To explore changes of Grp78 and Ca2+-CaM-CaMKIIα in hippocampus of PTSD rats may reveal part of the pathogensis.

The models of PTSD were created by SPS, which is an established animal model for PTSD. Wistar rats were selected for this study and randomly divided into a normal control group and SPS groups of 1d, 4d and 7d. The expression of GRP78 was examined by immunofluorescence, western blotting and RT-PCR. The intracellular free calcium level was examined by fluorescence spectrophotometer. CaM and CaMKIIα were examined by RT-PCR. Apoptosis was examined by TUNEL and TEM.

The results showed the intracellular free calcium level reached the peak 1 day after SPS stimulation, then gradually decreased to normal level. The expression of CaM 1 day after SPS is the most and then decreased. CaMKIIα expression showed a significant down-regulation 1 day after SPS throughout and then gradually increased to normal level. Grp 78 reached the peak 4 day after SPS stimulation. TUNEL-positive cells significantly more than the normal control group and peaked at 7d after SPS stimuli, then gradually decreased to normal level. Furthermore, some cells had a characteristics change, including chromatin condensation, appearance of chromatin crescents, and nucleus fragmentation.

The results suggest that Grp 78 and changes of Ca2+-CaM-CaMKIIα in hippocampal might play an important role in the pathology of PTSD.

One of the most important indicators of effectiveness of therapy in patients with fecal incontinence (FI) can be patient's quality of life. Therefore, a well-constructed questionnaires studying quality of life is necessary. The objective of this study was to assess the Iranian version of Fecal Incontinence Quality of Life Scale in a hospital-based study on patients with FI.

Two hundred women were recruited in the study. One group included patients with FI (n = 100) and the control group (n = 100) included patients with any gastrointestinal (GI) problems except FI. The Persian version of fecal incontinence quality of life scale completed by groups. The FI patients completed the SF-36 questionnaire too. Reliability and validity of questionnaire were evaluated by Cronbach's alpha, test/retest using correlation analysis, Intraclss correlation coefficient, paired t-test, and analysis of variance.

Mean age of FI patients and controls were 42.6 (±13.3) and 44.5 (±15.0) respectively. Cronbach's-α for all domains ranged between 0.72–0.92. All scales showed significant correlation between the test and retest administration of questionnaire. The FI patients had lower scores than the controls for all domains adjusted for gender. All correlations between six selected domains of Sf-36 scales and FIQL scales were significant at P < 0.05 levels.

The Persian version of FIQL had a good validity and reliability and can be used for accurate measure of quality of life in FI patients.

Obesity and depression are often comorbid conditions, with an apparent bi-directional relationship. Obesity at baseline has been shown to increase the risk of onset of depression and depression at baseline increased the odds for developing obesity. Less is understood about the impact of obesity on depression outcomes.

Our hypothesis was that obesity (BMI >= 30) and morbid obesity (BMI >= 40) would have negative effects on depression remission rates after six months of enrollment into collaborative care management (CCM).

This study was retrospective analysis of 1,111 depressed patients with a PHQ-9 score of 10 or greater that were enrolled in CCM. Of these patients, 81.5% (1,587) had BMI data available and only 27.4% (435) were of a normal BMI (BMI>=15 and < 25.0), while 44.7% (710) were obese (BMI >= 30). Multivariate analysis for the odds ratio of achieving remission at six months demonstrated that the patient's BMI at baseline was not a risk factor for depression outcome at six months. The clinical factors of recurrent depression, PHQ-9 score and an abnormal MDQ score were found to be statistically significant with an inverse relationship to remission at six months, an observation that had been shown in prior studies.

CCM for depression has been shown to be effective for improving depression outcomes. While obesity was common in our study population, it was reassuring, based on this study that six month depression treatment outcomes do not appear to be significantly impacted by the patient's baseline BMI.

There is an observed inter-dependency between the onset of obesity and onset of depression. Less is known of the outcomes of depression treatment on changes in weight, when compared to baseline body mass index (BMI). In a prior study we demonstrated that six month depression outcomes were not related to patient's baseline BMI.

To determine if there were significant weight changes for patients diagnosed with depression over a six month period.

This was a retrospective chart review of 1,551 patients diagnosed with depression by their primary care provider from March 2008.

A majority of the patients, 1,050 (67.7%) either had a weight loss or no significant change (+/- 2.5%). In logistic modeling, age was the only variable independently associated with weight gain of 2.5% or greater at six months (OR 0.9916, p = 0.0133). For the 501 patients with weight gain, BMI was inversely associated with weight gain at six months. With logistic modeling; increased BMI remained inversely associated with significant weight gain (+5%) at six months. The presence of clinical remission at six months was not associated with weight gain of greater than 5%.

The majority of patient diagnosed with depression by their primary care provider did not experience a significant change in their weight over the next six months. Clinical remission did not impact the weight changes seen. If a patient was going to gain weight, a baseline normal BMI was associated with an increased risk of >5% weight gain in six months.

There are several theories concerning potential associations between depression and levels of vitamin B12 and folate.

To investigate the relationship between depression and vitamin B12, folate, and the methylenetetrahydrofolate reductase 677C T polymorphism. To compare this associations, in anxiety and depression.

90 subjects were randomly selected in a comparative cross sectional study. The sample consists of three groups: a group of depressive disorders without psychotic symptoms (n = 30), a group of anxiety disorders (n = 30) and control group (n = 30). The patients were recruited from psychiatric out- patient clinic. Patients were diagnosed according to DSMIV criteria. Beck depression Inventory for severity of depression, Hamilton rating scale of depression, Hamilton rating scale of anxiety. Laboratory: Simultaneous assay of vitamin B12 and folic acid by Radio-immune assay technique and analysis of MTHFR (C677T) by means of PCR and RFLP.

Both anxiety and depression groups has the same percentage of gene mutation (33.3%). Folic acid and Vitamin B 12 mean values were highest in control group followed by the anxiety group then the least was in depression. Within the depression group there is a negative correlation between the severity of depression and folic acid. Within the depression group, patients with mutant gene have lower level of both Folic acid and Vitamin B12 than patients with non mutant gene.

Folic acid and Vitamin B12 were lower than normal in both anxiety and depression patients and this was combined with gene mutation.

School and academic performance are considered highly complex outcome. The pupil's intellectual capacities intervene, and other types of influencing factors can hinder or boost school performance. Aim of the work: To assess psychosocial variables including self-esteem, depression, anxiety symptoms and academic achievement in a selective sample of preparatory school students.

This is a school based cross sectional study. The sample consisted of all students in the preparatory stage in a private school of both sexes, age ranged from 12–15 years. The sample was divided according to the academic performance of the student based on the overall grade of each student at the end of the school year into: Insufficient < 60%, Sufficient 60–70%, Good 70–80% and Very good >80%.

All students were given a questionnaire to assess personal data, family background, past history of medical or psychiatric condition, scholastic achievement and psychometric tools: including Porteus maze, Coopersmith Self-Esteem Inventory, Children Depression Inventory (CDI) and, the Children's Manifest Anxiety Scale.

The higher the grades of students, the higher the level of anxiety and this was statistically significant. Girls had higher levels of anxiety than boys and this reached a statistically significant difference. There was significant correlation between depression and academic achievement of students. Self-esteem was significantly correlated with academic achievement.

Depression has a significant role in academic performance of adolescents. Self-esteem of adolescents is highly related to their academic achievement.

Alcohol abuse and dependence commonly exist with other psychiatric conditions and people who are dependent on alcohol have a higher probability of abusing other psychoactive substances. This can affect the prognosis of psychiatric disorders and also puts services under pressure.

The primary aim was to look into the incidence of psychiatric illnesses and comorbid use of other psychoactive substances amongst patients in an inpatient alcohol detoxification centre.

The study was cross-sectional survey. Data was collected from 100 consecutive inpatients admitted for alcohol detoxification in the unit in 2010. Data was collected from clinical records of the patients and we looked at demographics, daily alcohol consumption at the time of admission, incidence of psychiatric problems, use of other psychoactive substances and current episodes and history of delirium tremens and alcohol-related seizures.

Depression was present in 35% of patients, Psychotic illness was present in 10% patients, 5% of patients were diagnosed with Bipolar Affective Disorder and 6% had a diagnosis of Personality Disorders. There was a past history of Deliberate Self- harm in 36% of patients. As far as comorbid psychoactive substance misuse is concerned, 42% admitted using regular Cannabis, 12% were dependent on Opiates and 11% were using Cocaine.

This study reveals that comorbidity of psychiatric illnesses and other psychoactive substance misuse is high amongst patients dependent on alcohol. There appears to be a clear relationship between these two and further research is needed to investigate if the relationship is just causal or just an association.

Depression is a common mental health problem among elderly persons, about 10–15% of elderly suffers depressive symptoms.

To find out the prevalence of depression among geriatrics living in geriatric homes versus those in clubs (living in home with their families), to detect the underlying risk factors of depression.

In Beni Suef city there are three geriatric homes where the elderly are completely living away from their families, besides one geriatric club where the elderly people enjoy their daytime (there are two other clubs were inactive and under establishment), all the elderly above 60 years: males and females in geriatric homes and those attending the geriatric club were included (145) during the period (December 2008 – October 2009). Those who can not communicate and answer the questionnaire were excluded. Data collection tools were a pretested questionnaire besides, Geriatric Depression Scale and Life Satisfaction Scale and Facing Daily Stressful Live Events Scale- Arabic version-. Appropriate statistical analysis was applied.

Depression among elderly living in geriatric homes was higher (89.7%) in comparison to those in geriatric clubs (56.7%) i.e. living with their families (the difference was significant). Chronic medical conditions are not considered as a risk of depression among elderly. So it is recommended to strengthen social relationships and activities besides encouraging visiting geriatric homes either by related families or the civil societies and this is an important key in preventing depression.

Studying stigma in health care professionals may be helpful to address stigma in people with mental illness. The purpose of this study is to assess (stigmatising) attitudes of mental health care professionals (MHC), forensic psychiatric professionals (FP) and general practitioners (GP) in the Netherlands.

The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatising attitudes in three different groups of health care professionals. Scores range from 16 (minimum stigma) to 96 (maximum stigma). Additionally, background information was obtained including gender, age, work and personal experience.

All three groups of health care professionals had a positive attitude towards psychiatry and patients with a mental health problem. However, the total MICA score differed significantly between the three groups (p<0.001). GP's had the highest score (44) on stigmatising attitudes, followed by the FP's (39) and MH's (34). In our study population 25%-38% had personal experience with having a mental illness. Most stigmatising attitudes were found regarding protection of the public against patients with severe mental illness, telling colleagues about personal experience with mental illness and, appreciating psychiatry as less respectable compared to other medical disciplines.

General practitioners showed in comparison to mental health care professionals a significantly higher stigmatising attitude. The scores still represent a mild positive attitude towards psychiatry and psychiatric patients. Although all three groups have a relatively positive attitude, there is still room for improvement.

Cosmetic surgery in Iran is suggested to be the most common. The aim of this study was to determine the social factors affecting decision on undergoing nasal cosmic surgery.

100 participants were enrolled in this study (50 participants undergone nasal surgery and 50 controls who had no intention to apply for plastic surgery. Controls were selected among friends and relatives of the surgery group and were matched for sex, age (±1year), marital status, income and education (in the same category as surgery group).

A self administered questionnaire was used to measure social and family factors namely: having a car, having a house, father's job, mother's job, the participant birth order, out of marriage sexual contact, and number of sisters. Multivariate logistic was used to analysis the data.

Among the factors used in the final model only number of sisters shown a positive and significant association with application for nasal surgery (P = 0.019).

Being adjusted for monthly income and no significant association with the participant's father's or mother's job (social class of the participants) may explain the high rate of cosmic surgery among Iranian population. While matched for sex, a direct and significant association between number of sisters of the participants and undergoing plastic surgery suggests the importance of family members and their gender in making decision on undergoing nasal cosmic surgery.

Despite evidence that the majority of injection drug users (IDU) are polysubstance users and tend to have extensive substance use histories at time of first injection, little is known about the patterns of substance use associated with injection initiation.

To determine how injection drug use was associated with specific patterns of multiple substance use. Both concurrent (any use during a defined time period) and simultaneous (same session) polysubstance use patterns were assessed.

IDU receiving treatment at a low-threshold methadone maintenance clinic in Halifax, Nova Scotia, Canada completed structured interviews regarding their substance use histories.

Injection coincided with: concurrent heavy alcohol use; increasing use of stimulants such as cocaine; and the introduction of misused prescription medications. During their most recent injection session, participants were significantly less likely to inject a stimulant, and were significantly more likely to identify an opioid as their primary drug of injection, when compared to injection initiation. Moreover, alcohol was more likely to be co-administered at time of first-ever injection, whereas prescription sedatives and crack cocaine were more likely to be co-administered during the most recent injection.

Initiation into injection tended to occur after an extensive and relatively consistent sequence of substance use. First ever and most recent injection drug use often occurred within a polysubstance context; however, the specific patterns of substance use changed with time. Findings suggest that specific patterns of multiple substance use may be appropriate targets for treatment and prevention of injection drug use.

The present research has a goal tostudy self-imaginationlevel and to determine the effect of cognitive-behavioral therapeutic group in treatment of social anxiety disorder of the adolescents (teen-agers).

This research is of sub-empirical plans (designs) which were performed as pre-testing, past-testing and threemonth (quarterly) pursuance.two experimental and control groups are used in it. Group CBT therapy (treatment) is independent variable which was performed during 12 sessions weekly and the scores of anxiety symptoms in the patients developed by social anxiety disorder were considered as dependent variable. Statistical population of this research includes 1135 11–14 year-old girl students in state schools of Babol city which among this series, 368 students were randomized, clustered, stagebased selected during second academic (educational) semester of 2011–2012 as the samplegroup by the mean of 12.8 yearold and standard deviation of 4.05. After sampling, by help of social phobia structured recognition (determinant) interview based on DSM-IV recognition criteria and using of Kanver et.al. Social anxiety questionnaire and cooper smith's self stem questionnaire, data collection was performed.

The scores difference of two experimental and control groups in social anxiety is meaningful in two stages (steps) of pre-mediation (before manipulation) and after it based on Mann-Whitney Yu test.

The scales of evitable behaviors and fear from negative evaluation of social anxiety test have shown that cognitive-behavioral therapeutic group has meaningfully reduced the level of evitable behaviors and fear from negative evaluator.

Aim of audit was to assess attendance at clinic and determine factors that might influence attendance. The outcome of the audit showed that mainly young men from South asian background were not attending. Recommendations from the audit included education of patient about illness and importance of maintenance treatment, education of family about illness so they can get more involved in treatment and encourage patient's compliance with treatment.

Observe trends in attendance according to ethnicity.

Re-evaluate attendance after recommendations were put into practice.

Look at clinic lists and note DNA (did not attend) in clozapine clinic over period of 3 months. Note ethnicity of patients.

39 patients were booked into clozapine clinic over period of 3 months 8 DNA's - 2 black british and 6 white english Reasons for non attendance: 1 black british works full time, 1 black british AOT client, 1 white english was physically unwell, 1 discontinued clozapine without informing services. Another important reason for non attendance: patients don’t tend to attend clozapine clinic if blood test is not due the same day.

Improvement of non attendance in South Asian client group due to education of patient and family about illness and treatment. Non attendance in other client group is mainly due to non concordance between blood test appointment and clinic appointment.

Treatment team should consult client's diary to synchronise the time of blood test with time of clinic appointment.

Hair drug testing measures the drug molecules embedded inside the hair shaft, eliminating external contamination as a source of a positive result.

Four drug groups with 20 schizophrenic patients for each drug (Haloperidol, Trifluoperazine, Clozapine and Risperidon). The 1st visit included clinical assessment (semi-structured interview and diagnosis, and Positive and Negative Schizophrenia Symptom Scale PANSS) and urine & hair samples were taken after the first week of drug administration. The 2nd visit was done and samples were taken after 4th week of drug administration. The 3rd visit was done and samples were taken after 8th week of drug administration.

The four antipsychotics in this study can be detected earlier in urine than hair (starting from 1st week in the former and 4th week in the later) HPLC test. There were significant differences in the mean scores of PANNS for the four drugs in 1st, 4th, and 8th weeks.

The advantages of hair analysis over urine analysis include the non-invasiveness, low cost, easier to collect, store, transport, the ability to measure a large number of potentially interacting toxic and biologically essential elements.

Of the study is To evaluate the improvement of mood, anxiety and sleep disorders in patients treated with agomelatine and affected by drug addiction (heroin, alcohol and benzodiazepine

The efficacy of agomelatine was assessed by investigator at T0 and at monthly visit up to 6 months using HAM-A, HAM-D21, VAS for craving VAS for the quality of sleep.

• Weight, number of hours slept and quality of life were evaluated

• Blood parameters were assessed at T0 and T6

• Heroin, cocaine and cannabinoid metabolites were evaluated.

We evaluated the efficacy of agomelatine on top of conventional treatments for drug addiction in 3 different groups (heroine, alcohol and sedatives addiction). In all three groups we’ve observed the improvement over time in depressive symptoms and anxiety symptoms. We’ve noticed an important reduction of craving. The quality of sleep and the time of sleeping have markedly improved. The quality of life was increased in all patients treated with agomelatine.

Violence against professionals has been long documented as a source of stress and post traumatic stress. Interestingly, whereas the effects of violence directed at medical staff have been studied extensively, the frequency of exposure and effects on other practitioners of the helping professions has been scarcely studied.

To present the scope of the problem, frequency, and the moderating role of trust on the levels of PTSD experienced by the exposed practitioners.

A sample of 645 practitioners in social services in Israel. The instrument included the Client Violence Questionnaire, PTSD and related somatic symptoms.

80% of the practitioners were victimized in at least one form of violence over the last 3 months including verbal abuse, threats, vandalism, and/or physical violence. Positive association was found between each type of abuse and PTSD reactions. Interestingly, trust among team members has shaped the relationships between exposure to violence and PTSD reactions (moderating variable). Higher levels of trust were associated with lesser exposure on the one hand, yet higher levels of trust were also associated with higher correlation between exposure and PTSD.

Trust in team seems to serve a dual function. On the one hand, it serves as a buffer, reducing the odds for exposure to violence. On the other hand it increases the negative effects of exposure - when such occurs. In other words, trust in team may be associated with higher trust in clients, a factor that reduces the anticipation of violence, and thus increases its negative effect.

Modified Early Warning Scores (MEWS) are now commonly used for the assessment of unwell patients in general hospitals. It can be used to quickly identify the deteriorating patients who need urgent intervention. The use of MEWS has been shown to be effective in reducing mortality and morbidity of patients who deteriorate slowly. Its use in mental health has not been thoroughly studied.

Standard MEWS form was reproduced and customized for using in psychiatric wards. A survey was conducted on level of confidence of Chiltern unit's nursing staff before and after introducing the MEWS form.

They were asked to make a decision about management of two standard case studies and rate their level of self confidence from 1 to 5 before and after using the form.

10 nursing staff band 5 and 6 took part in this study with wide range of experience from 6 months to 20 years (Average 9.7 years).

The average level of confidence before introducing MEWS was 3.65± 0.66 and rose to 4.6±0.5 afterward. The improvement in the level of confidence was statistically significant (P = 0.002).

The validity of decisions made by nursing staff about two cases rose from 45% before using the form to 100% afterward. The improvement in the validity of decision making after introduction of MEWS system was also statistically significant (P< 0.0001).

Our study suggests promising potentials for improvement in patients’ safety and confidence of nursing staff by introducing MEWS system to in-patient psychiatric wards.

There are complicated relations between child's psychiatric problems secondary to epilepsy, maternal stress and parenting style.

The aim of the present research is to study psychological and behavioral characteristics in children with epilepsy, study maternal stress associated with parenting these children, and parenting styles of these mothers.

Children aged 3 to 7 years old with an established diagnosis of epilepsy for at least 1 year without other neurological disorders or mental retardation and their mothers were selected from child neurology clinics in Mashhad, Iran. Eligible participants were 30 epileptic children. Control group of 30 healthy children from Mashhad kindergartens were matched with epileptic children in terms of age and sex. Strengths & Difficulties Questionnaires (SDQ), Parenting Stress Index (PSI), Parenting Style Questionnaire (PSQ) and a demographic questionnaire were used for data collection.

Mothers of children with epilepsy had higher levels of parenting stress (in both parent and child domains) compared to the other group (P < 0.001). Parents with epileptic children scored higher on permissive and authoritarian parenting scales. However, the score was lower for authoritative parenting style in comparison with the scores of the control group. In general, these differences did not reach a significant level (P>0.05). Children with epilepsy had significantly higher scores than normal children in terms of emotional symptoms, conduct problems, hyperactivity and hence, the total difficulty score (P< 0.05).

Educational and psychological programs aimed at enhancing adjustment of parents with their children's epilepsy are greatly needed.