was conducted from August 13 to August 24, 2025, utilizing searches in the CINAHL, OVID, PubMed, Scopus, and Web of Science databases. The review included qualitative studies published in English that focused on AI applications in psychiatric nursing classroom instruction or practicums among nursing students. The selected studies were analyzed and synthesized following the steps outlined by Thomas and Harden. Results: Five studies that utilized virtual reality programs as a form of AI in psychiatric nursing practicums were included. Four overarching themes emerged: (1) effective learning tool; (2) enhancement of self-directed learning; (3) innovation in nursing education; and (4) challenges in replicating complex clinical environments. Conclusion: AI-based tools have the potential to enhance both clinical and theoretical psychiatric nursing education by providing enriched learning experiences tailored to the characteristics of each course. These findings offer valuable insights for developing costumized AI programs that address the unique aspects of psychiatric disorders, thereby supporting the advancement of AI-integrated educational strategies in nursing.

Purpose: This study evaluated the validity and reliability of therapeutic communication responses generated by GPT-5 by comparing different prompt-engineering strategies and identifying optimal methods for psychiatric nursing education. Methods: A methodological design compared four strategies—Zero-shot, Few-shot, Chain-of-Thought (CoT), and Role-prompt—applied to ten psychiatric nursing communication questions. Fourteen experts with over ten years of combined clinical and educational experience rated 40 anonymized responses using a 4-point scale. Inter-rater reliability was assessed with Fleiss' κ and Krippendorff's ⍺ from 400 repeated outputs. Semantic consistency was examined using cosine similarity. Analyses were conducted in Python. Results: Role-prompt showed the highest content validity (mean=3.54±0.39, S-CVI/Ave=0.95), followed by CoT and Zero-shot. Inter-rater agreement was slight (κ=0.07; ⍺=0.15). Semantic consistency was highest for CoT (0.76±0.12) and Role-prompt (0.75±0.11). A Friedman test indicated significant differences among strategies (&lt;i&gt;x&lt;/i&gt;&lt;i&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/i&gt;(3)=11.88, &lt;i&gt;p&lt;/i&gt;=.008). Conclusion: Role-prompt yielded the most valid therapeutic responses, while CoT produced the most consistent outputs. These findings support the use of Role-prompt and CoT strategies to enhance the validity and reliability of therapy.