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Introduction: Suicide is the most severe consequence of major depressive disorder (MDD). The most novel researches assume the role of immunological dysregulation in the background – several studies have reported alterations of inflammatory cells related to both MDD and suicidal behaviour (SB). Objectives: Changes in the number of certain immune cells and their ratios have been proposed as potential biomarkers of suicide risk (SR). The aim of our research was to investigate alterations of these values related not only to MDD as an assumed inflammatory state, but also to an increased risk of SB. Methods: In our restrospective cohort study carried out between January 2015 and January 2020, we investigated laboratory parameters of psychiatric patients diagnosed with MDD (n =101). Individuals with recent (≤48 hours prior) suicide attempt (SA) (n =22) and with past SA (>48 hours prior) (n =19) represented the high SR group. MDD patients with no history of SA (n =60) composed the intermediate SR group. We compared the number of neutrophil granulocytes, monocytes, lymphocytes, platelets, leukocytes, neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte ratio (PLR), red blood cell distribution width (RDW) and erythrocyte sedimentation rate (ESR). Furthermore, we evaluated alterations of these parameters related to antidepressant (AD) treatment, which has been proved to have anti-inflammatory effects. Statistical analyses were carried out using GraphPad 9.5.0 and MedCalc 16.8 programmes. Results: We found a significant increase in neutrophil granulocyte count (p =0.016), NLR (p =0.031, Fig. 1), monocyte count (p ≤0.0001), MLR (p =0.005, Fig. 2), leukocyte count (p =0.048) and ESR (p =0.037) in patients with recent SA compared to patients with no history of SA. Moreover, there was a significant elevation in monocyte count (p ≤0.0001), MLR (p =0.020, Fig. 3), ESR (p =0.041) and RDW (p =0.037) in patients with high SR compared to patients with intermediate SR. AD treatment resulted in a significant decrease in neutrophil granulocyte count (p =0.0163) and NLR (p =0.016), however, it did not affect the rest of the parameters. Image: Image 2: Image 3: Conclusions: Assuming immunological mechanisms in the background of MDD and SB, our findings support the role of NLR as a biomarker of acute SR, though its alterations may be masked by AD therapy in the long term. However, MLR – remaining unaffected by AD treatment – may be a possible indicator of both acute and long term suicidal vulnerability. In order to further specify the diagnostic value of these parameters, future prospective research is needed. The study was supported by the FIKP-IV and the TNIL projects. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Mentalizing helps us to understand the behaviour of others in our everyday social interactions. Spontaneous mentalizing without explicit instructions refers to representing mental state attribution. Several studies have described social cognitive deficit in schizophrenia, which largely determines the functional outcome of the disease. Objectives: To better understand the involvement of spontaneous mentalizing in schizophrenia, we consider it important to summarize the results of studies that used indirect instruction to measure spontaneous mentalizing performance in schizophrenia. Methods: In our meta-analysis, we conducted a systematic search of four large databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials [CENTRAL], Web of Science). A total of 14 articles were involved. Results: Based on our findings, the performance of patients with schizophrenia is significantly weaker than in the average population for both scripts with mentalizing interactions (MD: -0.63; 95%CI (-0.90, -0.35); p=0.0021), and with goal-directed movements (SMD: -0.55; 95%CI (-0.97, -0.13); p=0.02). The intentionality of expressions used by patients with schizophrenia is significantly lower compared to the average population (for both animations with complex social interactions: MD: -0.99; 95% CI (-1.39, -0.59); p=0.0003; and with goal-directed movements: MD: -0.31; 95% CI (-0.53, -0.08); p=0.0218). We have found no significant difference neither in appropriateness nor in intentionality of verbal terms between the two goups in the case of animations with random movements. Conclusions: Based on the meta-analysis, we found poorer performance in schizophrenia in spontaneous mentalizing. We also found poorer performance in tasks with goal-directed movements used as control tasks, suggesting a more pervasive impairment of mentalizing in schizophrenia. These deficits may affect the functional outcome of the disease and could potentially have therapeutic implications. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

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Introduction: Minor physical anomalies (MPAs) are insignificant errors of morphogenesis, which may reflect basic neurobiological features underlying the disease. Despite several studies about the presence of MPAs in bipolar disorders, the evidence in favor of a neurodevelopmental basis for the disease is still controversial. Objectives: The aim of this meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in bipolar disorders, and to investigate if MPAs may be found predominantly in the head and facial regions in patients with bipolar affective disorder compared to healthy controls (HC). Methods: Four studies, involving 155 patients with bipolar disorders (BPD), as well as 187 HC, were involved in the analysis after literature search. For the investigation of MPAs in the periferial (MPA-P) and in the head and facial regions (MPA-FC) two studies involving 121 BPD patients, as well as 133 HC passed the inclusion criteria. Results: The MPAs of BPD were significantly higher compared to HC (SMD = 0.62, p = 0.003). Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of healthy controls. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects (SMD = 0.84, p < 0.001). Conclusions: The findings of the present study suggest an early insult during the development of the brain in bipolar affective disorder. [ABSTRACT FROM AUTHOR]

Objectives: Team or group cohesion is a multifaceted construct with a variety of definitions and measurement instruments. However, most of these measures are context and group-specific and/or time-consuming. There is no adaptable and economic measure of group cohesion in Germany. Therefore, the aim of this study was to validate the German version of the 6-item Perceived Cohesion Scale (PCS) in a sample of adult nurses in a German University Hospital., Material and Methods: The German version of the PCS was generated according to existing guidelines. Confirmatory factor analysis was conducted to assess factor structure. Reliability was tested via internal consistency. To assess convergent and divergent validity, the authors applied the Copenhagen Psychosocial Questionnaire (COPSOQ), the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Inventory (ESSI), the Effort-Reward Imbalance (ERI) scale and the Patient Health Questionnaire (PHQ-4)., Results: The confirmatory factor analysis confirmed a 2-factor structure. Psychometric properties of the German PCS prove satisfactory. Internal consistency was excellent for the whole scale (α = 0.95), as well as for both subscales: sense of belonging (SOB) (α = 0.94) and morale (MOR) (α = 0.93). Moderate to strong correlations with the subscales of COPSOQ (Kendall's Tau (τ) = 0.239 - 0.471) indicated very good convergent validity. Regarding divergent validity, the correlations of the PCS subscales and the PHQ-4 were low (τ = -0.109-[-0.143]), as were the correlations with ESSI (τ = 0.045-0.136). Correlations with ERI were low to moderate (τ = -0.181-0.283)., Conclusions: The German version of the PCS showed good psychometric properties. Due to its economic and universal deployment, group cohesion can be measured in a variety of contexts and settings. Int J Occup Med Environ Health. 2024;37(4):421-32., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

It has been recognized that subtle, cosmetically insignificant anomalies tend to occur cumulatively in diseases with neurodevelopmental origin. These visible signs of morphogenesis errors are called minor physical anomalies (MPAs), serving as sensitive external markers of abnormal neurodevelopment. After the introduction of the Waldrop Scale, the studies conducted on MPAs in diseases with neurodevelopmental origin gave conflicting results. It has been debated that this discrepancy can be - at least partly - attributed to the use of the Waldrop Scale. Understanding the need of a comprehensive scale of MPAs that also differentiates according to the time of development, Hungarian pediatrician professor of University of Pécs, Károly Méhes developed a scale with 57 items, the only scale differentiating minor malformations from phenogenetic variants. With the use of the Méhes Scale, our research group has been investigating the role of abnormal neurodevelopment in different neuropsychiatric and neurologic disorders since 1997. 25 years into our research, in this review we summarize the results of our 18 research articles on MPAs in different diseases. We have found an increased number of MPAs, especially in the head and mouth region, in patients with schizophrenia, bipolar disorder, Tourette syndrome, autism and many epilepsy syndromes, fortifying the role of abnormal neurodevelopment in these diseases. Moreover, an increased number of MPAs was detected among the first-degree relatives of patients with schizophrenia and bipolar I disorder, supporting the hypothesis about MPAs being endophenotypic trait markers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tényi, Csábi, Janszky, Herold and Tényi.)

The usage of smart glasses in goods logistics and order picking has mainly been studied through cross-sectional experimental studies. Our longitudinal field study investigated the effects of smart glasses on the eyesight of 43 employees at two German companies. We combined ophthalmological examinations and questionnaire surveys at two points in time, six months apart. The vision of the employees was examined before and after each work shift. Mixed effects logistic regression was conducted to determine the associations between smart glasses use and effects on visual acuity. In the baseline examination, differences in eyesight before and after shifts were small and not statistically significant. However, some individuals experienced deteriorations, especially in visual acuity at near distances ( n = 7 for the right eye, n = 6 for the left). Participants over 40 years of age had 16.1 times higher odds of deterioration compared to those under 40 years (95% CI: 2.7-95.9, p = 0.002). The most commonly reported eye strains were eye fatigue ( n = 32), rubbing ( n = 25), and burning ( n = 24). If smart glasses are to be implemented in logistics companies, it is recommended to offer employees eye tests with an industrial physician in advance.

Background: To date there is no causal treatment for post-COVID syndrome, leaving symptomatic treatments as the primary recourse. However, the practical implementation and effectiveness of these interventions remain underexplored. This study aimed to investigate the utilization frequency of symptomatic therapies and patient-reported effectiveness across various treatment modalities at a German post-COVID center., Methods: As the baseline investigation we conducted a single-cohort retrospective study to analyze the frequency of symptomatic therapies among post-COVID patients who attended the post-COVID center of the University Hospital of Erlangen, between December 2022 to July 2023. Additionally, we administered a follow-up at least 3 months after the initial presentation, using a questionnaire to assess patient-reported improvements in post-COVID symptoms associated with the symptomatic therapies received., Results: Our study included 200 patients (mean age: 44.6 ± 12.6 years; 69.0% women; mean duration since acute infection: 15.3 ± 8.3 months). Pharmacotherapy was the predominant symptomatic treatment (79.5%), with psychotropic drugs (32.5%) and analgesics (31.5%) being the most frequently prescribed. Over half of the patients (55.5%) utilized vitamins and nutritional supplements. Hospital admission rates to acute care occurred in 35.5% of cases; 33.0% underwent inpatient rehabilitation and 31.0% pursued outpatient psychotherapy. Cardiologists (76.5%), pulmonologists (67.5%), and neurologists (65.5%) were the most consulted specialists. Therapies involving medical devices were infrequently employed (12.0%). In a follow-up questionnaire (response rate: 82.5%, 6.3 ± 2.2 months post-baseline), beta-blockers were the most effective pharmacological intervention with 31.5% of patients reporting strong to very strong symptom improvement, followed by antibiotics (29.6%). Furthermore, 33.0% of the patients perceived plasmapheresis to strongly alleviate symptoms. Only a small proportion of the sample attributed a strong or very strong symptom improvement to outpatient psychotherapy (11.0%)., Conclusion: This study provides initial insights into symptomatic therapy utilization and patient-reported symptom improvement in post-COVID syndrome. Further research into symptoms clusters and interdisciplinary collaboration are warranted to comprehensively address the multifaceted physical and psychological symptomatology., Trial Registration: The study was registered at the German Clinical Trials Register (DRKS-ID: DRKS00033621) on March 20, 2024., (© 2024. The Author(s).)

Introduction: In addition to physical symptoms such as dyspnea, fatigue, post-exertional malaise, and pain, a subgroup of patients with Post-COVID-19 syndrome (Post-Acute Sequelae of COVID-19, PASC) suffers from mental illnesses such as anxiety, depression, and neurocognitive impairments. To date, there are no causal treatments available for PASC. While initial studies show that psychotherapy improves psychological symptoms, PASC-related fatigue, and psychosocial functioning, further research is needed to evaluate the effectiveness of psychotherapeutic treatment for PASC., Methods and Analysis: This study presents a non-randomized controlled trial aimed at evaluating the effectiveness of a five-week multimodal inpatient psychosomatic treatment program for individuals experiencing PASC symptoms and comorbid mental illness. A total of 118 patients presented at the Post-COVID Center at the Universitätsklinikum Erlangen will be assigned to the intervention group receiving inpatient psychosomatic treatment or the control group receiving treatment as usual. The inclusion criteria for the intervention group are a diagnosis of PASC and at least one condition of mental distress and problems with coping with illness. The primary objective of the intervention is to reduce mental ailments, including depression and anxiety, as well as neurocognitive deficits, and to address PASC symptoms such as fatigue and pain. The core elements of the treatment are psychotherapy in individual and group settings, medical treatment, neurocognitive training, and physical therapy, adapted to the individual's capacity and oriented towards the concept of pacing. After enrollment, participants will undergo a 6-month follow-up to assess long-term results and the sustainability of the intervention effects., Discussion: This study examines the effectiveness of inpatient psychotherapeutic treatment in PASC patients with comorbid mental illness in comparison with a control group based on treatment as usual. The results of the study can contribute to the development of evidence-based interventions to address the complex needs of patients with PASC and comorbid mental illness., Trial Registration: German Clinical Trial Register (DRKS), retrospectively registered 15.02.2024 DRKSID DRKS00033562., (© 2024. The Author(s).)

Background and Objective: The impairments and duration of PASC (post-acute sequelae of COVID-19) symptoms in mental health have, to date, not been comprehensively examined. Our objective is to provide longitudinal data on the mental health of Post-COVID patients and to identify risk and protective factors associated with a severe or prolonged course., Methods: The mental health of 265 Post-COVID patients of the outpatient Post-COVID centre of the University Hospital Erlangen was assessed 17.1 (T0) and 22.5 months after infection (T1). An online survey with validated questionnaires for Post-COVID symptoms (Post-COVID Syndrome Score), depression (Patient Health Questionnaire-9), somatic symptoms (Patient Health Questionnaire-15), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale) and Post-Exertional Malaise (PEM) (DePaul Post-Exertional Malaise Screening) was conducted in the home environment., Results: In total, 80% of patients experienced severe PASC at follow-up. Clinically relevant symptoms of depression, persistent somatic symptoms, anxiety and fatigue were reported by 55.8%, 72.5%, 18.9% and 89.4% of patients, respectively. Depressive, anxiety and somatic symptom severity decreased significantly over time; fatigue and PEM remained at an unchanged high level. The risk factor for higher depression scores was older age; prior psychiatric illness treated with psychotherapy was associated with more severe depressive, somatic, anxiety and PASC symptoms. PEM symptoms were significantly associated with longer duration between acute infection and initial presentation in the Post-COVID centre., Conclusions: Our findings align with previous research, claiming severe mental health symptoms in PASC syndrome, lasting for months after infection. In-depth assessment of risk and protective factors for the mental health implications of PASC is needed for the planning of health services and disease prevention.

The COVID-19 pandemic exacerbated the challenging working conditions of healthcare workers (HCWs) in many regions. A considerable proportion of HCWs in Germany are migrants facing additional migration-related stressors. The aim of this cross-sectional web-based survey was to examine depressive and generalized anxiety symptoms among migrant and native HCWs in Germany during the pandemic. We compared 780 migrant (first- and second-generation) HCWs from different backgrounds with 6,407 native HCWs. Multiple linear regression analyses were used to examine associations between occupational and COVID-19 related variables, controlling for sociodemographics. Migrant HCWs from low-/middle-income countries more frequently had clinically relevant depressive symptoms (PHQ-2 ≥ 3) than did those from high-income countries (29.9% vs. 16.7%, p  = .002, ϕ = .156) (all other ϕs/Cramer's V s ≤ .036). There were no clinically relevant differences in anxiety levels (GAD-2 ≥ 3) between native vs. migrant HCWs, native vs. the individual migrant HCW groups, or between the sexes (all ϕs/Cramer's Vs  ≤ .036). After controlling for key sociodemographic characteristics, native HCWs did not differ from the individual migrant HCW groups on depression and anxiety severity (depression: all βs ≤ |.030|, anxiety: all βs ≤ |.014|). A high percentage of HCWs reported distress, with migrants from low-/middle-income countries reporting highest burden. The results indicate the need to establish prevention programmes for HCWs, with special consideration to vulnerable populations including certain migrant groups., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Service use among employees with mental health problems and the associated costs for the health and social system have not yet been systematically analysed in studies or have only been recorded indirectly. The aim of this article is to report the service use in this target group, to estimate the costs for the health and social system and to identify possible influencing factors on the cost variance., Methods: As part of a multicentre study, use and costs of health and social services were examined for a sample of 550 employees with mental health problems. Service use was recorded using the German version of the Client Sociodemographic Service Receipt Inventory (CSSRI). Costs were calculated for six months. A generalized linear regression model was used to examine influencing cost factors., Results: At the start of the study, the average total costs for the past six months in the sample were € 5227.12 per person (standard deviation € 7704.21). The regression model indicates significant associations between increasing costs with increasing age and for people with depression, behavioural syndromes with physiological symptoms, and other diagnoses., Discussion: The calculated costs were similar in comparison to clinical samples. It should be further examined in longitudinal studies whether this result changes through specific interventions., (© 2024. The Author(s).)

Background: The utilization of psychotherapeutic consultation at work (PT-A) has so far been investigated in large enterprises (LEs). These differ structurally from small(est) and medium-sized enterprises (SMEs). Differences in the user profiles of a PT‑A with regard to psychosomatic health, work-related self-efficacy, and work ability depending on company size have hardly been investigated. This study also examined differences in the employees' perception of the psychosocial safety climate (PSC) in the company, which represents management's efforts to promote mental health., Methods: As part of the Early Intervention in the Workplace intervention study called "friaa", employees from LEs and SMEs interested in a PT‑A were surveyed throughout Germany from September 2021 to January 2023. Using t‑ and χ 2 -tests, differences between employees in LEs (n = 439) and SMEs (n = 109) were examined with regard to the ICD-10 F diagnostic code ("International Statistical Classification of Diseases and Related Health Problems"; mental and behavioral disorders), depression (PHQ-9), anxiety (GAD-2), level of functioning (GAF), somatic symptom burden (SSS-8), health (VR-12), ability to work (WAI), self-efficacy (SOSES), and psychosocial safety climate (PSC-4). The association between these variables and especially the PSC‑4 were investigated using correlation analysis., Results: Both groups showed similar levels of stress. From the employees' perspective, psychosocial issues were addressed significantly more frequently in LEs than in SMEs with a medium effect size. The study provided initial indications that in LEs there were positive correlations of the PSC‑4 with SOSES and WAI and negative ones with PHQ‑9 and SSS‑8., Discussion: The comparable psychological strain on employees in LEs and SMEs points to the need for behavioral and structural preventive measures regardless of the company size. Mainly in SMEs, organizational communication of psychosocial health should be given greater priority., (© 2024. The Author(s).)

Background: Risk factors for mental health can be found in socio-economic-, gender- and migration-specific inequalities. These factors and the extent of depression, anxiety, and somatization among employees were examined in the present study., Methods: As part of the Early Intervention in the Workplace Study (friaa), mentally burdened employees at five locations in Germany were surveyed on socio-demographic-, work-, migration-, and health-related content. Regression analyses were used to examine the relationship between these factors and depression (Patient-Health-Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder-2, GAD-2), and somatization (Somatic Symptom Scale-8, SSS-8) in the entire sample and in people with migration background (MB). For the latter, acculturation (Frankfurt Acculturation Scale, FRACC) and the perception of burden in terms of demands of immigration (Demands of Immigration Scale, DIS) were also taken into account., Results: On average, the 550 employees (12% with MB) showed clinically relevant depression (M = 13.0, SD = 5.1) (PHQ-9 ≥ 10), anxiety (M = 3.5, SD = 1.7) (GAD ≥ 3) and somatization (M = 13.0, SD = 5.8) (SSS-8 ≥ 12). Female gender was associated with higher anxiety and somatization. Older age and night shift work were associated with higher somatization., Discussion: The results confirm the high level of mental burden among this sample of employees in Germany. In order to maintain their mental health, support measures should be offered, especially for vulnerable groups such as women, older employees, and night shift workers., (© 2024. The Author(s).)

Data on reproductive safety of recently approved newer antipsychotics are limited. Here, we report a case vignette of a patient with schizophrenia treated with cariprazine during pregnancy. The patient became pregnant unexpectedly while taking medication. As a result of shared decision-making, the patient and her psychiatrist decided to continue the treatment, which proved to be protective against relapse and had no adverse effect either on the course of pregnancy or on the health of the newborn. Cariprazine maintenance treatment during pregnancy was found to be safe in our case., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Herold, Tényi, Herold and Tóth.)

Developing new drugs or generating evidence for existing drugs in new indications for ultra-rare cancers is complex and carries a high-risk of failure. This gets even harder in ultra-rare tumours, which have an annual incidence of 1 per 1,000,000 population or less. Here, we illustrate the problem of adequate evidence generation in ultra-rare tumours, using Alveolar Soft-Part Sarcomas (ASPS) - an ultra-rare sarcoma newly diagnosed in approximately 60 persons a year in the European Union - as an exemplar case showing challenges in development despite being potentially relevant for classes of agents. We discuss some possible approaches for addressing such challenges, especially focussing on constructive collaboration between academic groups, patients and advocates, drug manufacturers, and regulators to optimise drug development in ultra-rare cancers. This article, written by various European stakeholders, proposes a way forward to ultimately get better options for patients with ultra-rare cancers., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Silvia Stacchiotti; Related to the submitted work: none. Unrelated to the submitted work: personal financial interests (honoraria, consultancy or advisory role): Aadi, Astex Pharmaceuticals, Bavarian Nordic, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Deciphera, Epizyme, Gentili, GSK, Agenus, Ikena, MaxiVAX, Novartis, PharmaMar, Pharma Essentia, Rain Therapeutics, Servier. Support for attending meetings and/or travel: Pharmamar. Institutional financial interests: Advenchen, Bayer, Blueprint, Daiichi Sankyo, Deciphera, Epizyme, Eli Lilly, GSK, Hutchinson, Inhibrx, Karyopharm, Novartis, PharmaMar, Rain Therapeutics, SpringWorks. Unpaid Member of the Scientifc Advisory Board of the Chordoma Foundation, of the Desmoid Foundation, of the Epithelioid Hemangioendothelioma Group, and of the Leiomyosarcoma Foundation. Kathrin Schuster & Roger Wilson; Related to the submitted work: none. Unrelated to the submitted work: Kathrin Schuster is employed by the Sarcoma Patient Advocacy Global Network (SPAGN); Roger Wilson is a voluntary Board member of SPAGN; SPAGN receives financial funding from: Bayer, Blueprint Medicines, Daiichi Sankyo, Deciphera, Novartis, PharmaMar, Boehringer Ingelheim, IDRx, INHIBRX, PTC Bio and Springworks. Bernd Kasper: Related to the submitted work: none. Unrelated to the submitted work: Personal financial interests (honoraria, consultancy or advisory role): Ayala, Bayer, Boehringer Ingelheim, GSK, PharmaMar, Springworks Therapeutics. Institutional financial interests: Ayala, Cogent, PharmaMar, Rain Therapeutics, Springworks Therapeutics. Gauthier Bouche, Pan Pantziarka, Ralf Herold and Francesco Pignatti have no competing interests to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Migrants and refugees/asylum seekers, as a large part of the European work force, are often confronted with unfavorable working conditions in the host country. Main aim of this systematic review was to compare the association of these working conditions with mental health between migrants and refugees/asylum seekers due to their diverse migration experiences and cultural origins, and between different European host countries., Methods: Systematic search for eligible primary studies was conducted in three electronic databases (PubMed/MEDLINE, PsycINFO and CINAHL) using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide and suicide attempts, psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Two reviewers independently completed screening, data extraction and the methodological quality assessment of primary studies using the Newcastle-Ottawa-Scale. Descriptive summary of primary studies on working conditions and their relationship with mental health were conducted, comparing migrants and refugees/asylum seekers, migrants and refugees/asylum seekers of different cultural backgrounds (collectivistic and individualistic) and migrants and refugees/asylum seekers living in different host countries., Results: Inclusion criteria were met by 19 primary studies. Voluntary migrants are more likely to experience overqualification in the host country than refugees. In all examined host countries, migrants and refugees suffer from unfavorable working conditions, with migrants from collectivistic countries being slightly at risk compared to migrants from individualistic countries. Most unfavorable working conditions are related to poor mental health, regardless of migrant status, cultural origin or host country., Conclusions: Although the results should be interpreted with caution due to the small number of studies, it is evident that to maintain both the mental health and labor force of migrants and refugees/asylum seekers, their working conditions in host countries should be controlled and improved. Special attention should be paid to specific subgroups such as migrants from collectivistic societies., Ethics and Dissemination: This systematic review is excluded from ethical approval because it used previously approved published data from primary studies., Trial Registration Number: CRD42021244840., (© 2024. The Author(s).)

Introduction: Theory of mind (ToM) is a crucial skill in navigating and functioning in the social world. Significant ToM impairment was consistently found in bipolar disorder; it can be both a state and trait marker of the disorder. However, most of the ToM tests are not sensitive enough to detect subtle individual differences, which would be necessary for an individualized treatment plan. The Short Story Task (SST) is a new way to sensitively assess individual differences in ToM performance. The aim of the study was to test the feasibility of SST in patients with bipolar disorder., Method: 31 persons (11 male, 20 female) with bipolar I disorder and 31 healthy individuals (15 males and 16 females) as a control group were recruited. SST was used to evaluate ToM performance. The SST uses a Hemingway novel, in which the patient is presented with a realistic social situation, where the motivations of the characters and the underlying relationships of events are not explicitly described., Results: In the explicit mental state reasoning questions the CG (M = 8.06) had significantly higher (p < 0.001) scores than the persons with bipolar I disorder (M = 5.03). There was no ceiling effect for explicit ToM scores in either group. Participants in CG (M = 8.03) also significantly outperformed (p = 0.006) the BG participants (M = 6.55) in the comprehension questions. The spontaneous mental state inference question was performed equally (M = 0.23) in both groups. Group assignment (t = -3.503, p < 0.001), comprehension score (t = 2.864, p = 0.006), and spontaneous mentalization (t = 2.846, p = 0.006) significantly predicted the explicit ToM performance., Conclusions: Overall, we found that the Short Story Task is a promising tool for measuring ToM in patients with bipolar disorder without ceiling effect. Primarily explicit ToM was found to be deficient, which corresponds well with the ToM literature in bipolar disorder. Contrary to our hypothesis we could not detect impairment in spontaneous ToM and found that patients living with bipolar disorder also showed deficits in comprehension. The lack of assessment of neurocognitive skills is a significant limitation of the current study., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 Elsevier Ltd. All rights reserved.)