Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction, restricted interests, and repetitive behaviors. Evaluating short-term treatment progress and outcomes in children with ASD is important for determining subsequent treatment goals. Aim: This study aimed to evaluate the outcomes during the first 3 months of applied behavior analysis (ABA)-based intervention using changes in Autism Treatment Evaluation Checklist (ATEC) scores. Materials and Methods: A prospective observational study was conducted among 21 children with ASD. Caregivers completed the 77-item ATEC before initiation of treatment and again after 3 months. Scores were calculated for four ATEC domains: Speech/Language/Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior. Result: The mean age of participants was 5.51±1.45 years, and 16 children (76.19%) were male. Mean baseline Clinical Global Impressions–Severity (CGI-S) score was 4.71±0.72, and participants received a mean of 10.00±1.38 hours of ABA-based intervention per week. Mean total ATEC score decreased from 72.71±7.60 at baseline to 67.14±7.81 after 3 months, corresponding to a mean change of -5.57±2.18 points (-7.66%; t=11.706, p<0.001, d=2.55). Speech/Language/ Communication decreased by 7.05%, Sociability by 6.96%, and Sensory/Cognitive Awareness by 6.56%. The largest relative change was observed in the Health/Physical/Behavior domain (-1.90±1.14; -9.80%; p<0.001). Wilcoxon signed-rank tests were significant across all ATEC domains (p<0.001). Sixteen children (76.19%) met the study-defined criterion of more than a 5-point reduction. Baseline CGI-S was correlated with pre-post ATEC change using Pearson correlation (r=0.466, p=0.033), whereas the corresponding Spearman analysis was not statistically significant (ρ=0.349, p=0.121); therefore, this association could not be considered a robust predictor. Weekly ABA treatment hours were not significantly associated with ATEC change (r=-0.183, p=0.427), and age was also not associated with change (r=-0.043, p=0.855). Conclusion Changes across all ATEC domains were observed during the period in which children received ABA-based intervention, suggesting that some treatment-related changes may be detectable over a relatively short period in everyday settings. However, because only two assessment points were available, the rate and sequence of change could not be determined. Future studies should include larger samples, a comparison group, repeated assessments over 6–12 months, and independent developmental and clinical outcome measures.

Background: In Mongolia, identifying the factors and circumstances associated with children and adolescents’ involvement in crime may provide an important evidence base for the early identification of risk factors and the development of effective preventive interventions. In 2021, juveniles accounted for 20.7% (n=218) of the 1,053 civil and criminal forensic psychiatric evaluations conducted at the National Center for Mental Health (NCMH) in Mongolia. However, empirical data regarding the context and risk factors associated with juvenile involvement in the justice system are limited, necessitating this investigation. Aim: To investigate some factors associated with criminal involvement and victimization among children and adolescents. Materials and Methods: A retrospective study was conducted using the records of 725 forensic psychiatric evaluation records of children and adolescents assessed at the NCMH between 2020 and 2022. Data were collected using a researcherdeveloped structured data collection form consisting of six domains and 84 variables. Statistical analysis was performed using STATA, with statistical significance established at p < 0.05. Result: Among the 725 cases included in the study, 197 (27.1%) involved children and adolescents who had committed criminal offenses, while 528 (72.9%) involved child victims of sexual violence. The reason for forensic psychiatric evaluation differed significantly by sex: girls were more frequently evaluated as victims of sexual violence, whereas boys were more frequently evaluated in connection with having committed a criminal offense (p<0.001). The mean age of children who had committed criminal offenses was 16.4±1.6 years, compared with 12.6±3.6 years among victims of crime. Significant differences were observed between these groups with regard to sex (p=0.001) and age (p=0.001). Conclusion 1. Of the 725 participants, 197 children and adolescents (27.1%) were subjected to forensic psychiatric assessment to evaluate their psychological state at the time of committing a crime, while 528 (72.9%) were assessed to determine their capacity to provide true and accurate testimony as victims. 2. Among the 197 crime cases committed, 45.7% involved sexual violence, 27.4% were drug-related offenses, and 13.2% were crimes against the health of others. Males accounted for 94.4% of all crime-committed cases.

Background: Peacekeeping operations (PKOs) demand not only high professional expertise but also immense physical and psychosocial endurance from military personnel. Comprehensively identifying the psychological health challenges and specific risk factors influencing combat stress is of paramount practical significance for maintaining unit combat readiness. Aim: This study aims to evaluate the changes in psychosocial health, personality traits, and underlying risk factors for combat stress among personnel during pre-deployment and active deployment phases. Materials and Methods: A prospective, two-phase longitudinal study was conducted during the pre-deployment training and the subsequent 6-month deployment in UNMISS, South Sudan. Data from 283 personnel who fully completed both phases were analyzed using SPSS via McNemar, Chi-square, Pearson correlation, and multivariable logistic regression. Result: Participants were predominantly male (92.9%) with a mean age of 28.9±5.8 years. During deployment, neurotic symptoms (33.9%), cognitive decline (15.9%), and sleep disturbances (15.2%) were highly prevalent. Female personnel demonstrated statistically significantly higher rates of neurosis, sleep disorders, and anxiety (p<0.05). Multivariable logistic regression analysis revealed that the presence of Post-Traumatic Stress Disorder (PTSD) symptoms significantly increased the risk of developing combat stress by 4.22 times (aOR=4.22, 95% CI: 1.36-13.16, p=0.013). Furthermore, a prior history of exposure to severe life stressors increased the odds of combat stress by 2.68 times (aOR=2.68, 95% CI: 1.01-7.11, p=0.048). Conclusion 1. During peacekeeping operations, service members most frequently encounter environmental and domestic challenges related to health, animals, and insects (44.2–44.5%). Furthermore, high rates of anxiety symptoms (>72.0%) and neurotic symptoms (33.9%, significantly higher in women, p<0.05) were reported. Consequently, personnel highly prioritize psychological resilience (59.0%) and teamwork skills (57.6%) in real-world deployment settings. 2. Logistic regression analysis demonstrated that the primary independent predictors increasing service members’ risk of exposure to combat stress are a personal history of severe life stressors (aOR = 2.68, p=0.048) and the presence of post-traumatic stress disorder (PTSD) symptoms (aOR = 4.22, p=0.013).

Background: In the context of Mongolia, identifying and establishing the causes and underlying factors associated with juvenile and adolescent involvement in crime carries substantial practical significance for the early detection of risk factors and the implementation of targeted preventive measures. In 2021, minors accounted for 20.7% of the total 1,053 cases subjected to forensic psychiatric evaluation at the National Center for Mental Health (NCMH). Subsequently, minors constituted 20.4% (n=251) of cases in 2022, 19.6% (n=203) in 2023, 19.4% (n=225) in 2024, and 23.6% (n=318) in 2025. Notably, the proportion observed in 2025 represents a 4.2 percentage point increase compared to the preceding year. Nevertheless, comprehensive empirical data regarding the underlying causes, surrounding conditions, and specific offense types associated with juvenile criminal involvement remain insufficient, thereby establishing the primary rationale for conducting this study. Aim: To investigate the underlying causes, contributing risk factors, and mental health status of juvenile offenders involved in criminal activities. Materials and Methods: A cross-sectional study design was utilized, enrolling a total sample of 105 male adolescents aged 15–18 years. This sample comprised 35 residents from a Specialized Training and Educational Institution (juvenile correctional facility) and 70 control students from general secondary schools. Primary data collection was conducted using the Child PTSD Symptom Scale for DSM-5 Self-Report (CPSS-5-SR), the Parental Bonding Instrument (PBI), the Kidcope / Family Life Scale (KFLS), and a specially designed structured questionnaire. Result: The overall mean age of participants was 16.69±0.87 years. Among the institutionalized juvenile offenders, 45.7% had a history of prior criminal involvement; specifically, 45.7% had committed rape and 17.1% had committed theft. Regarding substance use behaviors, 82.9% of the juvenile offenders reported smoking tobacco, 71.4% consumed alcohol, and 20.0% had experimented with other illicit or controlled substances, all of which were markedly higher than the rates observed among general secondary school students. Multivariate regression analysis demonstrated that adolescent tobacco use, alcohol consumption, paternal alcoholism, and domestic family conflict exerted statistically significant effects on criminal involvement. Furthermore, screen-positive cases for probable Post-Traumatic Stress Disorder (PTSD) were identified in 40.0% of the institutionalized juvenile offenders, compared to 27.5% among the general secondary school students. Conclusion The prevalence of tobacco, alcohol, and other substance use, alongside adverse family environment influences, is significantly higher among residents of the Specialized Training and Educational Institution compared to general secondary school students. Because juvenile criminal involvement is directly associated with the development of Post-Traumatic Stress Disorder, there is an urgent imperative to integrate targeted mental health care services into rehabilitation and protection efforts.

Background: The COVID-19 pandemic has profoundly impacted global mental health, exacerbating anxiety, depression, and insomnia, with prevalence rates of 25–30%, 27–32%, and 30–45%, respectively—2–3 times higher than pre-pandemic levels. Neuroticism, a key personality trait from the Big Five model, characterized by heightened negative emotions and stress reactivity, has been linked to increased vulnerability. Meta-analyses show neuroticism triples anxiety risk (OR=3.21; 95% CI: 2.35–4.39) and correlates strongly with insomnia (r=0.46, p<0.001) and depression during the pandemic. In Mongolia, empirical data on neuroticism's role remains limited. Objective: This study examines whether neuroticism acts as a risk factor for anxiety, depression, and insomnia among hospitalized patients during COVID-19. Methods: A cross-sectional descriptive study enrolled 552 patients (72.3% COVID-19 cases, 27.7% controls) from tertiary hospitals in Mongolia (2024). Participants (mean age 52.8±15.5 years; 60.5% female) completed self-reported questionnaires: Eysenck Personality Inventory (EPI) for neuroticism, PHQ-9 for depression, GAD 7 for anxiety, ISI for insomnia, and PCL 5 for PTSD. Sociodemographics were assessed. Data were analyzed using SPSS 26.0 with chi-square tests (p<0.05 significance). Instruments showed high reliability (Cronbach’s α=0.81–0.89). Ethical approval was obtained from MNUMS Ethics Committee (No. 2024-Psy-17). Results: Overall, 79.5% were depression free, 84.8% anxiety-free, and 77.5% insomnia-free. High neuroticism (n=381) was significantly associated with depression (24.4% vs. 11.7%, p<0.001), anxiety (18.6% vs. 7.6%, p<0.001), insomnia (28.3% vs. 9.4%, p<0.001), and any mental disorder (21.3% vs. 7%, p<0.001), but not PTSD (p=0.472). Cholerics (n=200) showed elevated risks (depression 29.5%, insomnia 34.5%, p<0.001), while sanguines/phlegmatics were protective. Verbal expression and trust levels showed no significant associations. Conclusion Neuroticism significantly heightens risks for anxiety, depression, and insomnia during COVID-19, underscoring the need for targeted psychological interventions. Temperament-informed screening could enhance prevention strategies in crisis settings.

Background: The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized patients affiliated with MNUMS, compared to a control group. Aim: To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD), and to identify their associated risk factors. Materials and Methods: The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital, Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia (ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted for group, age, and sex. Results: In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%, p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%, p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms (difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]). Conclusion Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic, clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.

Background: COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways (e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al., BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and PTSD among COVID-19 patients over 12 months, compared to a control group. Aim: To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD) among individuals who have had COVID-19 Materials and Methods: In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021 and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12 months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and multivariable logistic regression (p < 0.05). Results: Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12 months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p = 0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19 group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and individuals aged 40–59 years were at elevated risk. Conclusions 1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control group. 2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected after 12 months; this resolution is posited to be associated with the adaptive capacity of the population. 3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.

Background: According to WHO research, there are approximately 24 million people living with schizophrenia worldwide and schizophrenia is characterized by a combination of psychotic and non-psychotic symptoms. Since the cause of the disease is not fully understood, antipsychotic medications are used as symptomatic treatment. According to the 2022 statistics of the NCMH, 718 people with schizophrenia are being treated under active surveillance in Mongolia. The reason for conducting this study is that the manifestation of drug side effects resulting movement disorders in patients with schizophrenia, which has not been studied in Mongolia. Aim: To investigate the relationship between adherence of medication regimen and abnormal involuntary movements in patients with schizophrenia. Materials and Method: The study was conducted using a descriptive method, cross-sectional design, purposive sampling with the questionnaire and standardized tests. Ethical approval for this study was approved by the NCMH (№3/77 30th of January, 2023) and Research Ethics Review Committee of MNUMS (№2023/3-02). Each participant was asked to complete 5 groups of 36 questionnaires, and standard tests were used to assess patients’ adherence to medication regimens (Morisky scale) and abnormal involuntary movement scale (AIMS). The study was conducted between March and August 2023, and the results were summarized and analyzed using STATA 14 software. Results: The study included 209 patients with schizophrenia, aged 18-79 years, of whom 47.4% (n=99) were male and 52.6% (n=110) were female (p=0.21). Of the participants, 28.2% (n=59) had less than secondary education, 76.5% (n=160) were unmarried, and 85.2% (n=178) had a disability due to mental health. 32.5% (n=68) of the patients with schizophrenia in the study used a combination of typical and atypical medications, and the most commonly used antipsychotic drugs were haloperidol (30.6%), chlorpromazine (26.8%), levomepromazine (25.8%), risperidone (24.4%), and quetiapine (21.1%). 1.4% (n=3) of the patients had good, 52.6% (n=110) had moderate, and 45.9% (n=96) had poor adherence to the medication regimen (Cronbach’s α=0.781). However, according to the results of the test for assessing abnormal involuntary that are performed without self-control, 49.76% (n=104) responded that they felt more sensitive to facial and oral movements, and 44.5% (n=93) to limb movements. The patients’ adherence to the medication regimen was statistically significant with facial and oral movements (n=104; p=0.036) and general body movement disorders (n=94; p=0.05). Conclusion 32.5% of patients with schizophrenia were taking typical and atypical antipsychotics, and 45.9% had poor adherence to medication regimens and were more likely to exhibit clinical forms of abnormal involuntary movements, including facial (p=0.036) and general movement disorders (p=0.05).

Background: Sleep quality is frequently highlighted in the literature as a key factor for overall health. Poor sleep quality significantly affects both physical and mental health, diminishing quality of life and potentially harming personal finances. While this issue is influenced by various risk factors, no well-studied research has been conducted on it in Mongolia. Aim: The aim of this study was to assess the frequency of poor sleep quality among visitors to the Sleep center in Mongolia and to identify the factors associated with poor sleep quality. Materials and Methods: This study, conducted using a cross-sectional design, included 200 participants aged 18 to 65 years who visited the Sleep Center at the General Hospital for State Special Servants between January and May 2024. Data were collected using a structured questionnaire. Sleep quality was assessed using the Mongolian version of the Pittsburgh Sleep Quality Index, with a global score above 6 indicating poor sleep. Participants were divided into two groups: “Good sleepers” (n=105) and “Poor sleepers” (n=95). Socio-demographic and clinical variables such as age, sex, levels of education were also recorded. The level of depression, anxiety, and stress was assessed using the DASS 21 (Depression Anxiety Stress Scale) criteria. Univariate analysis was performed using the t-test, Mann-Whitney U test for continuous data, the Х2 or Fishers’s exact test for categorical data, and logistic regression for multivariable analysis. A P-value of less than or equal to 0.05 was considered significant. Results: Poor sleep quality, indicated by a PSQI global score above 6, was observed in 52.5% of the total participants. Univariate analtysis’s test results showed that age, being female, having depression, anxiety, BMI ≥ 25, alcoholism, comorbidities, and using concomitant medications were significantly associated with poor sleep quality (all p<0.05). In the multivariate logistic regression analysis, 50 < age (OR 3.133, 95% CI, 1.245-7.884, p<0.05), BMI ≥ 25 (OR 2.084, 1.039-4.179, p<0.05), alcoholism (OR 3.018, 95% CI, 1.495-6.093, p<0.01) and depression (OR 15.957, 95% CI, 1.592-159.922, p<0.05) were identified as significant risk factors for poor sleep quality. Depression and alcoholism were associated with longer sleep latency and decreased daytime activity (p<0.05). Conclusions 1. In our study, more than half of the participants experienced poor sleep quality. 2. Age over fifty, depression, BMI ≥ 25, and alcoholism emerged as independent significant risk factors for sleep disturbance. Alterations in sleep latency, sleep disruption, and impaired daytime functioning may be associated with poor sleep quality.

Background: Memory is a complex combination of the activities of fixation, keeping and recalling information, which is manifested by quantitative and qualitative changes due to organic mental disorders. Epilepsy is a disorder with neurological and mental symptoms, and depending on the course of the disease, adherence to medication regimen, and the frequency of seizures, memory can decrease leading to partial or complete dementia. Therefore, we conduct this study by Luria A.Ya’s assessment evaluating memory’s changes, such as mechanic memory. Aim: The aim of the study is to evaluate the memory changes in patients with epilepsy using standart questionnaire. Materials and Methods: The study was a hospital-based, descriptive, cross-sectional design, using a questionnaire survey method, and using a standard 10-word memorizing test. The study was conducted in NCMH from 1st of July to 1st of August of 2023 and ethical approval for this study was approved by the NCMH (3/603 14th of June, 2023) and Research Ethics Review Committee of MNUMS (2023/3-08 16th of June 2023). Collected data statistics were created by graphics and tables on Microsoft Word and Microsoft Excel programs and were analyzed in SPSS 21.0 software. Results: The study included 30 patients, 19 (62.5%) men and 11 (36.3%) women, aged 25-59, with a disease duration of 4-59 years. In 60% of cases cause of the disease was brain injury, n=18 had less than secondary education, and n=26 (86.6%) had defined with disability. 73.2% of the study participants fell 2-3 times a week, 73.3% did not take medication as prescribed, and 56.7% did not follow the medication regimen. The results of the 10-word memorizing test showed that 1-9 words were said more often in each repetition, with an average value of 3.2-3.9 for each repetition, and the frequency of the extra words was 0.8. When examining whether the word memorizing test scores depended on the duration of the illness, the number of words recalled by patients with illness lasting up to 59 years was 1-3, indicating that the longer the illness lasted, the lower memory. Conclusion 73.3% of patients do not take medications as prescribed by their doctor (p=0.35), 56.7% do not follow the medication regimen, the average value of the mechanical memory test is 3.2-3.9, and the results show that memory decreases with the duration of the disease, indicating that there are many reasons for the decrease in patients’ memory.