Temperament and mental illnesses are considered to be varying degrees along the same continuum of neurotransmitter imbalance in neurophysiological systems of behavioural regulation. Three studies investigated relationships between temperament traits and clinical scales measuring five groups of symptoms of mental illness: Depression, Anxiety, Antisocial behaviour, Dominance-Mania and Borderline/Schizophrenia.

The intake records of 395 (Study 1), 331 (Study 2), and 214 (Study 3) clients of a private psychological practice were examined, including their scores on the Structure of Temperament Questionnaire (STQ-77); Study 3 used the Personality Assessment Inventory (PAI). The sample was divided into four age groups (17-24, 25-45, 46-65, and 66-84).

Study 1 and 2 found changes in the dynamical aspects of behaviour, such as endurance, plasticity and impulsivity in patients suffering from anxiety and depression. Study 3: Scores on the Depression- and Anxiety-related scales of PAI correlated with temperament scales of the STQ in a pattern similar to Studies 1 and 2. Anti-social scales of PAI correlated positively with Sensation Seeking and Impulsivity of the STQ-77. Higher Anxiety and Anti-social symptoms appeared to be more prominent in the younger age (unlike Depression symptoms), and declined with age. Dominance-Mania scores of PAI correlated positively with the Social-verbal Endurance and Tempo, Empathy and Self-confidence.

The analysis of age differences in association between temperament and mental illness showed age-sensitive patterns. Strong concurrent validity between the STQ-77 and the PAI scales suggests links between temperament traits and disposition for the main group of mental illness.

Dysphoria is a complex emotional state that seems to be present in many psychiatric disorders (especially in BPD), but whose psychopathological core is still surrounded by a halo of vagueness, so that measuring its construct empirically is difficult and suitable tests to do that do not exist in Italy.

To analyze the psychometric properties of the Italian version of the Nepean Dysphoria Scale (NDS; Berle & Starcevic, 2012), a self-report questionnaire that measures dysphoria, reflecting its multidimensional nature.

To validate the Italian version of the NDS for using it in routine clinical practice and to assess dysphoria in a more conceptually coherent way.

The NDS was administered to 132 university students, along with other conceptually similar (Beck Depression Inventory II, Dysfunctional Attitude Scale – Form A and Toronto Alexithymia Scale) and conceptually distinct (Anxiety Sensitivity Index – 3) instruments. Then, its characteristics (internal consistency, factor structure, convergent and divergent validity) were examined, comparing them with those of the original version.

The 22-item NDS demonstrated excellent internal consistency (alpha = 0.94). A four-factor solution was confirmed, with factors pertaining to irritability, discontent, surrender and interpersonal resentment. There were medium to strong correlations with the Beck Depression Inventory II, and weaker but still significant correlations with Dysfunctional Attitude Scale – Form A, Toronto Alexithymia Scale and Anxiety Sensitivity Index – 3.

The Italian version of the NDS shows good psychometric properties, maintaining a high equivalence with the original version. Further research on clinical samples is needed.

In the present study, Cloninger's dimensions of temperament and character have been investigated in patients with bipolar mood disorder-I (BMD-I), and obtained results were compared to those of healthy control participants from the general population.

This cross sectional study investigates 96 patients with BMD-I, selected based on DSM-IV-TR criteria, who are admitted into a psychiatry hospital due to an acute episode of mania, depression or mixed episode in year 2011 in Iran. After stabilization of acute phase, patients completed the 125-item Persian version of Temperament and Character Inventory (TCI). Seven dimensions of temperament and character were compared between the designated bipolar group and 1212 healthy individuals via independent samples t-test. Moreover, the correlation between age, duration of disorder, and mood variables (depression and mania scores) with temperament and character inventory scores were assessed by Pearson's correlation coefficient.

Bipolar patients showed significantly higher harm avoidance (P=.001) and lower reward dependency (P=.001), persistence (P=.044), cooperativeness (P=.001), self-directedness (P=.001) and self-transcendence (P=.004) in comparison with healthy individuals. In females, Reward Dependency (P=0.001), Self-Directedness (P=0.001) and Cooperativeness (P=0.001) scores were lower. Furthermore, TCI scores had no significant correlation with scores related to depression and mania, duration of the disorder and marital status.

Personality profile of patients with BMD-I differ from those of healthy individuals. Lower scores on Self-Directedness and Cooperativeness in bipolar patients seem to be related with more immature personality traits.

Recently the need for modern psychiatrists to have strong psychopathological bases has been repeatedly affirmed.

To provide a general overview on the current status of training and practice in psychopathology across Europe.

1. 1) to describe the current status of training on psychopathology;2)to identify the unmet needs of European residents in psychiatry;3)to suggest future perspectives of training in psychopathology.

An online survey, promoted by the EPA Section on Philosophy and Psychiatry, was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member.

Thirty-two associations returned the questionnaire out of the 41 contacted (response rate: 78%). All respondents recognize psychopathology as a core component of training in psychiatry. The primary aims of psychopathology are to assess psychiatric symptoms, to understand patients' abnormal experiences, and to make nosographical diagnoses. A formal training course in psychopathology is available in almost all surveyed countries. In most countries:1)there is not a defined number of hours dedicated to psychopathology;2)teaching is mainly theoretical;3)a structured training on psychopathological rating scales is missing. At the end of the training, about half of respondents is not satisfied with received training in psychopathology.

European early career psychiatrists clearly recognize the need to rediscover psychopathology, which represents the heritage of European Psychiatry. Initiatives to improve training and practice of psychopathology should be addressed by national and international psychiatric organizations.

During the Eye Movement Desensitization and Reprocessing (EMDR) changes of brain electrical activity was recently demonstrated in victims of psychological traumas.

Thirty-one victims of psychological traumas were investigated at the first EMDR session (t0) and at the last one performed after processing the index trauma (t1).

To investigate differences in EEG source activity and EEG source functional connectivity (EEG-SFC) in eyes closed condition before the beginning of t0 and t1 EMDR therapy session.

Electrical source activity was computed by eLORETA from a 37-channel EEG. EEG-SFC analysis was based on the lagged phase synchronization (LPS), derived by a two-step eLORETA procedure: dimensionality reduction of inverse matrix from 6239 voxels to 28 regions of interest (ROIs); LPS indices computation, for each spectrum band, in all possible ROI pairs.

Resting-state EEG source activity resulted in a low frequency increase of posterior cingulate cortex and a high frequency (beta2 and gamma) decrease in right prefrontal and parietal cortex between t0 and t1. Significant enhancements of EEG-SFC were detected in t1 respect to t0 between ROI pairs of theta band right temporo-parahippocampal regions and alpha band fronto-parietal regions.

Significant modifications of resting-state electrical brain activity were present after EMDR therapy. These findings suggest that the elaboration of psychological traumas induced by EMDR produces, in a resting-state condition, an enhancement of activity and functional connectivity of cerebral sources involved in cognitive control and emotional processing.

Hipotalamoptuiter-adrenal axis dysfunctions (HPA) are thought to play an important role in PTSD. HPA axis responds to stress with secretion of glucocorticoids (i.e., cortisol), which is vital in maintaining biological homeostasis and adaptation (allostasis) to chronic stress. In this study, we aimed that the relationship between PTSD symptoms and serum cortisol levels were investigated.

Forty-eight (N=48) males inpatients with PTSD diagnosed according to the DSM-IV criteria were enrolled to the study. The mean±SD of their age was 26.6±5.8 years. The rates of patients were related with combat and other traumatic events: 83.3% and 16.7% respectively. The mean duration±SD of their illness was 17.9±20.1 months (median 8 months). The severity of PTSD symptoms was evaluated by clinician administered PTSD scale (CAPS) I, II and impact of the event scale (IES). Morning and evening serum cortisol levels were obtained before and after the applying dexamethasone suppression test.

The rate of comorbidity in PTSD was 66.6%. Co-morbidity increases the severity of PTSD, but the serum cortisol levels were not associated with comorbidity. The negative correlations were determined between the basal (morning) serum cortisol levels and severity of symptoms CAPS II intrusive and avoidance symptoms (r=-0.31, p=0.04), (r=-0.30, p=0.05); evening serum cortisol level and IES score (r=-0.30, p=0.05); morning serum cortisol after administration of dexamethasone and CAPS I intrusive symptom severity (r=-0.37, p=0.01).

We found that serum cortisol levels were negatively related to intrusive and avoidance symptoms of PTSD. These data show specificity of abnormal HPA axis dysfunctions in PTSD.

There is growing interest in the effectiveness of task shifting as a strategy for addressing expanding health care challenges.

To examine the perception of stakeholders about the adequacy of the training, supervision and support offered to community mental health workers in Ghana.

We administered three separate self-administered semi-structured questionnaires to 11 psychiatrists and 29 health policy coordinators and 164 Community Mental Health Workers (CMHWs), across Ghana including, 71 (43.3%) Community Psychiatric Nurses (CPNs), 19 (11.6%) Clinical Psychiatric Officers (CPOs) and 74 (45.1%) Community Mental Health Officers (CMHOs).

Almost all the stakeholders believed CMHWs in Ghana receive adequate training for the role they are expected to play but not the role they actually play within the health delivery system. There were statistically significant differences between the different CMHW groups and the types of in-service training they said they had attended, the frequency with which their work was supervised and the frequency with which they receive feedback from supervisors. CPOs were more likely attend all the different kinds of inservice training than CMHOs and CPNs while CMHOs were more likely than CPOs and CPNs to report that their work is never supervised or that they rarely or never receive feedback from supervisors. There was disparity between what CMHWs said were their experiences and the perception of policy makers.

There is a need to review the curriculum of the training institution for CMHWs and also to offer them regular in-service training and formal supervision.

Prior research on body-image-related issues has mainly focused on the relationship between overall body satisfaction and health-related outcomes, particularly among Western women. However, there is still a paucity of information on whether body satisfaction with specific body parts is differentially associated with body-image-related mental distress, especially across gay, bisexual, and heterosexual men in Taiwan.

To Identify the differences by sexual orientation regarding the relationship between satisfaction with specific body parts and body-image-related mental distress among Taiwanese men.

To develop effective interventions to reduce mental distress related to body dissatisfaction in men.

A total of 665 male participants were recruited via a popular electronic bulletin board system frequented by Taiwanese youth.

Increased levels of satisfaction with weight were significantly associated with lower odds of body-image-related mental distress across gay, bisexual, and heterosexual men (AOR=0.38, 0.31, and 0.56, respectively). Gay men who were more satisfied with their height (AOR=0.57) and body fat (AOR=0.28), as well as heterosexual men who were more satisfied with their facial features (AOR=0.51), muscle (AOR=0.53), and body fat (AOR=0.55), were significantly less likely to have body-image-related mental distress than their counterparts.

Higher levels of satisfaction with various specific body parts were associated with reduced risk of body-image-related mental distress. Further, these associations varied differentially across gay, bisexual, and heterosexual men. Future research may explore the possible mechanisms through which satisfaction with specific body parts influences men's body-image-related mental distress. Accordingly, interventions could be tailored for men of different sexual orientations.

Discontent towards our profession is increasingly reported by patients with mental disorders and their relatives. Criticisms by patients are mainly related to the existing divergences between the goals of clinicians and those of users and carers. Recent arguments suggest that opinions of people who use mental health services are fundamental to set priorities in mental health research field.

Within the ROAMER project funded by the European Commission, we promoted an online survey involving European associations of users and carers in order to identify their opinions on the future of mental health research.

To describe opinions towards mental health research of European National associations of users and carers.

An online survey was conducted with national associations/organizations of users and carers in the 27 countries of the European Union.

Twenty-three associations/organizations of users and carers out of the 44 contacted returned the questionnaire (response rate: 52.3%). Users and carers clearly affirmed that themes related to social psychiatry, such as stigma, rehabilitation and social inclusion, quality of mental health services, and development of new psychological treatment for mental disorders are perceived as priority for future research.

These results show that service users' views are progressively being considered in the process of developing public health recommendations and in research protocols, because the direct involvement of different categories of stakeholders can lead to a 'better' quality of health research.

The research within the ROAMER Project leading to these results has received funding from the European Union Seventh Framework Program (FP7/2007-2013)under Grant Agreement no282586.

Secondhand smoke (SHS) may be affecting the mentalhealth of children as many mental disorders have an onset in youth, a time whenexposure is high.

Investigation of the potential impact of SHS exposure on children’s mental health.

Forty five SHS exposed Egyptian children were enrolledas group I; all of them had at least one smoking parent and or were exposed toenvironmental tobacco smoke while group II included thirty age and sex wellmatched controls, with neither history of parental smoking nor exposures toenvironmental tobacco smoke. For all studied children, complete history taking,thorough clinical examination, psychometric assessment using Pediatric Symptom BehaviorChecklist (PSCL), Strength and Difficulties Questionnaire (SDQ), and IQmeasurement were done. DSM IV TR criteria were used to confirm any suspectedbehavioral and or psychiatric disorder. Laboratory assessment of secondhandsmoke was carried out measuring urinary cotinine levels.

SHSexposed children had significantly higher mean value of urinary cotinine level,total PSCL, and SDQ scores compared to controls (p<0.001, p<0.001,p<0.05 respectively). In studied SHS children, degree of smokingsignificantly positively correlated with PSCL internalization behavior subscoreand emotion subscore of SDQ while smoking index significantly positivelycorrelated with ADHD subscore of SDQ. Meanwhile, prosocial subscore of SDQ andurinary cotinine level were significantly negatively correlated.

SHS exposure significantly compromised mental health of thestudied sample of Egyptian SHS exposed children.

The aim of the present study was toinvestigate the epidemiology of psychiatric disorders in adolescents in fiveprovinces of Iran: Tehran, Shiraz, Esfahan, Tabriz and Mashhad.

In the present study, 9636 children and adolescents aged 6-18 yearswere selected from Tehran, Shiraz, Esfahan, Tabriz and Mashhad. The clinicalpsychologists were instructed to complete the Strength and Difficulties Questionnaire (SDQ), then each of them that received high score in SDQ, completethe Persian version of Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). Oneway ANOVA was used totest for significant differences of disorders according to sex, age and province of residence.

Based on the results, the highest prevalenceof psychiatric disorders in the five provinces was related to conduct disorder (20.9%), and the lowest prevalence was related to substance abuse andalcohol abuse (0%). Also, ADHD had the most prevalence in boys (23.6%) and ODDhad the most prevalence in girls (19%). Among the 5 provinces, Tehran and Shiraz allocated the highest rates of ODD; Esfahan, Tabriz andMashhad had the highest rates of social phobia

In this study, the highest prevalence ofpsychological problems in the five provinces was related to conduct problems, and the lowest prevalence was related to substance abuse andalcohol abuse. It was determined that girls have more ODD than boys. In the current study, theprevalence of psychiatric disorders in children and adolescents in the urbanpopulation in Tehran province was higher than expected.

Repetitive transcranial magnetic stimulation (rTMS) is an emerging intervention for treatment resistant major depressive disorder (MDD) in adolescents. Though rTMS is an effective technique, positive responses are not universal. As MDD is associated with alterations in brain chemistry, we investigated metabolite concentrations as a biomarker for predicting treatment response. We hypothesized that lower baseline glutamate levels would predict beneficial rTMS treatment response and associate with lower MDD scores post-treatment.

Anatomical and spectroscopy data was collected on a 3.0T GE MR750w. A 15-weekday rTMS treatment was applied targeting the left dorsolateral prefrontal cortex (DLPFC).

No significant adverse events were reported. Depression and anxiety scores decreased with rTMS (p < 0.001). At baseline, responders had lower left DLPFC glutamate concentration (p = 0.047) that increased with rTMS compared to non-responders (p = 0.01) and correlated with the change in Hamilton depression rating scores (HAMD; r = 0.58, p = 0.02). Reduced DLPFC thickness was observed in responders (p = 0.009), and was also associated with greater change in HAMD (r = -0.56, p = 0.03). Lower left DLPFC cerebral blood flow at baseline was associated with greater change in Children's Depression Rating Scale (r = -0.62, p = 0.02) and Beck Depression Inventory scores (r = -0.59, p = 0.03).

rTMS is an effective and safe treatment for adolescents with MDD. Measures of glutamate and cortical thickness in the left DLPFC may provide tractable predictions of rTMS treatment response in youth, leading to more personalized therapy regimens.

The aim of this study was to determine the association between Iron deficiency and ADHD and the impact and role of iron deficiency on the development of ADHD in children.

Case-Control design based on 630 ADHD and 630 healthy children and conducted at the School Health and Primary Health care Clinics. The health status of the subjects was assessed by ascertaining clinical presentations and symptoms, family history, BMI, iron deficiency, ferritin, serum 25(OH) vitamin D, calcium, magnesium, and phosphorus levels. Descriptive, univariate and multivariate statistical analysis were performed.

Mean age (± SD, in years) for ADHD and control children were 11.54±3.83 vs. 11.50±3.62. There were statistically significant differences between ADHD and healthy children control subjects with respect to paternal education level (p<0.001), occupation of father (p<0.002), educational level of mother (p<0.010), monthly income (p=0.034), consanguineous marriages of parent (p=0.019) and BMI in percentiles (p<0.001), child behaviour (p<0.001), and school performance (p=0.031). There were statistically significant differences between ADHD versus control children for vitamin D, serum iron, ferritin (36.26±5.93 vs 38.19±5.61 ng/ml), hemoglobin (12.02±2.13 vs 12.89±2.02 g/dL) magnesium, serum calcium level and phosphorous. Multivariate logistic regression analysis revealed that serum vitamin D level, serum iron, ferritin, serum calcium level, physical activity, nervous behaviour, consanguinity, BMI and child order were considered as the main factors associated with the ADHD after adjusting for age, gender and other variables.

The study indicates that low serum iron, ferritin levels and vitamin D deficiency may be associated with ADHD.

There is conflicting research data regarding the associationbetween ADHD and atopic disorders.

The objectiveof this study was to investigate the prevalence of asthma among ADHD children.

Case-control study 520 children with asthma and ADHD and 520 controls aged 5-16 years old controls matched by age and ethnicity. Data based questionnaire, clinical manifestations. Univariate andmultivariate statistical analyses were performed.

The mean agefor ADHD versus control subjects was 9.92±3.3 vs. 10.20±3.4. There was asignificant difference found in the mean values of vitamin Dbetween asthmatic with ADHD (17.25±10.53) and control children (23.91±9.82)(p<0.0001). Out of 520 asthmatic children with ADHD, 18.4% had severe vitaminD deficiency (< 10 ng/ml). Also, the proportion of overweight and obesitywas significantly higher among asthmatic children with ADHD than healthycontrols (p<0.001). The mean values of all biochemistry parameters such asvitamin D, serum iron, serum ferritin, hemoglobin, magnesium, and potassiumwere significantly lower among asthmatic children with ADHD than healthycontrols (p<0.001). The multivariate logisticregression analysis showed that predictors for asthmaticwith ADHDusing were the mean serum vitamin D serum calcium level, physical activity, nervousbehavior, consanguinity, BMI and child order were considered as the mainfactors associated with ADHD after adjusting for age, gender and others.

The presentstudy revealed that vitamin D deficiency was higher in ADHD children comparedto healthy children and supplementing infants with vitamin D might be a safeand effective strategy for reducing the risk of ADHD.

We performed a retrospective chart review in our Child Psychiatry outpatient clinic for visits between 7/1/11 and 6/30/13 looking at the effects of concurrent use of topiramate and antipsychotic medications. Exclusion criteria included concurrent treatment wuth other medications known to cause weight loss (e.g. stimulants), a primary diagnosis of eating disorder, a primary medical illness that would have an impact in weight (e.g. thyroid illness), and medications not prescribed through our clinic.

N = 47 with a mean age of 13.36 years.

Mean dosage for topiramate was 121.74 mg.

Mean baseline BMI = 31.82.

Mean treatment length = 200 days.

Mean weight loss = 0.97 BMI points

We will review the United States FDA indications for topiramate, the potential adverse events, and the preliminary data regarding the effectiveness for the treatment of weight gain, for patients prescribed and not prescribed antipsychotic medications.

Complex transitional changes in Croatia, lack of employment security and a large number of traumatized and unemployed individuals still strongly influence family functioning, the distribution of family roles as well as the capacity of parents to provide adequate emotional support to adolescents who are growing up in such families.

The aim of our study was to examine how many adolescents in the general population (students of secondary schools in Zagreb, Croatia) show auto-aggressive behaviors and whether their auto-aggressive behavior is dependent upon the financial circumstances of the family in which they grow up.

The study was conducted on 701 adolescents (both male and female with ages ranging 14-19 years). To determine the family financial circumstances we used a specially designed structured questionnaire with family and demographic data. To test auto-aggression we used the validated 'Scale of auto-destructiveness” (USA).

A significant social factor associated with aggressiveness is the parents financial situation (F(2,548=4,604, p=0,010), since adolescents from financially poorer families show greater aggressiveness. The results showed that adolescents who live in below-average financial conditions demonstrate more auto-aggressive behavior than adolescents living in average or above-average family financial circumstances.

Financial deprivation and perception of financial stress significantly affects the incidence of auto-aggression among adolescents. Through this research we emphasize the importance of social support to parents of adolescents who grow up in financially challenged families as well as to target key preventive interventions related to working in partnership with such families.