Prenatal maternal depression predicts disturbances in stress responses and an increased risk of psychopathology in offspring. However the foetal origins of these programming influences on the offspring's stress response mechanism are unclear. Furthermore, there are no inquiries into this issue from the developing world, where high rates of prenatal depression (25-45%) are reported.

To explore associations between prenatal depression and, foetal and infant responsivity, in a sample from rural South India.

67 pregnant women in their third trimester with high prenatal depression scores and 66 controls were assessed for their foetus’ responsivity to repeated vibroacoustic stimulation by measuring foetal heart rate responses. At 1.5-3 months postbirth, infant cortisol responses to immunisation and infant temperament were measured.

A curvilinear relationship existed between prenatal depression and foetal responsivity to a potential stressor (R2=0.98, p=0.02). Foetuses of mothers with both very high and very low levels of depression showed elevated responses compared to the foetuses of mothers with moderate levels of depression.

Prenatal depression predicted elevated infant cortisol responsivity independent of postnatal depression and other confounders (B=13.08, p=0.02). Quintile analysis revealed this relationship to be U shaped (R2=0.20, p=0.02), similar to the relationship between prenatal depression and foetal responsivity.

There were no associations between prenatal depression and difficult infant temperament.

The findings provide the first evidence of a curvilinear relationship between prenatal depression and offspring stress responsivity from the developing world suggesting that intra-uterine exposure to moderate stress levels may be beneficial in the context of socio-economic disadvantage.

The audit aims to investigate whether physical health assessment and VTE risk assessment were routinely completed and documented. The results will be used to develop plans around the prevention and management of VTE in inpatients.

An estimated 25000 people in England die from preventable hospital-acquired Venous Thromboembolism (VTE) every year. The recently issued NICE guidelines give a framework for assessment and management of VTE risk. This is a re-audit followed by an initial audit carried out in Sep 2011.

The audit was completed in May 2012 using the electronic patient information system (RiO) and where needed paper notes available on the wards were also reviewed. Data collection focussed on assessing evidence that the physical health proforma has been completed and VTE risk identified.

The sample included 144 adult and 65 older adult inpatients (cross sectional sample in May 2012).

• Completion of physical health assessment is improved (94%) compared to initial audit (92%).

• Where completed, 100% of the physical health assessments were documented.

• Recording of physical health assessment on RiO was improved.

• VTE risk assessment has improved (83%) as compare to the initial audit (79%).

• Physical health assessment completion needs to improve until 100% is achieved.

• After completion, physical health assessment for every patient needs to be recorded on RiO.

• To ensure that VTE risk assessment is completed for every patient on the ward.

• Repeating the audit in 6 months to see if these changes have been implemented.

Internet addiction is a multi-faceted construct which is currently under review for inclusion in the forthcoming fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association. In Greece, a specialized outpatient counseling service has been setup by our Psychiatric department in order to provide counseling for any students with related problems.

This survey has been setup in order to facilitate comparisons with those seeking help and validate the research measures used for their assessment. Furthermore, it sheds some light into Internet use from the future health professionals, an area of research that has been neglected.

To gather data on student Internet use, social media use, online gaming and gambling, use of online sexual content and any addictive phenomena related to those behaviors.

We employed an extensive battery of questionnaires identical to that employed by our counseling service. The battery includes detailed measures of all online behaviors, the SCL-90 psychopathology index, the Defense Styles Questionnaire (DSQ) and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ).

The presentation includes detailed results from the battery of questionnaires including comparisons with the validation samples and previous related research work carried out. Our sample demonstrated an unexpectedly high incidence of psychiatric symptoms and several cases of online addictive behaviors.

Our results are demonstrating the need for a broader reach out to the target populations since a large number of students may be hesitant to seek help for their online addictions or simply prefer to ignore them.

Anxiety disorders appear following disturbances in the transmission of serotonine and noradrenaline caused by the dysfunction in the hypothalamic-pituitary-corticalsuprarenal axis and the hypothalamic-pituitary-thyroid axis. Our objective was to highlight the advantages of associating atypical antipsychotic substances (AAS) in small doses with the usual anxiolytic treatment (benzodiazepines, SSRI antidepressants, dual antidepressants etc).

In a study performed on 40 patients with diagnosis of generalised anxiety disorder (DSM-IV-TR) an anxiolytic treatment of SSRI antidepressants (Sertralinum 150mg/day) was administered to 20 patients, while SSRI antidepressant (Sertralinum 150mg/day) associated with an atypical antipsychotic substance (Quetiapinum 50mg/day) was administered to the other 20 patients during 6 months. The patients were monitored for another 12 months after conclusion of treatment.

Anxiety symptomatology remitted in both groups of patients in a sensibly equal period In the group were AAS were not administered, 10% of the patients presented an exacerbation of anxious symptomatology after 4 months of treatment. During the post-therapeutic monitoring period, the anxious symptomatology reappeared in 25% of the patients treated only with SSRI antidepressants, after 4 months, while relapse was found in only 5% of patients from the group treated also with AAS.

The association of small doses of atypical antipsychotic substances in the usual anxiolytic treatment with SSRI antidepressants leads to rapid remission of anxious symptomatology during treatment.

The use of atypical antipsychotic substance in the treatment of anxiety disorders prevents relapses on medium and long term.

The “Paradox of insight” in schizophrenia is a fact of its controversial impact with both positive and negative sides. It is known that insight and depression are positively correlated: the more awareness of schizophrenic illness, the more likelihood of depression. The mechanisms of this correlation have been clarified insufficiently at the moment.

We hypothesized that the correlation between level of depression in patients and stigmatizing views of their close relatives depends on patient's illness awareness.

120 patients (response rate - 80%) with a diagnosis of “paranoid schizophrenia” were included in the cross-sectional, observational study. Following questionnaires were used: “The Scale to Assess Unawareness of Mental Disorder” (SUMD), “Calgary Depression Scale for Schizophrenia” (CDSS). The stigmatizing views were assessed in patient's closest relatives with questioner “Mental health in public conscience” developed by Iastrebov et all.

We have found statistically significant differences of correlations between patients’ groups with different level of insight (full, partial and absence of awareness of mental illness). Moreover, only in group of patients with full awareness of mental disorder the statistically significant correlation between level of depression in patients and intensity of stigmatizing beliefs in their close relative was found.

Received data support hypothesis that the correlation between the level of depression in patients and the intensity of stigmatizing views of their close relatives depends on the patient's illness awareness.

To explore the relationship between brain-derived neurotrophic factor (BDNF) and B-cell lymphoma Leukemia-2 (Bcl-2) plasma levels in subsyndromal symptomatic depression (SSD) patients.

In this case-control study, Enzyme-Linked Immunosorbnent Assay (ELISA) method was used to analysed the differences of BDNF plasma levels between SSD group (n=42) and healthy controls (n=51). At the same time Hamilton Depression Rating Scale-17(HAMD17) were assessed the patients'severity.

There were significant difference of BDNF plasma levels between SSD group (medium 2.97 ng/ml)and healthy group (medium 3.71ng/ml, z=-2.94, P 0.003). Furthermore, BDNF plasma levels in SSD patients were associated with Hamilton score (r -0.53, P < 0.001). Plasma Bcl-2 levels were not different between SSD group (medium 4951 U/ml) and health controls (medium 5574 U/ml) (z = -1.71, P =0.09); and plasma Bcl-2 levels in SSD group were not associated with Hamilton score (r -0.10, P 0.34).

The study suggested that the decreased BDNF plasma levels were related with the pathophysiology of SSD and it might reflect the severity of disorder.

To explore the factors associated with occurrence of suicidal risk after treatment of Selective Serotonin Reuptake Inhibitor (SSRI) in bipolar disorder with their first depressive episode.

One hundred and seventy seven bipolar patients were enrolled in this retrospective study. Demographic and clinic features between non-occurrence of suicidal risk group and occurrence of suicidal risk group were compared. Stepwise Logistic regression model was used to identify the associated factors. Concordance statistics (i.e. the area under the ROC curve) was used to compute the discrimination of the associated factors, and Hosmer-Lemeshow goodness-of-fit statistic was used to measure the goodness-of-fit.

One hundred and fifty four patients were included in non-occurrence of suicidal risk group, while twenty three were included in occurrence of suicidal risk group. Clinical features associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder were as follows: symptom of irritability (OR=4.04, 95 CI:1.40-11.67) and psychotic symptom (OR=6.23, 95 CI:1.40-27.56).

This study demonstrated indicated that psychotic symptom and symptom of irritability were associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder, and it suggested that these two symptoms might be potential to be the predictors of occurrence of suicidal risk after treatment of SSRI in bipolar disorder.

In 2011 Several institutions of the Catalan network of Mental Public Health initiated a project to improve the attention of patients with borderline personality disorder (BPD), following Prof. Otto Kernberg model: The Transference Focused Psychotherapy (TFP).

In every telematic meeting, the transcription of the clinical session with its video recording is presented to Dr. P. Foelsch and the rest of professionals from the supervision group.

From the different techniques of the TFP, the following were of great usefulness for the observed case: the therapeutic contract, which facilitated working the impulsiveness of the patient, the techniques of clarification, confrontation and interpretation that allowed the patient to understand what was happening to her and to integrate separated aspects of herself, and the recognition of the non verbal language that in numerous occasions was the best way to understand what was happening to the patient.

The advantages of the TFP on the observed case, and generally, in BPD patients are many, but I would highlight: First, as these patients manifest their primitive conflicts in dissociated behaviour rather than in the content of free association, the more systematized interventions of the TFP makes easier to work with them. Secondly, the therapeutic contract at the beginning, permits to maintain the treatment frame under even sever acting-out conditions.

Delusional disorder is traditionally considered a less severe clinical entity than schizophrenia or schizoaffective disorder. From the dimensional approach to psychiatric diagnostic classification it might be necessary redefine the diagnostic classification of psychosis.

To assess differences found in psychopathology, neuropsychology and functioning among schizophrenia, schizoaffective disorder and delusional disorder.

59 patients were included in this study. 30 out of them presented a diagnostic of schizophrenia, 15 patients delusional disorder and 14 schizoaffective disorder. All of them were assessed through different scales including PANSS, GAF, SIX, SCIP and DKEFS Stroop. To compare the different groups ANOVA, Post hoc Bonferroni analysis and X2 test were carried out.

We found statistically significant differences regarding negative symptoms between patients with schizophrenia and delusional disorder, being those less intense and severe in the last ones. In that way, a inversely proportional trend regarding negative and positive PANNS subtypes between schizophrenia and delusional disorder was observed.

In spite of the fact that the delusional disorder is considered less severe disease than other psychosis we only found a less degree of severity for negative symptoms. Further studies with greater sample size must be conducted.

Immature psychological defense mechanisms are psychological processes that play an important role in suppressing emotional awareness and contribute to psychopathology, including personality disorder. In addition, unhealthy food, television viewing, and alcohol consumption can be among the means to escape self-awareness. In contrast, engaging in, and responding fully to specifically penile-vaginal intercourse (PVI) is associated with indices of better emotional regulation, including less use of immature defense mechanisms.

To research the association of immature defense mechanisms with personal importance of junk food, alcohol, television, PVI, and noncoital sex.

In an online survey, 334 primarily Scottish women completed the Defense Style Questionnaire (DSQ-40), and rated the personal importance of junk food, alcohol, television, PVI, and noncoital sex.

Immature defense mechanisms correlated with personal importance of junk food, alcohol, and television. Importance of PVI correlated with mature defenses, and less use of some component immature defenses. Importance of alcohol correlated with importance of junk food, television, and noncoital sex. Importance of junk food was correlated with importance of television and noncoital sex.

The findings are discussed in terms of persons with poorer self-regulatory abilities having more interest in junk food, television, and alcohol, and less interest in PVI.

In contemporary society, schools play an increasingly important role in preparing young people for adulthood. This role is more prominent especially in female adolescents because of synchronization of puberty years and girls attendance in schools. the purpose of this paper is to explore adolescents and key informants' perception and experiences regarding to importance of schools in female adolescents' health needs.

This qualitative study was conducted in Sari in the North of Iran. Sixty-seven urban and rural female adolescents between 12-19 years of old participated in 8 focus group discussions. in addition, semi structured interviews were done with 11 key informants. Participants were selected based on purposeful sampling and with maximum variety. All taperecorded data was fully transcribed and thematic analysis was done to identify key themes.

Two main categories emerged from data: Optimal performance of teachers and administrators and Educational reform. Conscious teachers, Promotion counseling in schools and optimal management were the main subcategories of the first theme and reform of teaching patterns and reducing test anxiety were the main subcategories of the second.

The school is responsible for changing and modifying maladaptive behaviors, and providing emotional and mental health of students. So reform in educational system, improvement of teaching patterns and promotion of teachers, counselors and administrators performances are necessary.

Some studies showed that nicotine withdrawal may increase the likelihood to develop anxiety or distress.

Nicotine withdrawal symptoms (NWS) may specifically provide an opportunity to learn that physical sensations can be aversive, thus anxiety or distress-provoking.

We evaluated whether NWS predict the responding to a test inducing distress, the so called Breath Holding (BH) test, in regular smokers evaluated under nicotine withdrawal conditions or under non withdrawal conditions. Specifically, we studied if fear or discomfort are felt as a response to the test inducing distress.

We run a cross-over design study on current smokers. Each subject received either nicotine and placebo in two different test days according to a randomized, double-blind order. Four hours after the administration of nicotine or placebo, each subject underwent the BH test. Fear and Discomfort were evaluated by means of a Visual Analogue Scale (VAS-F for Fear and VAS-D for Discomfort).

20 subjects (10 females and 10 males) with a mean age of 32,05 ± 10,13 years were studied. At baseline the two conditions did not differ. No statistically significant results were found for VAS-F and VAS-D in terms of response to the BH test.

NWS seem not to affect the response to a distress test in current smokers at least when fear or discomfort are taken into account.

Relationships between total antioxidant capacity (TAC) and psychopathology in schizophrenia is controversial. Different methodological approaches may be a bias factor.

The aim of this research is to analyze the relationship between psychopathology as individual items and psychopathology as syndromes with the serum TAC concentration in schizophrenic patients.

20 DSM-IV paranoid schizophrenic outpatients were recruited from the psychiatric outpatient's clinic of the University Hospital of the Canary Islands. the severity of schizophrenia symptoms was measured with the Positive and Negative Syndrome Scale (PANSS). Blood samples were collected at 12:00 and 00:00 hours. Relationships between quantitative variables were assessed with the Pearson's correlation coefficient.

There was a significant correlation between the PANSS positive subscale and the nocturnal TAC levels (r=0.527, p< 0.02). the PANSS negative subscale was not correlated with TAC concentrations. Item by item scores of the positive and negative PANSS correlations with nocturnal and diurnal TAC levels revealed that only item 6 (suspicion) of the positive PANSS subscale was significantly correlated with the nocturnal TAC concentrations (r=0,491, p< 0.03). Only item 3 (poor contact) of the negative PANSS subscale was also significantly correlated with the nocturnal TAC concentrations (r=0,516, p< 0.02).

We strongly recommend analyzing not only global scores of psychopathology but individual items scores when researching on biological markers in schizophrenia.

This study was partly supported by a grant (PI: 08/115) of the Fundacion Canaria de Investigacion y Salud (FUNCIS).

None of the authors have conflict of interest to disclose.

A variety of hereditary spinocerebellar ataxia (SCA) develops a broad spectrum of both ataxia and non-ataxia symptoms. Cognitive and affective changes are one such non-ataxia symptoms, but have been described only in hereditary SCAs with exonic CAG gene expansion.

We newly found intronic hexanucleotide GGCCTG gene expansion in NOP56 gene as the causative mutation (=SCA36) in nine unrelated Japanese familial SCA originating from Asida river area in the western part of Japan, thus nicknamed Asidan for this mutation. These patients show unique clinical balance of cerebellar ataxia and motor neuron disease (MND), locating on the crossroad of these two diseases. We examined cognitive and affective analyses on 12 Asidan patients who agreed to join the examination.

The 12 Asidan patients demonstrated a significant decrease in their frontal executive functions measured by frontal assessment battery (FAB) and Montreal cognitive assessment (MoCA) compared with age- and gender-matched controls, whilst mini-mental state examination (MMSE) and Hasegawa dementia score-revised (HDS-R) were within normal range. the decline of frontal executive function was related to their disease duration and scale for the assessment and rating of ataxias (SARA). They also demonstrated mild depression and apathy. Single-photon emission tomography (SPECT) analysis showed that these Asidan patients showed decline of regional cerebral blood flow (rCBF) in a particular areas of cerebral cortices such as Brodmann areas 24 and 44-46.

These data suggest the patients with Asidan mutation show unique cognitive and affective characteristics different from other hereditary SCAs with exonal CAG expansion or MND.

Previous studies showed that persons with mental illness had poorer quality of life than persons with the other medical conditions. We developed a manualized treatment - Quality of Life Enhancement Program (QOLEP) based on literature review and clinical experiences. the contents of the program include 4 sessions of ‘occupational life scheduling’ and 4 sessions of ‘coping skills’ provided by an occupational therapist during a 4-week period (2 times/week) which each session lasts for one to two hours.

Twenty-one subjects were recruited from community mental health rehabilitation centers in northern Taiwan. They were randomly assigned to either treatment group (N=11) or control group (N=10). the subjects in the control group received general supportive therapy over the phone twice a week for 4 weeks. Both groups were evaluated at baseline and posttreatment. the mixed-effects linear model was applied to analyze the efficacy of the treatment.

The results showed that the subjects who participated in the QOLEP had significantly better physical QOL than that of control group (-9.66+4.24, p< .05). the suicidal ideation of the subjects for both groups decreased over time (2.64+3.16, p< .05). Most of the participants indicated that the activities were easily understood, helpful to them, and are willing to participate in the program again.

With the program developed based on concept of occupational engagement, we were able to demonstrate the efficacy of specific treatment on quality of life and used it as evidence to support future development in mental health area.

Significant neurological symptoms may be overlooked because of the traditional view that the non-Korsakoff's psychosis, middle aged alcoholic misuser is neurologically preserved.

In this study, we wanted to investigate the presence of neurological symptoms in individuals with misuse or dependence on alcohol who were abstinent for at least 1 month.

We used two scales from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) to ascertain the presence of both neurological symptoms (HEA-2) and symptoms of general health concern (HEA-3) in 70 individuals who had a diagnosis of alcohol misuse or dependence, who were abstinent for greater than 1 month.

Individuals reported significantly more neurological symptoms than general health difficulties (p0.001). We detected neurological symptoms, unlike general health difficulties in individuals who were abstinent from alcohol for 12 months. When we examined diagnostic subgroups, general health difficulties were most present in individuals with anxiety disorders; however, neurological difficulties were present across diagnostic groups.

Neurological symptoms persist to a greater extent than general health concerns in individuals who previously were dependent or misused alcohol.

HIV like other chronic illnesses is an important contributing factor for psychiatric co-morbidity in not only HIV sufferers as well as their caregivers. Few studies show that a significant proportion of caregivers of HIV positive patients had psychiatric illness which is otherwise neglected but in turn hampers the quality of care provided to the HIV positive patient as well as the caregiver himself. This chunk of population if identified at a earlier stage, steps to teach them healthy coping strategies as well as timely initiation of management of psychiatric illness can decrease the burden of disease.

To assess and compare the presence of psychiatric morbidity, stress and quality of life in primary caregivers of HIV patients.

All primary caregivers of HIV positive patient attending the Anti Retroviral Therapy(ART) center during six month period were assessed using a semi-structured Performa, International neuropsychiatric interview English version 5.0.0 (MINI PLUS) scale, PSLES, WHO QOL brief scale,. Data was segregated and analysed using appropriate statistical test.

Out of total 125 respondents 24(19.2%) were found to be depressive. Anxiety disorders were significantly prevalent (8.4%). other psychiatric disorders were somatisation, adjustment disorder etc. PSLES was fairly high and WHO QOL scoring was low in caregivers as compared to control group.

Significantly high number of caregivers was positively screened for psychiatric morbidity, most of them were stress related neurotic disorders. the stress level was more in caregivers and quality of life was compromised as compared to control group.

To assess the presence of communicability and regret in cases of deliberate self harm in a tertiary care hospital. to establish relation of communicability as a preventive sign and regret as a good prognostic sign in cases of deliberate self harm.

All consecutive patients with deliberate self harm presented to the emergency department during a 1 year period were assessed on a preformed Performa designed by authors after being declared physically fit and were screened by Standardized Assessment of Personality Abbreviated Scale (SAPAS), PSLES, HAM-D and HAM-A.

Majority of respondents screened negative by SAPAS scoring. Most of the patient had significant stress in life .Most of them had marital conflicts, family conflicts and economic burden as major stressor leading to suicidal behavior. Verbal communication was the most common mode of communication. Most of the subjects 86.3% (69 out of 80) had severe regret about their attempt of deliberate self harm. It developed a high motivation in them not to attempt suicide next time in life.

Most of the suicidal acts are impulsive in nature and are not associated with any psychiatric co morbidity. Our study showed that if communicability is enhanced and this is considered seriously, providing supportive care by family most of the suicidal acts can be avoided. Regret arising after the suicidal act can be used to motivate the subject of deliberate self harm to avoid repetition of future attempts.