Assessing the Trajectory of Bipolar Disorder Effectively in Order to Treat Effectively.

Accurate diagnosis of mood disorders, particularly depression and bipolar disorder, is essential for effective treatment planning and patient management. This article emphasizes the need for systematic symptom assessment and longitudinal analysis in facilitating the precise diagnosis and planning appropriate treatment interventions. By meticulously evaluating the symptomatology and delineating the longitudinal trajectory of the illness, clinicians can distinguish between unipolar depression and bipolar disorder, and therefore optimise patient outcomes.

The Concept of Staging in Schizophrenia; 13 Years After the 'Agius Concept of Staging' Was Published.

We review the development of clinical staging models of schizophrenia, which has developed as a logical extension of the Neuro-developmental theory of Schizophrenia. The staging approach, which involves assessing a disorder based on its severity, scope, progression, and characteristics, is gaining growing recognition in the fields of clinical psychology and psychiatry. We review the development of clinical staging models of schizophrenia, which has developed as a logical extension of the Neuro-developmental theory of Schizophrenia.

A Retrospective Longitudinal Analysis of Mental Health Admissions: Measuring the Fallout of the Pandemic.

Background: In this research article, we review the infrequently considered long-term impact of the pandemic on inpatient mental health, by reviewing the clinical parameters of all psychiatric admissions to Mount Carmel Hospital, our region's main psychiatric healthcare facility, from 2019-2021.

Methods: 4292 patients were admitted during the research period of this retrospective longitudinal analysis. Taking 2019 as the pre-COVID reference year, we compared mean monthly admissions from 2020 and 2021, looking at patient demographics, status under the Mental Health Act, diagnosis, and self-injurious behaviour.

Developing the 2020-2030 mental health strategy for Malta: Addressing the needs of a small island state undergoing rapid socioeconomic transition.

Malta has embarked on a renewed national endeavour to reform the mental health sector, prioritising mental health in the context of the national health strategy post 2020. Past attempts at reforming this sector were stifled due to insufficient and unsustained political commitment, leaving it direly under-resourced. An interplay of factors over recent years has rekindled political and public interest in mental health.

The interplay between pharmacogenetics, concomitant drugs and blood levels of amitriptyline and its main metabolites.

The research considers the impact of genotype-inferred variability on blood levels of amitriptyline and its main metabolites, as may be moderated by phenocopying. and genotypes, and serum concentrations of amitriptyline, nortriptyline and hydroxymetabolites, were determined in 33 outpatients. Co-medications were reviewed to identify CYP inhibition risk.

Audio-visual Technology and Its Impact on Mental Wellbeing.

Audio-visual technology can have a significant impact on a person's metal wellbeing to the extent that research shows that it can cause structural brain changes. In this paper we explore some of the associations between this technology and mental wellbeing. Audio-visual technology can help in fulfilling the need of human beings for connectedness, but it can be doing this inadequately.

Effect of COVID-19 pandemic on mental health hospital admissions: comparative population-based study.

Background: The coronavirus disease 2019 (COVID-19) global pandemic caused mental health services to be downscaled to abide by the public health restrictions issued.

Aims: The aim of this study was to investigate whether the pandemic and resultant restrictions had an impact on Malta's admissions to hospital for mental health issues by assessing the number and nature of psychiatric admissions to our only national mental health hospital.

Method: Data collection was carried out retrospectively for the 13-week period between 7 March 2020 and 4 June 2020, compared with the equivalent in 2019.

WITHDRAWN: The way in which COVID-19 changed behaviour on social media in Malta.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.

A Prospective Study of Short-term Outcomes of a Residential Programme for the Morbidly Obese in Malta.

Obesity is a worldwide problem, and Malta is no exception. In Malta, a Foundation was established to address weight problems amongst the population, and this initiative included the opening in 2014 of an 8-week residential programme for morbidly obese patients. This multidisciplinary programme is managed and coordinated by a team consisting of doctors, psychiatrists, nurses, physiotherapist, psychologists, dietitian, nutritionists and occupational therapists.

Evidence That the Urban Environment Moderates the Level of Familial Clustering of Positive Psychotic Symptoms.

If the shared familial risk factors that predispose to psychotic disorder interact with early-life exposures in the urban environment, familial correlations of psychosis proneness measures should be higher in the exposed environment. We tested the hypothesis that in sib-pairs with one member affected by psychotic disorder, the familial correlation of psychotic experiences, but not depression, negative symptoms, or intelligence quotient (IQ), would be higher if the nonaffected sibling was raised in an urban environment until age 15 years. The sample analyzed consisted of 959 sib-pairs of whom one was affected with psychotic disorder.

Epidemiology of Serious Mental Illness in Malta - Consequences for developing a new psychiatric hospital and community psychiatry.

Mental Health Services in Malta are presently at crossroads, because they are in the stage of increasing and strengthening the community services and considering closing the main psychiatric inpatient facility and replacing it with a new hospital. For proper planning of such changes, and ideal approach is that of basing these plans on results of population based epidemiological findings on rate of mental illness and required care. Such studies are strongly recommended, and this approach has already been used in Malta a couple of years ago prior to establishing inpatient care for Eating Disorders.

Stigma in Malta; A Mediterranean Perspective.

The aim of this paper to describe what Transcultural Psychiatry is. It attempts to describe stigma in Malta and how it comes about that the Mental Hospital in Malta is named for Our Lady of Mount Carmel and finally attempt to put Mount Carmel Hospital and its dedication within Maltese Culture and the culture of the Mediterranean. The paper demonstrates that to understand this, it is necessary to employ History, Anthropology, Theology, among other issues.

The mental health services for detained asylum seekers in Malta.

Approximately 17 000 individuals have claimed asylum in Malta over the past 10 years. Maltese law stipulates mandatory detention. Here, we review Malta's asylum procedures and detention policy, and explore the impact of detention on mental health.

'Dar Kenn Ghal Sahhtek'--an eating disorder and obesity service in Malta.

This paper will describe the incidence of eating disorders, with particular focus on obesity and binge eating, within the Island of Malta. The development of and 'Dar Kenn Ghal Sahhtek', the first centre for eating disorders in Malta will then be recounted, and the effective therapeutic interventions provided in it will be described. One important function of this unit is the treatment of excessive obesity.

A National Snapshot of Substance Misuse among Child and Adolescent Psychiatric Inpatients in Malta.

This paper reports on a patient record survey that was undertaken with the central aim of establishing reliable, baseline information to inform strategic planning and organisation of future CAMHS in Malta. The records of the total population of children and adolescents admitted into the psychatric hospital over a five year period were surveyed. Results showed that the characteristics and circumstances of children and adolescents with mental disorder and comorbid substance misuse in Malta are similar to those described in international studies.

The multidisciplinary approach to mood disorders.

This article outlines the use of the multidisciplinary approach to mood disorders in the Short Stay Psychiatric Unit (SSPU) in Mater Dei Hospital, Msida, Malta. An audit was carried out on all patients whose first admission to SSPU was in 2008 and who were diagnosed with having a mood disorder. The aim was to see whether the use of a multidisciplinary approach is in actual fact affecting patient outcome or not.

Eating disorders in Malta.

In the beginning of 2014 a new service (residential and non residential) for eating disorders is being planned to open in Malta. A telephone based survey was conducted between 30 May and 11 June 2012. A randomized sample of 6000 of the population between 15 and 50 years old was chosen.

The mental health of newly graduated doctors in Malta.

Background: Several studies have shown high rates of psychiatric morbidity in young doctors at various stages of their training (Paice, et al. 2002, Levine et al. 2006).

Socio-economic status and population density risk factors for psychosis: prospective incidence study in the Maltese Islands.

Malta is an archipelago (with three inhabited islands) in the Mediterranean Sea. According to the 2006 census, Malta has a population of just over 400 000 and is the eighth most densely populated country in the world (1272 persons/km) and the most densely populated of the member states of the European Union (EU). The most densely populated town in Malta is Senglea, with 22 744 persons/km (situated in the Southern Harbour Area).

Distribution of symptom dimensions across Kraepelinian divisions.

Background: Dimensional structures are established for many psychiatric diagnoses, but dimensions have not been compared between diagnostic groups.

Aims: To examine the structure of dimensions in psychosis, to analyse their correlations with disease characteristics and to assess the relative contribution of dimensions v. diagnosis in explaining these characteristics.

Cannabis use and outcome of recent onset psychosis.

Purpose: To test the hypothesis that recent onset psychotic patients who use cannabis will have psychotic symptoms that are more severe and more persistent than those who do not use cannabis.

Subjects And Methods: We carried out a 4-year follow-up study of a cohort of 119 patients with recent onset of psychosis. The patients were divided into four groups according to duration of cannabis use, taking index admission and follow-up as reference points.

The relationship between volumetric brain changes and cognitive function: a family study on schizophrenia.

Background: We examined the cerebral correlates of intelligence, memory, and executive processing in 56 patients with schizophrenia or schizoaffective disorder and 90 of their nonpsychotic relatives to establish whether the pattern of structure--function relationships in these two groups was different from that in 55 control subjects.

Methods: Magnetic resonance imaging data were acquired, and volumetric measurements were made for whole brain, prefrontal region, lateral ventricles, third ventricle, temporal lobes, hippocampi, and cerebellum.

Results: In the total sample, full intelligence quotient (IQ) and verbal IQ correlated with the volume of the whole brain and right hippocampus; the latter was also associated with performance IQ.

Normal cerebral asymmetry in familial and non-familial schizophrenic probands and their unaffected relatives.

Loss of normal fronto-occipital cerebral asymmetry has been reported in patients with schizophrenia and also in their well relatives from multiply affected families, suggesting a relationship with susceptibility genes. We sought to confirm this relationship in a family study of patients with schizophrenia and their unaffected relatives of presumed differing genetic risk. MRI scans were carried out on 25 probands from families multiply affected with the disorder, and 36 of their unaffected relatives, 34 probands from families with no other affected members, 42 of their unaffected relatives, and 76 controls.