The dialectic between artistic creativity and severe mental illness has long been documented, yet individual cases may offer unique insights into the phenomenological unfolding of psychosis. This narrative analysis examines the clinical and artistic trajectory of Peter Green, founder of Fleetwood Mac and one of the most influential British guitarists of the 1960s, whose mental health declined markedly following intense LSD consumption. During the late 1960s, Green developed progressively intrusive mystical delusions, identity disturbances and significant behavioral dysregulation, culminating in a critical psychotic episode during a tour in 1970. Shortly after leaving the band, he released The End of the Game, a fully instrumental and improvisational album characterized by dissonant textures, repetitive rhythmic patterns and a markedly hallucinatory atmosphere. Drawing on biographical accounts, interviews and historical documentation, the present work interprets the album as an early expressive manifestation of Green's psychotic experience. Its fragmented musical structure, cyclical motifs and escalating tension appear to mirror the emerging disorganization of thought, persecutory anxiety and affective turmoil typical of early-phase psychosis. The album may be understood as a creative attempt to regulate internal chaos while communicating a form of distress otherwise inaccessible through conventional language. Green's subsequent evolution into full-blown schizophrenia, requiring repeated hospitalizations and electroconvulsive therapy, retrospectively reinforces the album's value as a phenomenological document of prodromal psychopathology. This case highlights the importance of interdisciplinary approaches integrating psychiatry, cultural history and musicology to better understand how psychotic processes may be encoded within artistic expression. Parallels with other psychedelic-era musicians underscore the complex interplay between creativity, substance use and vulnerability to severe mental illness.
BACKGROUND: Mental health disorders have been noted as public health menaces that can derail the development of individuals such as young adults. The risk and negative effects of mental health disorders have been widely studied in Western contexts. However, in the non-Western context, research on the risk of mental health disorders is very limited. The purpose of this study was to explore the risk of mental health disorders among young adults across Bangladesh, Egypt, Ghana and the United Arab Emirates. METHODS: A total of 1871 young adults completed the Depression, Anxiety and Stress Scale-21, which was validated via confirmatory factor analysis. Frequency counts, analysis of variance and linear regression were computed to understand the associations between demographics and the domains of mental health disorders. RESULTS: The Depression, Anxiety and Stress Scale-21 was found to be a valid instrument, and the prevalence of mental health disorders ranged between 15% and 18%. However, the risk of mental health disorders seemed to be greater among young adults from Bangladesh than among those from the other three countries. CONCLUSIONS: This study recommends tailored mental health disorder awareness programs in the countries where data are collected. Specifically, targeted training could be designed by policymakers on the basis of characteristics such as age and gender.
BACKGROUND: Prevalence of mental disorders in chronic pain varies widely across studies and can be overestimated using screening tools. The main aims of this cross-sectional investigation were to estimate baseline prevalence of previous clinically assessed psychiatric comorbidity in a chronic pain population during their first contact within an Italian specialist pain clinic, and to examine differences in socio-demographic, clinical, and pain features between patients with and without this comorbidity. An additional aim was to explore prevalence of current psychopathology in the subgroup without psychiatric comorbidity. METHODS: One-hundred-seventy-two participants were enrolled within the "Pain Therapy Service" at the Parma University Hospital. They completed the Brief Pain Inventory (BPI) and the Millon Clinical Multiaxial Inventory-III edition (MCMI-III). Inter-group comparisons were analyzed using the chi 2 or the Mann-Whitney U Test. RESULTS: Thirty-one (18%) participants had a previous clinically assessed psychiatric comorbidity, especially depressive disorder (9.9%). Comorbid patients were more likely to be unemployed and to have longer pain duration, higher BPI severity and interference scores, and fixed-dose analgesic treatment. They also had a greater prevalence of current major depression. Notably, 51.8% (N.=73) of individuals without psychiatric comorbidity showed MCMI-III scores indicative of the current presence of clinically relevant psychiatric syndromes, especially anxiety and somatoform disorders. CONCLUSIONS: Although psychiatric illnesses are more frequent among patients with chronic pain than in the general population, a large proportion of them remain undiagnosed and potentially undertreated. A stable presence of mental health professionals within multidisciplinary teams for chronic pain treatment is recommended.
BACKGROUND: (3-thalassemia major is a chronic, early-onset disease, whose psychopathological correlates in adulthood have only recently been investigated, thanks to the increased availability of treatments that have extended the average life expectancy of these patients. CASE PRESENTATION: The case report presented highlights the importance of psychiatric and psychotherapeutic management of adults with thalassemia. CONCLUSIONS: This management must include a psychodiagnostic assessment, focused on studying the personality profile and defensive styles, in order for realizing targeted psychotherapy interventions when there are psychopathological conditions that reduce compliance with medical treatments and the quality of life of these patients.
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a treatment modality for hematological diseases. Curative treatment administered in a sterile room affects both physical and psychological symptoms of patients during therapy. However, because the physical effects and psychological adaptation to HSCT vary greatly among individuals, improvement in Health-Related Quality of Life (HRQoL) is not always guaranteed, and predicting the actual state of HRQoL in the early post-HSCT period is difficult. Therefore, we explored the psychological factors that contribute to care during protective isolation and HRQoL improvement after discharge. METHODS: Logistic regression analysis was conducted to predict whether participants (N.63; 42 men, 21 women; mean age, 53.6 +/- 12.2 years) would score >= 7 on the 30-item General Health Questionnaire (GHQ-30) at 3, 6, or 12 months post-HSCT. The explanatory variables included subscales of the Center for Epidemiologic Studies Depression Scale, Profile of Mood States (POMS), and the Mental Adjustment to Cancer (MAC) Scale. RESULTS: The Total Mood Disturbance Score from the POMS and Avoidance subscale from the MAC at the time of hospital admission yielded an area under the curve of 0.837 (95% confidence interval: 0.718-0.956), with sensitivity and specificity of 0.696 and 0.864, respectively. The Hosmer-Lemeshow Test showed no significant difference, indicating that the model appropriately predicted a GHQ-30 Score >= 7. CONCLUSIONS: Patients' overall mood state is subjectively experienced even before HSCT through their physical condition. Patients who do not employ avoidant coping strategies in response to cancer-related stress may have better HRQoL outcomes.
BACKGROUND: Mobility restrictions during the COVID-19 pandemic have affected individuals' lifestyles. Autonomic nerve activity fluctuates in response to physical and psychological states and can be assessed using heart rate variability (HRV). This study investigated the associations between HRV-based sympathetic activity, physical activity and dietary habits, and psychological stress in Japanese college students during pandemic-related mobility restrictions. METHODS: Physiological and behavioral measurements were conducted over two days: a sedentary day spent at home and an active day involving exercise with each college club. Electrocardiographic data was obtained using a wearable system to record the heart rate for 24 hours. Sympathetic activity was evaluated using a power spectral analysis of HRV. Questionnaires assessed physical activity and dietary habits and psychological state. RESULTS: The stress values estimated from sympathetic nerve activity were higher on sedentary than on active days. A positive correlation was observed between the estimated stress and negative psychological states. The estimated stress value was negatively associated with physical activity. CONCLUSIONS: The findings indicate that high psychological stress and sympathetic nerve activation were likely linked to altered dietary habits and reduced physical activity. HRV-based stress estimation may be useful for assessing psychological stress and autonomic function in young adults under restricted mobility conditions.
BACKGROUND: Cognitive impairment (CI) is common in chronic kidney disease (CKD). We quantified its prevalence across renal-replacement therapies (RRTs) and identified independent predictors. METHODS: In this cross-sectional study (November 2023-November 2024, Mother Teresa University Hospital, Tirana), 319 adults completed the Montreal Cognitive Assessment (MoCA): 193 CKD patients (hemodialysis [HD]=96; peritoneal dialysis [PD]=22; renal transplantation [TX]=75) and 126 non-CKD controls. Independent t-tests/ANOVA compared mean scores; multivariable logistic regression (N.=193 complete cases) modelled CI (mild-severe). Discrimination was assessed with a receiver-operating-characteristic (ROC) curve. RESULTS: CKD participants scored lower on MoCA than controls (23.1 +/- 3.1 vs. 24.4 +/- 2.6; P<0.001). Severe/moderate CI occurred in 9% of CKD patients versus 2% of controls. In the adjusted model, lower executive/visuospatial ((3=-2.00, P<0.001), attention ((3=-1.96, P<0.001) and memory scores ((3=-1.73, P=0.003) independently predicted CI. Treatment modality influenced risk: PD (odds ratio=0.30, P=0.018) and TX (OR=0.14, P=0.043) were protective, whereas HD was not. Age, systolic blood pressure, glycaemia and diastolic blood pressure were non-significant. The model showed excellent discrimination (AUC=0.842, 95% CI 0.773-0.911) with 95% sensitivity and 72% specificity at the Youden cut-off (J=0.573). CONCLUSIONS: CI is highly prevalent in CKD and chiefly affects executive, attentional and memory domains. Peritoneal dialysis and renal transplantation appear neuro-protective relative to hemodialysis. The high-sensitivity prediction model can serve as a frontline screen to triage CKD patients for full neuropsychological evaluation and inform RRT selection aimed at preserving cognition.
This review examines the efficacy of cognitive-behavioral therapy (CBT) for high-functioning autistic adults, emphasizing its effectiveness, adaptations, and limitations. Adapted CBT effectively addresses common mental health issues such as anxiety, depression, and obsessive-compulsive symptoms by providing structured, concrete strategies tailored to autistic cognitive preferences. Essential adaptations include visual support, structured session formats, mindfulness practices, emotional regulation exercises, and focused social skills training. Despite these benefits, challenges persist, notably in generalizing skills to everyday contexts, managing abstract cognitive restructuring tasks, and addressing diverse autism's presentations, which require personalized interventions. Methodological shortcomings, such as small sample sizes and limited follow-up periods, constrain current evidence. Future research should prioritize rigorous, adult-centered studies, extensive therapist training, caregiver engagement, and technological innovations. Addressing these areas can significantly enhance CBT's efficacy, accessibility, and sustainability, improving overall quality of life, independence, and emotional well-being for autistic adults.
