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Violence risk is a major challenge among acute psychiatric inpatients. The study aimed to predict violent behavior risk in an acute psychiatric ward using video recordings from the emergency department. 69 videos of the emergency department recording the first ten minutes following patients' arrivals were included. Psychiatrists watched the videos, completed relevant Brief Psychiatric Rating Scale items and answered intuitive questions about each patient's risk of violence. Demographic and clinical data were also collected. Motoric mannerisms as rated in the BPRS significantly differed between violent and non-violent patients (p < 0.05). Additionally, we found a significant correlation between intuitive prediction of violence and actual violence (p = 0.008). Violent behavior was predicted in 42.1% of the cases by the intuitive evaluation compared to 11.5% mistakenly evaluated patients. Logistic regression revealed that the intuitive question and the BPRS items regarding tension and motoric mannerism created a successful model for predicting violence with 88.2% sensitivity and 72.5% specificity. We sought to define the factors that most accurately predict violence in the acute psychiatric ward, based solely on behavior in the emergency department. Intuitive impressions of clinicians and motoric mannerisms should be considered when evaluating patients for potential violent behavior., Competing Interests: Declarations Ethics approval and consent to participate The study was approved by the IRB Committee of Lev Hasharon Mental Health Center on 9th December 2020 (Trial number LH13/2020). Due to the retrospective design of the study, the IRB Committee of Lev Hasharon Mental Health Center waived the participants from signature on informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

The role of the endocannabinoid system (ECS) in depression and suicidality has recently emerged. The purpose of the study was to identify changes in plasma endocannabinoid concentrations of several endocannabinoids and correlate them with depressive symptoms and suicidality in patients with severe major depression undergoing electroconvulsive therapy (ECT). The study included 17 patients that were evaluated in four visits at different stages of therapy. At each visit depression, anxiety and suicidality symptoms were assessed and blood samples collected. Several endocannabinoid concentrations increased following six sessions of ECT, as 2-AG (p < 0.05) and LEA (p < 0.01), and following twelve sessions of ECT, as 2-AG (p < 0.05), AEA (p < 0.05), LEA (p < 0.05) and DH-Gly (p < 0.05). Endocannabinoids also correlated with symptoms of depression, anxiety and suicidality at baseline and at the sixth ECT session. Finally, we found one endocannabinoid, l-Gly, that differentiated between remitted and not-remitted patients at the seventh and thirteenth ECT sessions (p < 0.05). Our findings suggest that depression is markedly related to imbalance of the endocannabinoid system, and further regulated by ECT. Plasma endocannabinoids could be promising biomarkers for detection of depression response and remission., Competing Interests: Declaration of competing interest None of the authors reports any financial or other conflict of interest with regard to this study. The authors furthermore confirm that this manuscript or parts thereof have not been published and are not under consideration for publication elsewhere. They also confirm that all of them contributed significantly to the study. They furthermore, confirm giving their approval to all statements and declarations included in this submission., (Copyright © 2024. Published by Elsevier B.V.)

Aims: To find clinical and immunological signatures of the SARS-CoV-2 and the COVID-19 pandemic on children newly diagnosed with type 1 diabetes (T1D)., Methods: A single-centre, retrospective, observational study comparing the clinical and immunological characteristics of children diagnosed with T1D the year before and during the first 2 years of the COVID-19 pandemic. Data extracted from the medical records included clinical and demographic parameters, COVID-19 PCR results and the presence of anti-islet, thyroid and celiac-related antibodies. Also obtained from the medical records was a family history of T1D, celiac disease and autoimmune thyroid disease in a first-degree family member., Results: A total of 376 children were diagnosed with T1D during the study period. A total of 132 in the pre-COVID era and 246 in the first 2 years of the pandemic. At diagnosis, the pH in children with DKA was lower, and HbA1c tended to be higher in the COVID-19 group compared to the pre-COVID-19 group (7.30 [7.18, 7.35] vs 7.33 [7.19, 7.36], p = 0.046) and (110.9 [86.9, 129.5] vs 100 [80.3, 129.5], p = 0.067]) respectively. Multiple islet antibodies (IA) were significantly more common among patients in the pre-COVID-19 group compared to the COVID-19 group (72% vs 61%, p = 0.032). Tissue transglutaminase antibodies were more common among children diagnosed in the COVID-19 compared to the pre-COVID group (16.6% vs 7.9%, p = 0.022)., Conclusions: Our findings suggest that SARS-CoV-2 and the environmental alterations caused by the pandemic affected the clinical characteristics and the immunological profile of children diagnosed with T1D. It is, therefore, plausible that the virus plays a role in the autoimmune process causing T1D., (© 2023 Diabetes UK.)

Introduction: Chloral hydrate (CH), a medication dating back to 1832, is tranquilizer and sleep promoter still used today. It remains an option for short-term insomnia therapy and sedation before medical procedures, despite its controversial safety profile., Methods: This study investigated the potential benefits of chloral hydrate addition for increasing sleep duration and reducing agitation and violence in inpatients with treatment-resistant schizophrenia (TRS). A retrospective, observational case series design was utilized, analyzing data from fourteen patients diagnosed with TRS disorders., Results: CH addition increased the rate of full night sleep and decreased the rates of agitation and verbal and physical violence events. Notably, no adverse events including falls were reported during CH addition., Discussion: CH shows some short-term benefits in improving sleep disorders and reducing violent and agitated behavior in patients with TRS. Our study has limitations due to its small sample size, retrospective design and lack of a control group. A large-scale, double-blind, randomized trial is needed to further explore the efficacy and safety of CH in psychiatric populations with TRS accompanied by agitation, violence and disturbed sleep., 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 Shelef, Alaa, Bloemhof-Bris, Halperin, Weizman and Stryjer.)