Vol 6, No 3 (2025)

BACKGROUND: The “Perceived Ability to Cope with Trauma Scale” (PACT) is designed to assess individuals’ perceptions of their ability to use various coping strategies when facing potentially traumatic events. These include focusing on the cognitive processing of the trauma (the “Trauma Focus” subscale) and overcoming the trauma (the “Forward Focus” subscale). The key advantages of the PACT scale include an emphasis on perceived self-competence, the absence of the “flexibility/rigidity” dichotomy, and moderate correlations with distress that confirm discriminative validity.

AIM: To adapt the PACT scale for the Russian population and conduct a psychometric assessment of its Russian-language version.

METHODS: The adaptation procedure included direct and reverse translations of the PACT scale and expert assessment of their quality. To validate the adapted version of the PACT questionnaire, a survey was conducted involving adults who had experienced at least one potentially traumatic event (with assessment according to the Life Events Checklist for DSM-5). The sample was made up of civilians and employees of emergency services (firemen, rescue workers, physicians, psychologists). The psychometric assessment included a check of the factor structure, assessment of sex, age, occupation, and post-traumatic status invariance, as well as assessment of internal consistency and test-retest reliability. The International Trauma Questionnaire and Depression Anxiety and Stress Scale-21 were used to test convergent validity.

RESULTS: A psychometric assessment of the adapted version of the PACT scale was conducted with 1,054 respondents (56% male) with a mean age of 37.2 (standard deviation 9.54) years. Confirmatory factor analysis confirmed the two-factor structure of the scale, complete invariance by age and partial invariance by sex, occupation, and post-traumatic status. The reliability coefficients (Cronbach’s α and McDonald’s ω) showed good values for the “Trauma Focus” subscale (ω=0.810, α=0.806) and the “Forward Focus” subscale (ω=0.896, α=0.893). The test-retest reliability was partially confirmed. The convergent validity of the adapted version of the PACT scale was confirmed: symptoms of distress and post-traumatic stress were negatively correlated with the score on the “Forward Focus” subscale and positively correlated with the “Trauma Focus” score.

CONCLUSION: The Russian-language version of the PACT scale is valid, reliable, and can be used to assess the perceived ability to cope with trauma for research or counseling purposes.

BACKGROUND: During the COVID-19 pandemic, Tunisia implemented a national lockdown between March and May 2020. This disrupted daily life and limited access to essential services. The restrictions significantly reduced social interactions and outdoor activities for children and adolescents, raising concerns about the psychological impact on this population.

AIM: To assess the psychological impact of the COVID-19 lockdown on children and adolescents in Tunisia.

METHODS: A cross-sectional study using a telephone survey was conducted among 514 Tunisian households in August 2020. We included parents of children aged five to 15 years. The collected data included sociodemographic characteristics, general information, and details on the establishment of routines and adaptive containment measures. A 26-item questionnaire was developed to assess anxiety and emotional and behavioral symptoms. Data were analyzed using descriptive statistics and chi-square tests.

RESULTS: Parents reported depressive symptoms, anxiety symptoms and behavioral manifestations in 38.7%, 69.8% and 61.9% of their children, respectively. Among children, female sex was associated with significantly greater levels of depressive symptoms, sleep disturbances, and eating disturbances (p=0.002, p=0.034 and p=0.011, respectively). Children who had somatic chronic illnesses or whose parents had such conditions reported significantly greater levels of somatic complaints (p=0.037). Those whose fathers continued to work during the lockdown had a more positive attitude toward the COVID-19 pandemic (p=0.027). Children with anxiety symptoms had more positive attitudes towards the COVID-19 pandemic (p=0.002); however, those with depressive symptoms did not (p=0.19).

CONCLUSION: The COVID-19 lockdown had a substantial psycho-logical impact on children and adolescents in Tunisia, as indicated by high rates of anxiety, depression, and behavioural disturbances. These findings may contribute to the formulation of evidence-based recommendations aimed at safeguarding the mental health of children and adolescents in future pandemic scenarios, thereby minimizing adverse psychological outcomes.

BACKGROUND: Cognitive impairment in schizophrenia patients is characterized by decreased functioning, reduced quality of life, and is a predictor of a more severe course of the disease. The rs4680 variant of the COMT gene (Val158Met), which encodes catechol-O-methyltransferase, affects dopamine metabolism in the prefrontal cortex and is a key genetic modifier of cognitive endophenotypes. However, the associations of the rs4680 alleles with the severity of cognitive impairment remain unclear. This review summarizes and critically re-evaluates the evidence on the role of rs4680 in the development of cognitive deficits in schizophrenia.

AIM: To explore the associations of the rs4680 variant of the COMT gene with cognitive functions in schizophrenia.

METHODS: A literature search of the PubMed database for the last 10 years (2014–2024) was performed with the search query “rs4680 schizophrenia cognition”. The review included 11 studies.

RESULTS: In the majority of studies (9 out of 11), carriers of the Met allele demonstrated better cognitive parameters, such as verbal and visual memory, information processing speed, and regulatory functions (especially in men). Individuals with the Val/Val genotype demonstrated worse attention. Women in the Russian population with Met allele had better conceptualization and inhibitory control results, and men in the Han population with Met allele had a better association with memory and attention.

CONCLUSION: The results of this review confirm the association between the rs4680 variant of the COMT gene and cognitive function. Although the quality of the studies included in this review was low, the overall results indicate that further investigation of this association is promising. The identification of a stable association between the COMT genotype and the severity of cognitive deficit provides the basis for a personalized approach in the management of patients with schizophrenia. Further studies on the validation of genetic markers in independent cohorts and the development of algorithms for the integration of genetic data with complex neurocognitive assessments and clinical endophenotypes are needed to make the clinical implementation of this approach successful.

BACKGROUND: Delirious mania (DM) is a severe neuropsychiatric syndrome characterized by the acute onset of delirium, psychosis and increased psychomotor activity. Its classification remains debated, with overlapping features of mania, catatonia, and delirium complicating diagnosis and treatment. The condition poses significant challenges in differential diagnosis, particularly in patients with comorbid medical conditions.

CASE PRESENTATION: We report the case of a 52-year-old man with bipolar disorder who presented with acute agitation, disorientation, confabulation, incontinence, and severe behavioral disturbances, initially suggestive of DM. Despite targeted psychiatric treatment, his condition remained refractory until a syphilitic infection was identified, with a possible presentation of neurosyphilis, and treated with antibiotic therapy. Resolution of his symptoms followed, with the delirium persisting briefly after the mania had subsided, suggesting an organic contribution to his presentation.

CONCLUSION: This case highlights the importance of considering organic etiologies, such as neurosyphilis, in presentations of DM. It also supports the view that DM may represent a syndromic entity with both psychiatric and medical underpinnings, rather than merely a subtype of bipolar disorder. Early identification and treatment of DM, along with any underlying medical conditions, are crucial for patient recovery.