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.

Background: The career and work of medical workers are considered to be the occupation of the highly responsible job of the worldwide. Goal: To identify the percentage of the work-related stress, the burnout, and the symptoms of work-related stress of the physicians and nurses who is working at the critical and intensive care units of UB hospitals. Materials and methodology: The survey was done by quantitative methods and cross sectional design. The study data was collected using the validated questionnaire for the work related stress. The results of the study were analyzed by the Microsoft Excel and SPSS 20 program. Results The response rate was 97.3% The study found that 78.7% of respondents reported having regular stress; and 89.4% of all participants in the survey had a personal burnout, 90.4% had work-related burnout and 94.5% had a high level of client-related burnout.
Physical symptoms include the insomnia 76.7%; psychological symptoms - the headaches 65%; behavioral symptoms as like forgetfulness and annoyance 53.3%; cognitive symptoms as like an increase in sick days or absenteeism by 40% for all physicians and nurses.

BACKGROUND. In 1929, Mongolian mental health department established and since then it has been showing qualified professional health care towards population. In code of mental health (7.1.2) it is defined as “mental health care can be carried out by person with professional license that indicated in health law” However, recently people tend to seek help from nonprofessional organizations. Because of psychiatric misconception among population, people usually don’t seek help from professional service that it makes diagnostic delay and people suffer longer from their illness. GOAL. To define diagnoses and pathway of people who seek help first-time from mental health care. MATERIAL AND METHOD. This study was relied upon to NCMH out and inpatient unit. Cross-sectional study method with purposive sampling and questionnaire method wasused in this study. RESULT. In total of 145 patients, 76 males and 69 females, who are aged between 18 to 56 years participated in our study. According to ICD 10, majority of participants (40.7%, n=59) had schizophrenia and schizophrenia spectrum disorders, 21.4%had stress induced disorder, 12.4 % had organic disorder, 11% had affective disorder, and 14.5 % had substance use disorder.According to their help seeking pathway, every patient sought help from professional organization or several nonprofessional organizations and individual person. As we demonstrated the initial help seeking pathway of participants 40% sought help from religious service, 26.2% sought help from psychiatrist, 17.2% sought help from general and 16.6% sought help from other professional doctors. Therefore we demonstrated the amount of participants who sought help from nonprofessional organization and individual person that 60.6% sought help from shaman, 62% sought help from lama. Primary or secondary educated people are tend to seek help from religious service which was statistically significant (p≤0.006).in total of 107 participants sought help from nonprofessional organization and each patient spent about 5,629,122.30±928799 tugrug, but average of total medical fee for per patients in NCMH was 83916±7793 tugrug which costs 7 times lower than nonprofessional organization but improves patients` mental state more, significantly (p≤0.001) Primary or secondary educated patients likely to have diagnostic delay 1 time more than high educated patients, people with nonprofessional initial help seeking likely to have diagnostic delay 2 times more than psychiatric initial help seeking patients and people who imply that religion causes mental illness have diagnostic delay with 2 times more, significantly. (p≤0.001). CONCLUSION. According to study result stress induced disorder and schizophrenia were the majority of total participants. People tend to seek professional help far lately from symptom onset. Psychiatric misconception and inadequate health education among the population are the main reason of diagnostic delay.

Introduction Violence is defi ned by the WHO as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation”. Violence can be divided into many types such as physical, psychological, sexual, neglect and economical etc. Violence against women and child is a manifestation of historically unequal power relations between men and women or child due to patriarchy in many countries of the world. Child maltreatment or violence is one of common public health problems in worldwide and psychologically harm in child’s later life. Objective To detect types, percent and some infl uencing factors of violence against child and adolescent among cases, which were involving into forensic psychiatric evaluation procedures. Materials and Methods We are analyzed all archive documents of NCMH, 2000-2014 by retrospective methodology on based ethical approval of NCMH administration (by ordering 2/189 Oct 28, 2015). Results Total 1067 cases of violence against child and adolescent were registered in 2000-2014 years and 84.7 percent of those (n=904) were sexual violence cases. Gender difference was defi ning among sexual violence cases (girls n=885, p<0.000; boys n=19, p<0.000) with statistically signifi cant. Sexual offender can be act his violence in drunken (OR=2.355; p<0.000; CI 95%; 1.601-3.463) or negative relationship between family members (OR=3.723; p<0.000; CI 95%-2.356-5.883) are more infl uenced to sexual violence against child and adolescent. Conclusion Sexual violence is more registered among child and adolescent maltreatment cases. Children and adolescents are more affected into sexual violence likely to have a negative relationship between the family members or offenders have used alcohol.

Grand mal is the main characteristic of epileptic isorder. Other seizures that caused by non-epileptic disorders are called symptomatic epilepsy, epilepsy-like seizure and symptomatic seizure. The primary treatment of seizure patient is anticonvulsive medication. Therefore, adherence to medication regimen is important to reducing seizure incidence and preventing complications. Accreditation processes to study that how influence on the institution and individual development The survey was conducted by descriptive cross-sectional design in outpatient clinic of NCMH. Morisky Medication Adherence Scales are used to assess adherence to medication regimen of seizure patient’s. Folstein rapid test is used to assess dementia. Overall, 70 patients, aged 20-71 years, 36 males and 34 females were participated our survey. 81.4% of total participants were patients with seizure syndrome caused by brain injure; 14.3% were patients suffering from congenital epilepsy and 4.3% of them could not described causes of their disease. 29.9% of all participants assessed as mild and moderate dementia, 34.3% of participants assessed non-adherent to medication regimen by scale 4 item and 77.1% of participants assessed non-adherent to medication regimen by scale 8 item. 29.9% of all participants have dementia, and 34.3%-77.1% of patients are non-adherent to medication regimen. Thus, our study suggests that there is a direct correlation between dementia and an adherence to medication regimen.

Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.

WHO informed that across world an average of 565 young eople aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological onsequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study nxiety among abused adolescents, some physical parameters and level of cortisol in saliva.Total number of participants were 149 children aged between 11-16 years (number cases were 53, matched control subjects were 96). The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report uestionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, USA. Average age of all subjects in the study was 13.52±1.57 and 102 of all subjects were female and 47 were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (21.3±8.1 ng/ml) statistically significantly lower (p<0.01) than average amount of control group (31.56±16.9 ng/ml). Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.

WHO informed that across world an average of 565 young people aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological onsequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study anxiety among abused adolescents, some physical parameters and level of cortisol in saliva.Total number of participants were 149 children aged between 11-16 years (number cases were 53, matched control subjects were 96). The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report uestionnaire that assesses multiple symptoms of childhood anxiety isorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, USA. Average age of all subjects in the study was 13.52±1.57 and 102 of all subjects were female and 47 were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (21.3±8.1 ng/ml) statistically significantly lower (p<0.01) than average amount of control group (31.56±16.9 ng/ml). Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.