Background: Schizophrenia is a chronic and severe mental illness that ultimately leads to reduced quality of life (QoL). Over the years, QoL has emerged as an important outcome in the treatment of schizophrenia patients, but the role of psychosocial variables in determining QoL is still ambiguous. Therefore, in the present research, demographic, clinical and psychosocial variables were examined for their influence on QoL. Methods: We conducted a prospective and cross-sectional study on a sample of 139 patients with schizophrenia (72.7% females, age 48.17 ± 10.22) attending an outpatient service. QoL was measured using Schizophrenia Quality of Life Revision-4 (SQLR4) and internalised stigma, self-esteem, perceived social support, resilience and coping mechanisms were assessed using a battery of standardized self-report scales. Results: Female patients and those less adherent to treatment had reduced cognition and vitality QoL. The worst QoL in all domains was observed in patients with a younger age at illness onset and with six or more hospitalizations. Regression analysis indicated that reduced self-esteem, perceived social support, a larger number of hospitalization and increased internalised stigma predicted poorer overall QoL and accounted for 44.9% in the variance in SQLSR4 global score (adjusted R² = 0.449, p = 0.046). Conclusions: Routine assessment of internalised stigma, self-esteem and perceived social support, in addition to demographic and clinical variables and addressing possible deficits in these areas through personalized intervention, could improve QoL in schizophrenia patients.

Caregiving for a patient with schizophrenia (PwS) imposes a high burden on caregivers and often affects their quality of life. This systematic review aims to synthesize the current evidence on the sociodemographic and psychological factors of caregivers, as well as patient-related sociodemographic and clinical factors, that may influence caregivers’ QoL. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed in three major databases—PubMed/Medline, SCOPUS, and Web of Science—to identify original studies examining informal caregivers of PwS and assessing the relationship between caregivers’ QoL and various sociodemographic, psychological, or clinical factors. Methodological quality appraisal was performed using the Joanna Briggs Institute checklist. In total, 31 studies were included in the review and discussed at length. Lower QoL was associated with unemployment, older age, female gender, financial difficulties, being unmarried, and lower education. Additionally, increased schizophrenia symptom severity, higher caregiver burden, and elevated levels of depression and anxiety may negatively influence caregivers’ QoL. Given these findings, future research should focus on developing tailored interventions to improve caregivers’ QoL. Addressing these modifiable risk factors through targeted support programs and policies could significantly enhance caregivers’ QoL.

The aim of this analysis was to investigate the socio-demographic and clinical profile, the effectiveness, and the association of pharmacological treatment in patients who underwent electroconvulsive therapy during the last 10 years in the largest psychiatric hospital in Romania. This study includes 249 patients aged between 18 and 73 years old. Recurrent depression was the most frequent diagnosis for which ECT was performed (T = 96, 38.55%), followed by schizophrenia (T = 72, 28.91%). The most frequent indication for ECT was treatment resistance (T = 154, 61.84%), followed by persistent suicidal ideation (T = 54, 21.68%) and catatonia (T = 42, 16.86%). In 111 (44.60%) cases included in this study, re-hospitalization was required after performing ECT, while 138 (55.40%) participants did not require any further hospital readmissions. Significant differences were found between these groups in terms of socio-demographic data, diagnosis, number of ECT sessions performed, and association of psychotropic medication during and after the procedure, therefore two separate patient profiles were found based on these characteristics. Patients necessitating re-hospitalization post-ECT were mainly males aged 25–44 diagnosed with schizophrenia and underwent a greater number of ECT sessions (7–12), whereas those not requiring re-hospitalization were predominantly females aged 45–64 with recurrent depressive disorder for which 4–6 ECT sessions were performed.

Introduction: In recent decades, the burden of mental disorders has become a major determinant of population health in the European Union, generating profound clinical, socioeconomic, and institutional consequences. Despite political recognition of this silent crisis, substantial methodological challenges persist in the transnational monitoring of mental health and in linking disease burden with the resources allocated to address it. The present analysis develops a multivariate taxonomy of EU Member States from a psychosocial perspective, using an integrative quantitative approach. Methods: This cross-sectional, comparative study follows international standards for transparent and reproducible quantitative reporting and is based on 18 harmonized clinical, epidemiological, and institutional indicators collected for 27 EU Member States over the period 2014–2023. The indicators used in this study were grouped according to their position along the care continuum. Hospital-based indicators refer to inpatient activity and institutional capacity, including total hospital discharges, psychiatric admissions (affective disorders, schizophrenia, dementia, alcohol- and drug-related disorders), and hospital bed availability. Outpatient and community-level indicators reflect the capacity of systems to provide non-hospital psychiatric care and consist primarily of psychiatrist density and total specialist medical workforce. Finally, subjective perception indicators capture population-level self-assessed health status, complementing clinical and institutional measures by integrating a psychosocial perspective. After harmonization and standardization, Principal Component Analysis (PCA) with Varimax rotation was applied to identify latent dimensions of mental health. Model adequacy was confirmed using the Kaiser–Meyer–Olkin coefficient (0.747) and Bartlett’s test of sphericity (p < 0.001). Results: Three latent dimensions explaining 77.7% of the total variance were identified: (1) institutionalized psychiatric burden, (2) functional capacity of the health care system, and (3) suicidal vulnerability associated with problematic substance use. Standardized factor scores allowed for the classification of Member States, revealing distinct patterns of psychosocial risk. For example, Germany and France display profiles marked by high levels of institutionalized psychiatric activity, while the Baltic and Southeast European countries exhibit elevated suicidal vulnerability in the context of limited medical resources. These results highlight the deep heterogeneity of psychiatric configurations in Europe and reveal persistent gaps between population needs and institutional response capacity. Conclusions: The analysis provides an empirical foundation for differentiated public policies aimed at prevention, early intervention, and stigma reduction. It also supports the case for institutionalizing a European mental health monitoring system based on harmonized indicators and common assessment standards. Overall, the findings clarify the underlying structure of mental health across the European Union and underscore the need for coherent, evidence-based strategies to reduce inequalities and strengthen system performance at the continental level.

Background/Objective: A substantial proportion of patients with obsessive–compulsive disorder (OCD) does not respond adequately to first-line treatments such as selective serotonin reuptake inhibitors and cognitive-behavioral therapy. OCD has traditionally been conceptualized as a serotonergic disorder. However, emerging evidence suggests that glutamatergic dysfunction plays an important role. Ketamine and esketamine are NMDA receptor antagonists with rapid antidepressant effects and have therefore attracted interest as potential treatments for OCD. This scoping review aims to map and synthesize the existing preclinical and clinical evidence regarding the therapeutic potential of ketamine and esketamine in OCD. Methods: A scoping review methodology based on the Arksey and O’Malley framework and Joanna Briggs Institute guidance was applied. Searches were conducted in PubMed, Scopus, and Web of Science. Studies that examined ketamine or esketamine in OCD populations or relevant experimental models were included. Results: Twenty-one studies met the inclusion criteria, of which five were preclinical studies and sixteen were clinical investigations. Preclinical evidence suggests that ketamine and esketamine improve compulsive-like behaviors. Clinical studies suggest that ketamine can produce rapid reductions in obsessive symptoms, though results remain inconsistent. Most trials evaluated single administrations, while limited evidence suggests that repeated dosing strategies may provide greater clinical benefit. Conclusions: Ketamine and esketamine show promise as rapid acting interventions for OCD, particularly in treatment refractory cases. However, current evidence remains preliminary and heterogeneous. Future research should prioritize adequately powered randomized trials and investigation of repeated administration protocols with longer follow-up periods to determine efficacy and optimal clinical implementation.

Background: Electroconvulsive therapy (ECT) remains an effective intervention for severe and treatment-resistant psychiatric disorders. While acute response to ECT is well established, clinical predictors of long-term outcomes remain insufficiently characterized. This study examines the impact of illness duration on long-term ECT effectiveness, operationalized specifically as the amount of time elapsed from treatment completion to psychiatric rehospitalization. By controlling for primary diagnosis, psychiatric comorbidities, sleep disorders, and number of ECT sessions, this study aims to clarify the role of illness chronicity in sustaining remission and reducing relapse risk, while recognizing rehospitalization as a primary indicator of long-term clinical stability. Methods: We conducted a retrospective cohort study of 249 patients treated with ECT at a tertiary psychiatric hospital. Time to first psychiatric rehospitalization following completion of ECT was used as a proxy for relapse. Illness duration was analyzed alongside primary diagnosis, psychiatric comorbidities, sleep disorders, and number of ECT sessions to assess its independent association with long-term outcomes. Results: Nearly half of patients (44.6%) demonstrated sustained clinical benefit, defined by delayed or absent rehospitalization during a three-year follow-up period. Shorter illness duration emerged as a key predictor of more durable remission. Patients with illness duration below 15 years, and particularly those with less than 5 years of illness, experienced significantly longer periods without rehospitalization compared with individuals with longer disease trajectories, despite the latter often receiving more ECT sessions. Conclusions: Shorter illness duration is associated with improved long-term outcomes following ECT, suggesting that earlier intervention may enhance treatment durability. These findings support reconsidering ECT earlier in the course of treatment-resistant psychiatric disorders. Prospective studies integrating clinical, cognitive, and biological markers are warranted to improve patient selection and develop personalized ECT strategies.