The implementation of Mobile Mental Health Units (MMHUs) was a decisive step in the psychiatric reform and the development of community psychiatric care in Greece

In this open-label naturalistic study, we assess the feasibility, tolerability, and effectiveness of a repetitive transcranial magnetic stimulation protocol with a reduced total pulse number for treating patients suffering from bipolar disorder type II. All patients received one rTMS treatment session of 1000 pulses for 20 consecutive working days, accumulating to 20.000 rTMS pulses applied over 4 weeks. We measured the patients’ symptoms before the start, halfway through, directly after, and one month after treatment. We quantified the depression symptoms using both the Beck depression inventory scale and the symptom checklist-90 depression subscale. Patients showed a significant reduction in depression symptoms directly after treatment and an even further reduction one month after treatment. The remission rates were at 26% halfway through treatment (after the 10th session), 61% directly after treatment (after the 20th session), and increased to 78% at the 1-month follow-up. Importantly, the protocol proved to be feasible and highly tolerable in this patient population, with no adverse effects being reported. Considering these positive results, further research should focus on replicating these findings in larger clinical samples with control groups and longer follow-up periods, while potentially adding maintenance sessions to optimize the treatment effect and stability for bipolar disorder type II patients.

Background/Objectives: Sleep plays a key role in female fertility. Sleep disturbances (SDis) during pregnancy are common and may negatively affect maternal health, contributing to an increased risk of perinatal depression and anxiety. Aim: The present prospective study aimed to examine the interplay of sleep, anxiety, and depression during the pregnancy and postpartum stages, comparing women who conceived naturally (NC) with those who conceived through assisted reproductive treatment (ART). Methods: The study included five timepoints: pre-pregnancy (t0), the end of each trimester (t1–t3), and the postpartum period (t4). SDis were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Fatigue Severity Scale (FFS); perinatal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Demographic and clinical characteristics were also collected. Given the imbalance in group size and the dispersion of values, a negative binomial regression model with robust variances and Satterthwaite approximation for the degrees of freedom was applied. Results: Compared to women with NC (N = 37), those undergoing ART (N = 57) were more likely to be older (p < 0.001), married (p < 0.001), unemployed (p < 0.001), and have a history of thyroid disease (p = 0.008). Significant differences between different time points were observed in both NC (N = 37) and successfully conceived ART groups (N = 9) in all sleep, fatigue, and well-being parameters. Notably, at the end of the first trimester (t1), the ART group reported more severe insomnia symptoms (p = 0.02). Conclusions: SDis are common in pregnancy, but more pronounced during the first trimester among women on ART. These findings highlight the need for early screening and targeted psychological support during perinatal care.