Introduction Paraphrenia is a chronic psychosis that has generally lost its status as an independent nosological entity, not being included in DSM-5. From the perspective of the particular psychopathological picture and the impact of the disease on the patient’s functioning in roles, paraphrenia remains a challenge for the clinician in terms of nosological classification and the correct therapeutic approach. Objectives We take into account a patient who presents the classic diagnostic criteria of paraphrenia with a clinical and evolutionary picture followed for 15 years, with the aim of bringing the paraphrenic phenomenology back to the fore. Methods The case presentation will focus on the richness and absurdity of the delusional ideas that are in great contrast with the good insertion into reality of the subject and the preservation of the core of the personality. We will also describe the main landmarks of positive and differential diagnosis. Results We believe that paraphrenia deserves to be differentiated from other psychotic disorders through the particular variant of insight that also explains the significant capacities of dissimulation and as a result of insertion into the roles of life. This attribute also explains the increased potential for danger and unpredictability of the paraphrenic patient. Conclusions Our approach is an argument for the psychopathological understanding of paraphrenic psychotic phenomenology independent of different nosographic classification systems. We are trying to contribute to increasing the quality of differential diagnosis in psychoses. Keywords psychosis, paraphrenia, differential diagnosis Disclosure of Interest None Declared

Background and Objectives: Cortisol, the stress hormone, is an important factor in initiating and maintaining lactation. Maternal suffering during pregnancy is predictive for the initiation and shorter duration of breastfeeding and can also lead to its termination. The aim of this study is to evaluate the relationship between the level of salivary cortisol in the third trimester of pregnancy and the initiation of breastfeeding in the postpartum period in a cohort of young pregnant women who wanted to exclusively breastfeed their newborns during hospitalization. Materials and Methods: For the study, full-term pregnant women were recruited between January and May 2022 in the Obstetrics and Gynecology Clinic of the Mureș County Clinical Hospital. Socio-demographic, clinical obstetric and neonatal variables were collected. Breastfeeding efficiency was assessed using the LATCH Breastfeeding Assessment Tool at 24 and 48 h after birth. The mean value of the LATCH score assessed at 24 and 48 h of age was higher among mothers who had a higher mean value of salivary cortisol measured in the third trimester of pregnancy (p < 0.05). A multivariate logistic regression model was used to detect risk factors for the success of early breastfeeding initiation. Results: A quarter of pregnant women had a salivary cortisol level above normal limits during the third trimester of pregnancy. There is a statistically significant association between maternal smoking, alcohol consumption during pregnancy and the level of anxiety or depression. Conclusions: The most important finding of this study was that increased salivary cortisol in the last trimester of pregnancy was not associated with delayed initiation/absence of breastfeeding.

Aggression is simultaneously a concept and a phenomenon with a particular complexity, being specific to both the psychic life and the human personality. The most various ways of manifesting aggressiveness are found in pathological personalities. In their case, most variants of hetero-aggressiveness and auto-aggressiveness are described, having multiple implications, from social and moral to the medico-legal ones. The representation levels of personality dimensions have a major contribution to the dynamics of aggressive manifestations and can also explain their severity. The social and cultural environment, the economic status and the facets of the spiritual dimension of personality also shape the clinical-evolutive particularities of hetero-aggressive and self-aggressive manifestations.

IntroductionGeneralized Anxiety Disorder (GAD) is a prevalent emotional disorder associated with increased dysfunctionality, which has a lasting impact on the individual's quality of life. Besides medication, Cognitive-Behavioral Therapy (CBT) represents the golden standard psychotherapeutic approach for GAD, integrating multilevel techniques and various delivery formats that enable the development of tailored treatment protocols. The objective of this study was to compare the efficiency of a standard CBT protocol targeting worries, dysfunctional beliefs, and intolerance of uncertainty with an integrative and multimodal CBT intervention augmented with Virtual Reality (VR). Materials and methodsThis study included 66 participants (M-age = 22.53 years; SD = 2.21) with moderate GAD symptoms that were randomized to the standard CBT group (CBTs; N = 32) and the Integrative and Multimodal CBT augmented with VR (IM-VRCBT; N = 34) group. The interventions comprised 10 weekly sessions conducted by trained CBT therapists, including cognitive restructuring, problem-solving, behavioral exposure, and relaxation techniques. Baseline and post-assessments were conducted with both groups. Primary outcome measures included the Hamilton Anxiety Rating Scale (HARS) and Penn-State Worry Questionnaire (PSWQ) to evaluate the severity of GAD symptoms and worries, respectively. Secondary outcomes involved the administration of Automatic Thoughts Questionnaire (ATQ), Dysfunctional Attitudes Scale (DAS) and Unconditional Self-Acceptance Questionnaire (USAQ). ResultsBoth interventions determined statistically significant effects on both primary and secondary outcomes (ps < 0.001) in the expected direction. However, CBTs was associated with higher effect sizes for anxiety (Cohen's d = 2.76) and worries (Cohen's d = 1.85), in contrast to IM-VRCBT. Also, secondary analyses revealed positive correlations between changes in anxiety and worries level and the reduction of dysfunctional cognitive processes. ConclusionThis research emphasized the effectiveness of CBT interventions for treating adults with moderate GAD symptomatology. Specifically, both interventions were efficient for reducing anxiety symptomatology present at individuals with GAD. However, regarding cognitive dysfunctions like worries, the standard CBT protocol performed better, as compared to the IM-VRCBT. In addition, we conclude that VR could be integrated within CBT interventions in a single protocol for GAD treatment.

Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.

The academic and health system requirements are constantly growing due to the continuous development of this sector. Therefore, it is important to investigate the structural factors that improve performance in the medical system. The aim of our pilot study is to analyze if there are associations or correlations between personality and motivation and the results obtained for the National Residency Exam of Romanian medical graduates. We conducted a prospective pilot study on 179 medical students from George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania between February 2021 and December 2021, who were evaluated by the DECAS, IM, and SPM scale. Our results showed that all the dimensions of personality according to the Big Five Model, which include openness (OR = 0.392, p = 0.01), extraversion (OR = 0.512, p = 0.03), conscientiousness (OR = 3.671, p = 0.004), agreeableness (OR = 2.791, p = 0.07), and emotional stability (OR = 4.863, p = 0.0003), are statistically associated with the result obtained. Motivation also plays an important role in academic achievements, through motivational persistence and motivational involvement which correlates with the conscientiousness dimension and the result obtained. This study confirms that both personality structure and motivation are associated or correlated with the academic results of medical students and represent a starting point for future research.

Borderline personality disorder is the most severe and frequently studied personological diagnosis. There is a significant increase in the frequency and severity of manifestations in this spectrum. It is important to have early detection of risk factors and comorbid conditions, in order to determine the most efficient therapeutic and rehabilitative approach. Affective symptoms, suicide risk and self-control are particularly targeted. Studies in recent years have confirmed the complexity of the phenomenon by offering new ways of understanding the therapeutic efficiency.

The medical specialty contributes to the professional training process through the development of personal skills, through the permanent accumulation of knowledge, but also through the acquisition of new skills, things that are dependent on each individual personality. Choosing an inappropriate specialty can lead to a low level of fulfillment and resolution of the specific requirements of the profession, failures, frustrations, lack of satisfaction and self-affirmation through the profession, overwork, aspects that sometimes even lead to loss of control. Their presence for a longer period can trigger the burnout syndrome. That is why it is very important that the medical specialty be chosen in accordance with the personality, individual abilities, interests, values, but also with personal expectations. Quality of life pursues several aspects, such as physical and mental health, self-esteem, interpersonal relationships and environmental conditions. The right medical specialty will improve the quality of the medical act through the ability to fulfill the obligations at work, but at the same time it also contributes to increasing the quality of life by reducing stress at work. This approach can be integrated in the future in educational programs in order to guide medical graduates in choosing the right medical specialty.

The human personality is always confirmed as a complex and dynamic structure. It integrates dominantly inherited as well as acquired traits, the latter mainly being flexible and malleable in roles and throughout the ages of life. The psycho-behavioral attributes of young age, adulthood and old age can shape personality traits but can also mask their maladaptive variants. The five dimensions of the Big Five model offer the chance for dimensional comments and scenarios that confirm the interferences between personality traits and also their sociocultural conditioning. The dimensions with a protective role or with a dominant adaptive role prove to be, regardless of age, conscientiousness and agreeableness, and the role of stability and depth of emotional feelings in conditioning the subjective well-being and self-esteem should be noted.

The medical specialty contributes to the professional training process through the development of personal skills, through the permanent accumulation of knowledge, but also through the acquisition of new skills, things that are dependent on each individual personality. Choosing an inappropriate specialty can lead to a low level of fulfillment and resolution of the specific requirements of the profession, failures, frustrations, lack of satisfaction and self-affirmation through the profession, overwork, aspects that sometimes even lead to loss of control. Their presence for a longer period can trigger the burnout syndrome. That is why it is very important that the medical specialty be chosen in accordance with the personality, individual abilities, interests, values, but also with personal expectations. Quality of life pursues several aspects, such as physical and mental health, self-esteem, interpersonal relationships and environmental conditions. The right medical specialty will improve the quality of the medical act through the ability to fulfill the obligations at work, but at the same time it also contributes to increasing the quality of life by reducing stress at work. This approach can be integrated in the future in educational programs in order to guide medical graduates in choosing the right medical specialty.

The human personality is always confirmed as a complex and dynamic structure. It integrates dominantly inherited as well as acquired traits, the latter mainly being flexible and malleable in roles and throughout the ages of life. The psycho-behavioral attributes of young age, adulthood and old age can shape personality traits but can also mask their maladaptive variants. The five dimensions of the Big Five model offer the chance for dimensional comments and scenarios that confirm the interferences between personality traits and also their sociocultural conditioning. The dimensions with a protective role or with a dominant adaptive role prove to be, regardless of age, conscientiousness and agreeableness, and the role of stability and depth of emotional feelings in conditioning the subjective well-being and self-esteem should be noted.

Introduction. Psychosis is one of the most debilitating psychiatric disorders, being characterized by loss of contact with reality, without consciousness being affected. Cognitive fusion as a concept is governed by metacognitive processes, in which thought dominates and directs behavior, perceived by the psychotic patient as valid and in line with reality. Materials and method. The sample consists of two groups, a target group (N=20), which includes patients diagnosed with psychosis, hospitalized in the Second Psychiatry Clinic from Târgu-Mures, and a control group (N=20), consisting of students from the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology from Târgu-Mures. There were applied the self-acceptance questionnaire (USAQ) to assess self-esteem and the cognitive fusion questionnaire (CFQ). Aim. The aim of this study is to highlight the relationship between the unconditional acceptance of one’s own person of the subjects diagnosed with psychosis and the cognitive fusion. Results. The statistical interpretation of the data showed a statistically significant difference between the target group and the control group in terms of cognitive fusion (M=26.15; t=13.07, df=38, p 0.05; CI -0.27, 19.28). Conclusions. Cognitive fusion is a mechanism that is found more in psychotic patients than in controls. The present work highlights the need for more studies regarding the field of cognitive fusion and unconditional self-acceptance, for a better understanding of the factors that trigger or maintain psychotic symptoms.

Introduction. Psychosis is one of the most debilitating psychiatric disorders, being characterized by loss of contact with reality, without consciousness being affected. Cognitive fusion as a concept is governed by metacognitive processes, in which thought dominates and directs behavior, perceived by the psychotic patient as valid and in line with reality. Materials and method. The sample consists of two groups, a target group (N=20), which includes patients diagnosed with psychosis, hospitalized in the Second Psychiatry Clinic from Târgu-Mureş, and a control group (N=20), consisting of students from the "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu-Mureş. There were applied the self-acceptance questionnaire (USAQ) to assess self-esteem and the cognitive fusion questionnaire (CFQ). Aim. The aim of this study is to highlight the relationship between the unconditional acceptance of one's own person of the subjects diagnosed with psychosis and the cognitive fusion. Results. The statistical interpretation of the data showed a statistically significant difference between the target group and the control group in terms of cognitive fusion (M=26.15; t=13.07, df=38, p<0.0001; CI -62.42,-45.68), but without differences between the two groups in terms of unconditional acceptance of one's own person (M=34.95; t=1.97, df=38, p>0.05; CI -0.27, 19.28). Conclusions. Cognitive fusion is a mechanism that is found more in psychotic patients than in controls. The present work highlights the need for more studies regarding the field of cognitive fusion and unconditional self-acceptance, for a better understanding of the factors that trigger or maintain psychotic symptoms.

According to DSM‑5 criteria, schizotypal personality disorder is characterized by social anxiety accompanied by poor interpersonal relationships, inability to maintain close relationships, bizarre behavior, suspicious character or paranoid ideation, and perceptual experiences. We present the case of a 21-year-old patient, student, without a documented psychiatric history, who presented to our clinic for a psychopathological picture that had begun about one month before: depersonalization and derealization, emotional lability, emotional ambivalence towards family members, irritability, generalized and anticipatory anxiety, flight of ideas, wear and tear, mixed insomnia, repeated statements with autolytic issues, diminished intellectual performance affecting the management of activities. During the hospitalization, the patient had an oscillating evolution, with the highlighting of obsessive and schizotypal personality traits. The two personality inventories allowed the monitoring for 6 months of the pathological psychobehavioral manifestations in which we consider the psychotic symptoms as efferents of the personality dimensions. Psychotropic, neuroleptic and mood stabilizing treatment has been shown to be useful both in fading psychotic symptoms and in normalizing personality trait levels.

According to DSM‑5 criteria, schizotypal personality disorder is characterized by social anxiety accompanied by poor interpersonal relationships, inability to maintain close relationships, bizarre behavior, suspicious character or paranoid ideation, and perceptual experiences. We present the case of a 21-year-old patient, student, without a documented psychiatric history, who presented to our clinic for a psychopathological picture that had begun about one month before: depersonalization and derealization, emotional lability, emotional ambivalence towards family members, irritability, generalized and anticipatory anxiety, flight of ideas, wear and tear, mixed insomnia, repeated statements with autolytic issues, diminished intellectual performance affecting the management of activities. During the hospitalization, the patient had an oscillating evolution, with the highlighting of obsessive and schizotypal personality traits. The two personality inventories allowed the monitoring for 6 months of the pathological psychobehavioral manifestations in which we consider the psychotic symptoms as efferents of the personality dimensions. Psychotropic, neuroleptic and mood stabilizing treatment has been shown to be useful both in fading psychotic symptoms and in normalizing personality trait levels.

Introduction: It is considered that the role of a doctor is in the territory between his/her intellectual capacity, his/her personality, the interests and values by which he/her is guided [2]. Among the many factors that influence the choice of medical specialization, personality traits play a central role [3]. Objectives: the associations between the personality dimensions and the individual abilities, respectively the option. The present study is of observational-transversal type and targets doctors currently in their residency training. The sample of the study consists of a number of 129 resident doctors from different medical specialties, whose personality was DECAS personality inventory. We aim to evaluate regarding the specialty in the professional career. Material and method: evaluated from a dimensional point of view after the Big Five model with the help of autochthonous scale. Results: Resident psychiatrists highlight lower conscientiousness compared to other specialties, also showing higher agreeableness. Lower extraversion is associated with paraclinical specialties, while higher extraversion was attributed to surgical specialties. Higher conscientiousness characterize a doctor's vocation in general, and was found in sub-specialties of internal medicine. At the same time, the doctors in this specialty also showed an increased agreeableness. Doctors in all specialties had a low level of emotional stability. Conclusions: The study highlights the connection between personality dimensions and orientation in professional activity among the subjects studied. Research in this area can lead to the development of educational programs in order to advise future doctors on the choice regarding a medical career.