International Neuropsychiatric Disease Journal

Awareness of Chronic Migraine Diagnosis and Management among Primary Care Physicians in PSMMC in Riyadh

Abdullah Ahmad Aleidan — 2025-09-03

Background: Chronic migraine (CM) is a disabling neurological disorder frequently underdiagnosed and undertreated in primary care, despite its high prevalence and burden on patients and healthcare systems. Primary care physicians (PCPs) are the frontline providers for headache management, and their knowledge and attitudes directly impact early recognition and evidence-based treatment. Limited regional studies have suggested significant gaps in PCPs’ knowledge of CM in Saudi Arabia.

Objective: This study aimed to assess the level of awareness, diagnostic accuracy, and management knowledge of chronic migraine among PCPs at Prince Sultan Military Medical City (PSMMC), Riyadh, and to identify factors associated with higher knowledge scores.

Methods: A cross-sectional survey was conducted among PCPs in PSMMC from June to July 2025. A validated, self-administered questionnaire comprising 20 knowledge items (scored correct/incorrect) and two attitude questions was distributed electronically. Knowledge scores (0–20) were categorized using modified Bloom’s cut-offs: high (16–20), moderate (12–15), and low (0–11). Data were analyzed with descriptive statistics, score results, chi-square tests, and KR-20 for reliability.

Results: A total of 145 physicians completed the survey. Overall reliability of the knowledge scale was strong (KR-20 = 0.84). The mean total knowledge score was 17.4 ± 3.3, with 77.9% classified as high knowledge, 13.8% as moderate, and 8.3% as low. Diagnostic criteria, red flag recognition, and acute management were well known, but gaps persisted regarding attack duration, follow-up intervals, and non-pharmacological therapies. Significant associations with knowledge levels were observed for age (p = 0.019), nationality (p < 0.001), grade (p = 0.032), years of experience (p = 0.008), and prior course attendance (p = 0.007). Most participants felt very confident in diagnosing CM (64.8%), but fewer expressed confidence in managing it (43.4%).

Conclusion: PCPs at PSMMC demonstrated generally high knowledge and diagnostic confidence in CM, yet important deficiencies remain in preventive strategies and non-pharmacological management. Regular continuing medical education and structured training programs are recommended to address these gaps and optimize migraine care in Saudi primary care settings.

Assessment of Psychological Well-being among Residents of Ilobu, Erin-Osun and Ifon-Osun in Osun State, Nigeria

Olawale Sunday Asabi — 2025-09-06

Background: Housing conditions are increasingly recognised as key social determinants of mental health, yet evidence from semi-urban Nigeria remains sparse.

Objective: To quantify the prevalence and predictors of psychological well-being among adult residents of Ilobu, Erin-Osun and Ifon-Osun, Osun State, and to determine the extent to which housing quality and basic infrastructure explain mental-health outcomes.

Methods: A cross-sectional survey of 383 adults (≥18 years) was conducted between March and May 2024. Psychological well-being was assessed with the WHO-5 index and categorised as high (≥60 %), moderate (40–59 %) or low (<40 %). A composite Housing Quality Index (0–10) captured dwelling type, room occupancy, ventilation, water, sanitation, electricity and refuse disposal. Data were analysed with descriptive statistics, χ² tests, Pearson correlation, one-way ANOVA and multiple linear regression (SPSS v.25).

Results: Only 29.2 % of respondents attained high psychological well-being; 45.2 % were moderate and 25.6 % low. There was a strong dose-response gradient: 72 % of residents in adequate (Type A) housing reported high-to-moderate well-being versus 51 % in sub-standard (Type C/D) dwellings (χ² = 12.84, p = 0.045). Housing Quality Index correlated positively with psychological well-being (r = 0.562, p < 0.001). ANOVA confirmed significant differences across housing-quality tertiles (F = 11.78, p < 0.001). Multiple regression (adjusted R² = 0.47) identified ventilation adequacy (β = 0.31), room occupancy (β = –0.28), water source reliability (β = 0.24) and electricity stability (β = 0.19) as the strongest predictors. Narrative data revealed that overcrowding, noise, tenure insecurity, and poor sanitation were cited three times more often by the low-well-being group.

Conclusion: Housing quality is a critical, modifiable determinant of psychological well-being in these semi-urban communities. Integrated interventions targeting ventilation, overcrowding, water and electricity could shift up to one-quarter of residents from low to moderate/high well-being. Policies should embed mental-health outcomes into rural housing standards and primary-care programmes.

Exploring the Role of Probiotics and Antioxidants in Potentiating the Efficacy of Citalopram Hydrobromide for Depression Therapy: A Preclinical Study in Swiss Albino Mice Model

Siddharth Kamble — 2025-09-12

Background and objective: Depression is a leading cause of disability worldwide, characterized by mood disturbances and neurobiological alterations. The gut–brain axis and oxidative stress have emerged as critical factors in its pathophysiology. Probiotics, through microbiome modulation, and vitamin C, via antioxidant effects, have shown potential to improve depressive symptoms. Citalopram hydrobromide, a selective serotonin reuptake inhibitor, is widely used but has limitations, including delayed therapeutic onset and partial remission. This study aimed to investigate whether adjunctive administration of probiotics and vitamin C could enhance the antidepressant efficacy of citalopram hydrobromide in a stress-induced murine model of depression.

Materials and methods: Adult Swiss albino mice (n=12) were randomized into four groups: vehicle control, stress control, standard (citalopram hydrobromide 10 mg/kg), and test (citalopram hydrobromide + probiotics + vitamin C). Stress was induced using deprivation and cold-water swim protocols over four weeks. Antidepressant activity was evaluated through the forced swim test, tail suspension test, and locomotor activity using an actophotometer. Data were analyzed using analysis of variance (ANOVA) with Tukey’s post hoc test.

Results: The stress protocol significantly increased immobility and reduced locomotor activity compared to controls (p<0.0001). Citalopram hydrobromide reduced immobility in both forced swim test and tail suspension test, confirming antidepressant activity. The test group (citalopram hydrobromide + probiotics + vitamin C) showed significantly greater reductions in immobility (p<0.05–0.001) and enhanced locomotor activity compared to citalopram hydrobromide alone. These findings suggest synergistic effects via modulation of serotonergic pathways, antioxidant mechanisms, and gut–brain interactions.

Conclusion: Adjunctive supplementation with probiotics and vitamin C potentiates the antidepressant efficacy of citalopram hydrobromide in a murine depression model. This multimodal strategy may represent a promising therapeutic approach for major depressive disorder, warranting further mechanistic and clinical investigation.

Understanding of Medical Students’ Attitudes towards Mental Illness: A Cross-Sectional Study at the State University of Zanzibar

Rodolfo Isidro Bosch Bayard — 2025-09-27

Introduction: Mental illness imposes a significant global health burden, often compounded by stigma that hinders care. Medical students, as future healthcare providers, play a crucial role in shaping perceptions of mental health and service delivery. Understanding their attitudes toward mental illness is essential for improving outcomes.

Objectives: To assess attitudes toward mental illness among medical students at the State University of Zanzibar (SUZA).

Methods: A cross-sectional study was conducted among 156 SUZA medical students using a self-administered questionnaire adopted from the Mental Illness: Clinician’s Attitudes Scale, version 2 (MICA-2). Attitudes were measured on a 16-item, 6-point Likert scale. Independent variables included socio-demographic and educational factors. Students were stratified based on the year of study, while a simple random sampling was used to choose a specific number of students from each group.

Results: Overall, 50.6% of students exhibited negative attitudes, while 49.4% demonstrated positive attitudes. Year of study (χ² = 18.393, p = .001) and close contact with a person with mental illness (χ² = 5.635, p = .018) were significantly associated with attitudes. Students in their earlier years were more positive, but those in their third and fifth years were more negative. Having close contact with someone with a mental illness was unexpectedly associated with more negative attitudes. Other factors, such as gender, age, socioeconomic status, workshop attendance, and personal or family history, showed no significant association. While most students showed some positive views, like seeing the scientific value of psychiatry and supporting respectful communication and care, they still held misconceptions, particularly regarding recovery and the belief that people with mental illness are dangerous.

Conclusion: The SUZA medical students had a mix of positive and negative attitudes toward mental illness. Although the students were aware of mental health issues, this awareness did not always reduce the stigma. The findings show a need for specific educational programs, especially for students in their later years of study, to address ongoing misunderstandings about mental illness.

Occupational Stress and Coping Mechanisms among Morticians in Nairobi, Kenya

Jane Wanjiku Kamau — 2025-10-07

Morticians face unique occupational stressors due to repeated exposure to death, grief, and trauma, which may predispose them to high levels of occupational stress and psychological distress. This study sought to evaluate the coping strategies employed by morticians working in selected mortuaries in Nairobi County, Kenya. The objectives were to identify the adaptive and maladaptive coping mechanisms used, to explore the role of spirituality and social support in coping, and to assess implications for mental health interventions. A convergent mixed methods design was adopted to strengthen the reliability of findings by combining both quantitative and qualitative data. Quantitative data were collected using the Brief COPE Inventory (Carver, 1997) administered to 18 participants, while qualitative insights were gathered through semi-structured interviews with a purposively selected subset of morticians. Data analysis was conducted separately and then integrated during interpretation to allow for triangulation. The quantitative findings revealed a predominant reliance on adaptive coping strategies, including acceptance (90%), religion (90%), emotional support (84.29%), positive reframing (82.86%), and instrumental support (81.43%). In contrast, maladaptive coping strategies were less frequent, with denial (37.14%), self-blame (38.57%), and substance use (30%) reported among participants. The qualitative analysis reinforced these patterns, identifying emotion-focused coping (50%), meaning-making through spirituality (22.2%), and problem-focused strategies (16.6%) as dominant themes. A minority of participants reported avoidant strategies, including emotional suppression and substance use (5.5%). The integration of findings suggests that morticians balance adaptive strategies rooted in spirituality, social support, and positive reframing, while a minority resort to maladaptive coping mechanisms. These results highlight the duality of coping among morticians, resilience on one hand and vulnerability on the other. Based on these findings, interventions such as Stress Inoculation Therapy (SIT), structured peer support groups, and workplace wellness programs are recommended to strengthen adaptive coping, reduce reliance on maladaptive strategies, and ultimately enhance resilience among morticians working in high-stress environments.

Saponins, Tannins and Alkaloids Fractions of Bridelia micrantha: Effects on the Prefrontal Cortex of Ketamine-Induced Cognitive Dysfunction in Wistar Rats

Eru Mba Eru — 2025-10-11

Cognitive dysfunction represents a continuum of cognitive decline with mild cognitive impairment making the intermediate stage between normal cognitive aging and dementia. Mild cognitive impairment may progress to dementia resulting in a substantial loss of cognitive abilities and the capacity for independent living; hence, individual with mild cognitive impairment are at high risk of progressing to dementia with conversion rate as high as 15%. In this study, we investigated the effect of saponin, Tannins and alkaloids rich Bridelia micrantha on the cytoarchitecture of the prefrontal cortex of ketamine-induced cognitive Wistar rats. Thirty-six adults male Wistar rats were randomly divided into six groups designated A, B, C, D, E and F each containing six rats. Group A received animal feed and water ad libitum while group B served as the positive control. Bridelia micrantha leaves were fractionated into saponin, tannins and alkaloids and were administered to Groups C, D and E respectively while group F received Diazepam for two weeks. The results revealed hypertrophied and hypoplasic cells in groups B and C; group E revealed atrophied and hypoplasic cells while group F revealed cellular hypoplasia. Group D revealed normal cytoarchitecture with cellular hyperplasia compared to the control group and the treated groups. In conclusion, the tannins group D only arrested cellular alteration in the prefrontal cortex of ketamine induced-cognitive dysfunction Wistar rats caused by chronic administration of ketamine and restores cellular injury and its proliferations.

Self-Esteem, Parental Attachment and Mental Health Correlates of Non-Suicidal Self-Injury (NSSI) among in-School Adolescents in Gboko LGA, Benue State

ZAR, Vershima Daniel — 2025-10-11

The study investigated the role of self-esteem and parental attachment in the relationship between mental health states (specifically depression and anxiety) and Non-Suicidal Self-Injury among in-school adolescents in Gboko Local Government Area. Three specific objectives with corresponding research questions guided the study. The correlational research design was adopted for the study. The population for the study consisted of 420 in-school adolescents in Gboko Local Government Area, Benue State. The sample size for the study was drawn using a multi-stage sampling technique. The instruments for data collection were the Rosenberg Self-Esteem Scale and the Reasons for Attempting Suicide Questionnaire. Data were analysed using frequencies, percentages, mean and standard deviation, and point-biserial correlation. The results of the study showed that in-school adolescents had a low proportion (11.4%) of engagement in Non-Suicidal Self-Injury behaviour. There was a positive weak relationship between Non-Suicidal Self-Injury behaviours and depression (rbp = 0.20) and anxiety (rbp =.26). There was a weak negative relationship between Non-Suicidal Self-Injury behaviours, self-esteem (rbp = - 0.148), while there was a moderate negative relationship between Non-Suicidal Self-Injury behaviours and parental attachment (rbp = -0.434). In-school adolescents with good self-esteem (OR = 0,949; 95% C.I. = 0.86 – 1.05; P = 0.319) and good parental attachment (OR = 0,869; 95% C.I. = 0.84 – 0.90; P = 0.000) are 0.95 times and 0.87 times less likely to engage in Non-Suicidal Self-Injury behaviour than those with poor self-esteem and parental attachment in Gboko Local Government Area, Benue State. It was recommended among adolescents that public health campaigns should be conducted to raise awareness about Non-Suicidal Self-Injury, its risk factors, and its preventive strategies. These campaigns should target adolescents, parents, and teachers, focusing on reducing stigma around mental health and encouraging help-seeking behaviour.

Determinants of Readiness to Change among Treatment-seeking Patients with Substance Use Disorders in a Psychiatric Facility in Lagos State

ALALADE, OBATOMI A. — 2025-10-18

Aim: This study aimed at identifying the association between sociodemographic and clinical variables in substance users and their readiness to change.

Study Design: This was a descriptive cross-sectional study.

Place and Duration of Study: Federal Neuropsychiatric Hospital, Lagos between July and September 2023.

Methodology: We included 161 participants with ICD-10 diagnosis of substance use disorders. Participants were assessed using a sociodemographic and clinical questionnaire and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) was used to assess the readiness to change alcohol and other drug use with three subscales—Recognition, Ambivalence, and Taking Steps. The relationship between sociodemographic and clinical correlates of readiness to change were analysed using the Chi square test. Data was analysed using the SPSS version 26 at 95% confidence interval.

Results: Among patients with alcohol use disorder (AUD), the presence of physical illness was significantly associated with higher recognition (p = 0.02) and ambivalence (p = 0.04), while lack of previous treatment predicted greater “taking steps” toward change (p = 0.01). For those with drug use disorder (DUD), previous treatment history was linked to lower ambivalence (p = 0.03), and shorter duration of illness was associated with higher recognition (p = 0.02). No other clinical characteristic was significantly related to readiness to change at the 5% level.

Conclusion: Readiness to change among patients with SUDs in this Nigerian sample was influenced by treatment history, physical comorbidity, and illness duration. These findings underscore the need for individualized motivation-enhancing interventions that consider prior treatment experiences and health comorbidities to improve substance use outcomes in resource-limited settings.

Atypical Presentation of Bipolar Disorder in Adolescents: The Role of Obsessive-Compulsive Features

Buket Kılıç — 2025-09-16

Background: Although bipolar disorder (BD) typically begins in adulthood, early signs may manifest in different clinical forms. This article presents a case of an adolescent diagnosed with bipolar disorder who initially exhibited prodromal symptoms resembling Obsessive-Compulsive Disorder (OCD).

Presentation of Case: A 15-year-old girl with insomnia, anxiety, palpitations, weight gain, and social issues was initially evaluated medically, then diagnosed with OCD due to sexual obsessions and compulsions, along with approval-seeking behaviors and body image concerns. She responded to sertraline, but after dose increase, she developed a manic episode, leading to stopping sertraline and starting olanzapine. Her mood stabilized, and her OCD symptoms improved, emphasizing the importance of assessing possible BD in early OCD presentations.

Discussion: The findings underscore the importance of careful longitudinal assessment in adolescents presenting with OCD-like symptoms, especially when affective traits are present, to facilitate early detection and management of BD.

Conclusion: Further research into the developmental trajectory and genetic links between OCD and BD is essential.

The Influence of Hormonal Contraceptive Use on Psychiatric Health

Luiz Costa — 2025-10-07

Introduction: The use of hormonal contraceptives represents a significant advancement in reproductive health, offering effective contraception and the management of gynecological conditions. However, their effects on psychiatric health remain a subject of debate. This article aims to synthesize current evidence and contribute to individualized clinical counseling, striving for a balance between contraceptive efficacy, safety, and psychiatric well-being. Methodology: This is a literature review based on articles in both Portuguese and English, retrieved from PubMed, Scielo, and Google Scholar. The search included observational studies, cohorts, and meta-analyses published from 1997 to August 2025. Older references were utilized to provide historical context.

Results and Discussion: The majority of HC users experience neutral or minimal effects on mood. However, adolescents, young women, and those with a history of psychiatric conditions may be at a higher risk of developing depressive symptoms, anxiety, and, in rare cases, suicidal behavior. Progestin-only methods show a stronger association with mood alterations, whereas some combined formulations may reduce affective symptoms in specific conditions such as premenstrual dysphoric disorder. Neurobiological mechanisms include the modulation of neurotransmitters, the hypothalamic-pituitary-adrenal axis, and emotional processing. Psychosocial factors and the subjective perception of adverse effects influence method adherence and discontinuation.

Conclusion: Although psychiatric adverse effects are relatively rare in the general population, a vulnerable subgroup exists that requires individualized clinical monitoring and a careful choice of contraceptive method, considering the hormonal formulation, age, and psychiatric history.

Sports Betting Expansion in Brazil: Impacts on Psychiatric Health

Luiz Fernando Costa Campos — 2025-08-14

This article presents a psychiatric analysis of the rapid growth of online betting (bets) in Brazil and its connections to the political structure of the country. Current data indicate that approximately 30% of Brazilians, mainly young men, have engaged in online bets, with alarming consequences for public health, such as unpayable debts and a fifteen-fold increase in suicide risk among gamblers. The landscape of sports betting in Brazil has undergone significant changes over the decades, and concurrently, modern society has experienced substantial shifts in digital inclusion. Within this context, the bets market has exhibited remarkable growth in the country, driven by easy access to platforms and instant payment methods, which has turned anyone with a cell phone and internet access into a potential customer. However, health policies have not kept pace with this growth, transforming bettors into potential victims of psychiatric disorders across a broad spectrum. It is important to highlight that the treatment of gambling-related disorders is multifactorial, including therapeutic techniques (CBT, motivational interviewing, group therapy, psychoeducation and family support), in addition to the use of pharmacological strategies. This study aims to investigate the correlation between the expansion of this market and the potential harm to psychiatric health caused by betting addiction, like Suicide Related to Financial Losses, severe depression, self-destructive behavior, acute psychotic episodes or dissociative states and comorbidities with substance use and personality disorders. For the reserch, it was included scientific articles and journalistic reports published in Portuguese and English, using as databases the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the International Classification of Diseases, Eleventh Edition (ICD-11), as well as national and international scientific journals accessed through Google Scholar, since 1994 until 2025; older references was used for historical context.

Synthetic Xanthone Derivatives as Multifunctional Therapeutics for Alzheimer’s Disease: Chemistry, Mechanisms and Future Perspectives

Kanchan Ghatge — 2025-09-11

Introduction: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, with limited effective therapeutic options available. Synthetic xanthone derivatives have recently garnered attention due to their diverse pharmacological properties and potential to target multiple AD pathological pathways.

Methods: This review comprehensively analyzes recent advances in the synthesis, chemical modifications, and biological activities of synthetic xanthone derivatives relevant to AD. Literature from various databases was critically evaluated, focusing on structure activity relationships (SAR), mechanisms of action, pharmacokinetics, and drug delivery approaches. Emphasis was placed on multidisciplinary strategies integrating medicinal chemistry, pharmacology, and neuroscience to accelerate therapeutic development.

Results: Synthetic xanthones demonstrate multiple bioactivities including antioxidant, anti-inflammatory, acetylcholinesterase inhibitory, and anti-amyloidogenic effects, contributing to their neuroprotective potential. SAR studies and computational modeling have identified key structural motifs that enhance potency and selectivity for AD targets. However, challenges such as limited blood–brain barrier permeability and In vivo efficacy require innovative drug delivery systems, including nanocarriers and prodrug strategies. The review highlights successful preclinical studies showcasing cognitive improvements and neuropathological mitigation in AD models.

Conclusion: Synthetic xanthone derivatives represent a promising scaffold for multi-targeted AD therapy. Future research should focus on optimizing pharmacokinetic properties, expanding In vivo validation, and clinical translation through a collaborative multidisciplinary approach. Harnessing advances in chemistry, biology, and drug delivery will be critical to realize the therapeutic potential of xanthone-based compounds and address the unmet needs in Alzheimer’s disease treatment.

Diagnostic and Differential Challenges of Psychoses in Adolescence: A Cognitive Perspective

Josimar Silva — 2025-09-13

Introduction: Adolescence is a period of high neuropsychological plasticity and vulnerability for the onset of psychotic symptoms. Diagnostic criteria validated in adults do not always capture the complex developmental dynamic and the overlap with anxiety, mood, and trauma, which can lead to diagnostic errors and inadequate interventions.

Aim: The study aims to investigate how to diagnose and differentiate the challenges of psychoses in adolescence. Methodology: An integrative narrative review on PubMed/MEDLINE and SciELO of studies published between 2020 and June 2025, focusing on childhood/adolescent psychosis, clinical high risk (CHR), phenomenological semiology, and differential diagnoses (substances, autoimmune/neurological conditions, dissociative states). Systematic reviews, meta-analyses, cohort studies, and clinical guidelines were included, prioritising Brazilian evidence when available.

Results: Recent evidence points to heterogeneity and dimensional continuity of psychotic experiences, CHR conversion rates of 20–30% in 2–3 years, a high prevalence of negative symptoms and cognitive deficits with functional impact, a marked influence of sociocultural determinants and traumas, and the relevance of screening for mimics such as high-potency cannabis use and anti-NMDAR encephalitis. Useful clinical subtypes for adolescence are described: anxiolytic-apoplectic, subacute, dysmorphophobic, and functional/bipolar psychoses. The evaluation must be multidimensional, including neurocognitive examinations, substance use screening, investigation of medical comorbidities, and the use of specific scales, such as the Scale of Prodromal Symptoms (SOPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS), which are widely used in early intervention centres.

Discussion: Diagnostic approaches centred on development and the self, with a phenomenological listening and longitudinal follow-up, can increase diagnostic accuracy and avoid early stigmatisation. Implications for public policies, multi-professional management, and future research are discussed.

Conclusion: The integration of detailed phenomenological assessment, longitudinal monitoring, and targeted screening for mimicking and risk factors allows for increased diagnostic precision in adolescents, the anticipation of therapeutic interventions, and the reduction of functional damage. This approach contributes to more individualised clinical decisions, a decrease in early stigmatisation, and the optimisation of public policies and early intervention programs, promoting more effective, humanised, and culturally sensitive mental healthcare for adolescents.