Atypical antipsychotics bind to multiple receptor types and subtypes. Improved outcomes in schizophrenia are linked to activity at D2 and serotonin receptors 5-HT7, 5-HT2A and 5-HT1A.

To characterize the receptor-binding profile of lurasidone and other antipsychotics.

To compare receptor-binding profiles of antipsychotics.

Replicated, side-by-side receptor-binding assays used human recombinant receptors (for 5-HT7, α2A, and α2C) or membrane-fractions of animal CNS tissue. Affinities were determined via Hill plot analysis for IC50values; Ki values were determined using Ki=IC50/(1+ S/Kd) (S=concentration of competing radioligand, Kd=dissociation constant).

Lurasidone displayed potent binding and full antagonism at dopamine D2(Ki, 1.68nM) and serotonin 5-HT2A(Ki, 2.03nM) receptors (the highest D2affinity of all tested agents). Lurasidone's dopamine binding was selective for D2receptors. Unlike other antipsychotics tested, lurasidone had very high affinity and full antagonism at serotonin 5-HT7(Ki, 0.49nM), and nanomolar affinity (Ki=6.75nM) with weak-moderate partial agonism at serotonin 5-HT1Areceptors., Lurasidone showed higher affinity for 5-HT7, 5-HT2A, and 5-HT1Areceptors relative to D2receptor-binding than other agents. Lurasidone displayed moderate affinity for α2C adrenoceptors (Ki, 10.8nM); moderate-weak affinity for α1adrenoceptors (Ki, 48nM); and minimal or unappreciable affinity for receptors associated with undesirable effects (5-HT2C [Ki, 415nM], histamine H1[IC50>1000nM] and muscarinic [cholinergic] M1[IC50>1000nM] receptors).

The unique pharmacological profile of lurasidone is consistent with observed antipsychotic efficacy, low-tomoderate likelihood of EPS, low weight-gain potential, and possible mood, anxiety, and cognitive benefits.

A new approach to health assessment and the rate of working capacity decline of patients suffering from dementia, is based on the results (as of January 1, 2010) of a project entitled: Advances in medical science reflected in functional health state assessment and working incapacity in relation to International Classification of Diseases and International Classification of Functioning, Disability and Health.

The total number of hospitalizations due to dementia (F01, F03, G30) increased by more than one fifth (from 6549 to 7981 hospitalizations) between 2006 and 2010. However, the overall number of disabilities between 2006 and 2009 decreased by one half (from 2998 to 1571), and between 2010 and 2011 dropped to 5% of its original number (190 and 144 cases respectively). Nevertheless, between 2007 and 2011, there was a 50% increase in the number of patients with institutionally confirmed disabilities (from 6270 to 9504).

Conclusion The new approach to incapacity assessment is in accordance with medical experts' opinions and advances in medical science, related to function ability, activity and participation.

The new way of incapacity assessment could be the reason for the dramatic decrease in the number of institutionally confirmed disabilities in 2010 and 2011, despite the growing number of patients suffering from dementia.

Such discrepancy may also be explained by early diagnostics and more effective treatment, which prevent patients with dementia from becoming disabled.

Moreover, this hypothesis corresponds to the increasing number of patients with a certain degree of dependence due to dementia.

Patients with schizophrenia are at high risk for diabetes, dyslipidemia, hypertension, and obesity, which can be exacerbated by some atypical antipsychotics.

To evaluate the effect of lurasidone on weight and metabolic parameters.

To establish the cardiometabolic safety of lurasidone.

Short-term data were pooled from seven, double-blind, 6-week studies of subjects with acute exacerbation of schizophrenia treated with lurasidone 20-160 mg/day (N=1508); haloperidol 10 mg/day (N=72); olanzapine 15 mg/day (N=122); risperidone 4 mg/day (N=65); quetiapine XR 600 mg/day (N=119) or placebo (N=708). Long-term data (6-22 months) were pooled from patients treated with lurasidone 40-120 mg/day (flexibly dosed).

Proportions of patients experiencing ≥7% weight gain during short-term treatment were: lurasidone 4.8%, haloperidol 4.2%, olanzapine 34.4%, risperidone 6.2%, quetiapine XR 15.3%, and placebo 3.3%. Median lipid changes were: triglycerides (mg/dL), lurasidone -4.0, haloperidol -3.0, olanzapine +25.0, risperidone +4.0, quetiapine XR +9.5, and placebo -6.0; total cholesterol (mg/dL), lurasidone -5.0, haloperidol -8.0, olanzapine +9.0, risperidone +6.5, quetiapine XR +6.0, and placebo -5.0; trends were similar for LDL. Median changes in glucose (mg/dL) were similar for lurasidone (0.0) and placebo (0.0), and higher for haloperidol (+2.0), olanzapine (+4.0), risperidone (+3.0), and quetiapine XR (+3.0). Minimal-to-no changes in HbA1c were observed. With long-term lurasidone treatment, mean weight change after 12-month exposure was -0.73 kg and median metabolic changes were: -2.0 mg/dL for total cholesterol and -5.0 mg/dL for triglycerides.

Short- and long-term treatment with lurasidone showed minimal changes in weight and decrease in mean total and LDL cholesterol and triglycerides.

Long-term head-to-head studies comparing atypical antipsychotics are important for clinical decision making.

To evaluate long-term treatment of schizophrenia with lurasidone (LUR) vs. quetiapine XR (QXR; Study 234), or risperidone (RIS; Study 237).

To assess efficacy and safety of lurasidone relative to other antipsychotics.

In study 234(efficacy and safety), subjects received 12 months double-blind, flexible-dose lurasidone(40-160 mg/day) or QXR(200-800 mg/day) after completing a 6 week, randomized, double-blind, placebo-controlled trial with LUR or QXR. In Study 237 (safety) clinically stable adult outpatients received 12-months double-blind treatment with flexible-dose LUR 40-120 mg/day or RIS 2-6 mg/day.

Study 234: continued treatment of LUR responders (n=139) reduced relapse risk by 27.2% vs. continued QXR treatment of QXR responders (n=79). Hospitalization risk was 56.7% lower with LUR vs. QXR. More LUR subjects achieved sustained remission vs. QXR (61.9% vs. 46.3%; p=0.043; 12 months, LOCF), and lower all-cause discontinuation (48% vs 61%). Triglycerides were reduced with LUR; total and LDL cholesterol were unchanged or reduced. Median prolactin change was +0.6 for LUR vs. -0.7 ng/mL for QXR. Study 237: clinically significant weight gain was observed with LUR 13%) vs. RIS (19%) with median change in prolactin 0.4 vs. 14.8 ng/mL, respectively. Comparable efficacy was observed for LUR and RIS (change from baseline in PANSS total score:-4.7 vs. -6.5, and CGI-Severity score:-0.4 vs. -0.4, respectively).

The results of these two 12-month trials suggest that lurasidone is safe and well-tolerated with efficacy comparable to quetiapine XR and risperidone for long-term treatment of schizophrenia.

Patient reported outcomes (PROs), i.e. quality of life (QoL), psychosocial functioning and medication adherence are vital assessments of results in schizophrenia treatment.

Quality of life, psychosocial functioning and adherence attitude were evaluated among adult patients with schizophrenia switched from current antipsychotics to lurasidone, using the Personal Evaluation of Transitions in Treatment (PETiT) scale, a PRO measure.

Evaluate PROs after switching to lurasidone.

Stable but symptomatic adult outpatients with schizophrenia were switched from their previous antipsychotics to lurasidone, in a 6-week, open-label trial. Subjective responses to antipsychotic therapy were evaluated at baseline and study endpoint using PETiT (Higher scores=better outcomes). Score change was obtained for all patients and those switched from “sedating” (olanzapine, quetiapine) or “non-sedating” (risperidone, aripriprazole, ziprasidone, others) agents. Change from baseline to endpoint in total (overall QoL) and subscale scores (psychosocial functioning, adherence attitude) were compared using ANCOVA.

Of the 244 patients switched to lurasidone, 213 had available data. Changes from baseline in mean total PETiT score (3.2, P< 0.0001) and subscale scores of psychosocial functioning (2.5) and adherence attitude (0.7) were reported in all patient groups (p< 0.001). Improvement in mean total PETiT score was observed in patients switched from non-sedating (3.5, n=139) and sedating (2.7, n=74) antipsychotics and was statistically significant (P< 0.0001) in the non-sedating group. Differences in statistical significance (sedating vs non-sedating) may arise from smaller changes, not sample size.

In this study, patients switching to lurasidone experienced improvement in QoL, psychosocial functioning and adherence attitude.

During the past three decades psychiatry has suffered from a decline in the recruitment of young physicians across Europe. The challenges for clinical psychiatric research are even worse. After psychiatry has declared itself a medical (neuro) speciality the situation is now shifting towards the better.

Active innovation programs are however needed to accelerate this recent positive trend.

To introduce and train medical students in clinical psychiatric research methodology by practical research work supported by theoretical teaching.

To describe a local initiative done by AUH Risskov, Department M in Denmark implementing a clinical research teaching program for medical students.

We invited students of medicine known as dedicated and pro-active and posted the program on our website. Students responding positively to our invitation were interviewed by the first and senior author before being accepted into the program.

The group consists of 8 medical students and one psychology student in their third to the tenth term (of 12) at university. They are all given minor research questions relevant to the clinical department. The trainees are supervised in groups and individually parallel to systematic teaching. Further details will be given at the presentation.

We have deliberately sought out the most qualified students with an elitist approach. The participants commit themselves to act in an active, independent and disciplined way when accepted into the program.

The participants will be present at the Nice congress ready for discussion and with answers to any questions about the program.

Major depressive disorder, the most prevalent psychiatric disorder in general population, raises a series of clinical challenges, chronic medical comorbidity being regular one.

Our main objective was to analyze the weight of anxiety and depressive symptoms levels, and that of premorbid personality traits, in co-occurrence of medical diseases in subjects with major depressive disorder.

A cross-sectional research was performed on 32 inpatient subjects admitted in Timisoara Psychiatric Clinic during 2010 - 2012 with major depressive disorder. Anxiety symptoms level were self-assessed with Beck Anxiety Inventory and depressive symptoms level were self-assessed with Beck Depression Inventory. Temperament and character personality traits were self-assessed using Cloninger TCI tool, which was administrated once that clinical remission has occurred.

Majority of studied subjects (71%) have had at least one comorbid chronic medical diseases. Despite the results of other studies, the level of depressive and anxiety symptoms has no significant impact in medical comorbidity occurrence. Major depressive subjects with medical comorbidity, have had significant higher scores in Harm Avoidance, more exactly in Shyness with Strangers (p = 0.007) and Fatigability (p = 0.013). Significant higher total scores were revealed, in the same subjects, for all three character dimensions like as Self-Directedness (p = 0.004), Cooperativeness (p = 0.039) and Self-Transcendence (p = 0.030).

According to our research results, rather than temporary clinical symptoms constituting clinical picture of subjects with major depression there is possible that premorbid personality traits could weigh more significant to the appearance of medical comorbid conditions.

The aim of this study is identifying the predictors of major depression and anxiety disorders and the predictors of the remission of these disorders.

A longitudinal study under the form of a community survey includes a randomly selected sample of 2,434 individuals between 15 and 65 years of age (T1); 1,815 agreed to be re-interviewed two years later (T2). Mental disorders were identified with the Composite International Diagnostic Interview, including mood disorders (major depression, and mania), and some anxiety disorders: panic disorder (PD), social phobia (SP), and agoraphobia (AG). Logistic regression was used to identify predictors (T1) of remission of mood disoders and anxiety disorders at T2 and predictor of new cases at T2.

The prevalence of mental disorders for the two waves of the research program will be presented. For major depression (MD), among the 145 subjects who had MD at T1, 69% recovered at T2 and among the 1553 that did not have MD at T1, 5.7% developed MD at T2. For anxiety disorders, among the 93 subjects who had these disorders at T1, 78.4% recovered at T2 and among the 1635 subjects who were free of an anxiety disorder at T1, 1.8% developed it at T2. Predictors identified for remission of disorders and for developing new disorders at T2 will be presented.

The predictors of new cases identified will allow to develop more effective prevention program and those associated to remissions will help to improve mental health services.

Self-harm is a major public health problem, being a frequent condition among youth and young adults. Psychiatric conditions, like borderline personality, depression, substance misuse and anxiety disorders, are commonly associated with self-harm. The effects of media and contagion are also important and the internet has an important role in divulging and sharing self-harm behaviors.

We pretend to study the role the internet in potentiating or preventing self-harm behaviors.

We used combined literature searches in PubMed and B-on using the terms “self-harm”, “self injury”, “self mutilation” and “internet” and we also present a clinical case from our service.

Most of the individuals that have self-harm behaviors may never present in psychiatric ward. Today, there is more information about self-harm available to the public domain than ever and web sites about self-harm include personal pages, forums, blogs, communities and even video-sharing sites. These web sites have supportive content that allow the users feeling that they are not alone, sharing feelings and narratives. However, most of them have potentially harmful material, including self-injury related tips, reinforcing messages and triggering material, normalizing or even glamorizing self-injury.

Most of the websites normalize and promote self-harm behaviors. Only the better knowledge of these phenomena would allow the use of internet as an effective tool for self-harm prevention, especially for socially-isolated and vulnerable individuals.

The study of the relationship between insight, psychopathology and executive functions has revealed contradictory results, which seems to demonstrate the complex and multidisciplinary nature of insight. Several studies in psychotic patients confirmed the association between lower insight and poor prognosis, emphasizing the impact of poor adherence to treatment in greater symptom severity and greater likelihood of aggressive behavior.

To study the relationship between insight, psychopathology and executive functions. Analyze the association between these variables and the type of crime committed in a sample of forensic patients.

The sample is comprised by patients hospitalized for more than 6 months in the Department of Forensic Psychiatry of the Centro Hospitalar e Universitário de Coimbra, diagnosed as measured by DSM-IV-TR, in the category “Schizophrenia and other Psychotic Disorders”. Of these, we excluded those that according to DSM-IV-TR had a diagnosis of “Mental Retardation” (IQ as measured by WASI - Wechsler Abbreviated Scale of Intelligence) or “Substance Dependence”. Patients were evaluated using PANSS (Positive and Negative Syndrome Scale), SUMD (Scale to Assess Unawareness of Mental Disorders) and TMT (Trail Making Test). Biographical data, type of crime that led to the hospitalization and the security measure applied, was gathered through the review of patient's clinical files.

Data will be analyzed using the Statistical Package for Social Sciences (SPSS - 19th version) and the results will be interpreted according to the current literature.

Comorbidity between ED and depression is high. Causal relation between two is bidirectional. Person with ED can have MDD because of psychological factors. MDD symptoms and associated hypogonadism affect on libido and erectile function. Diseases like ankolysing spondolysis, asthma, rheumatoid arthritis, coronary heart disease, psoriasis, diabetes, and multiple sclerosis have strong co morbid ED and MDD. Inflammation is common overlapping factor in these illnesses.

An internet search was made on pubmed, and psychiatrist.com, using key words, major depression, endothelial dysfunction, inflammation, erectile dysfunction, and cytokines. This was followed by study of relevant martial in different journal and books.

Men with ED had high levels of depressive, somatic, and anxious symptoms. Approximately one-third of people with MDD had higher levels of peripheral inflammatory marker. Incidences of ED are two fold higher in depressed people as compared with nondepressed.

Levels of pro inflammatory cytokine like IL-1,I patient L-6,TNF,CRP, interferon-gamma and homosystien are raised in MDD. Cytokines effect on the HPA axis, glucocorticoid resistance, neurotransmission and hippocampal neurogenesis. Patients treated with interferon have higher risk of developing MDD .Antidepressant therapy results in decreased inflammatory response.

Erectile function depends on integrity of endothelium which is target of inflammation. Endothelial dysfunction is linked to ED as they share a common pathway through the release of nitric oxide. Proinflammatory cytokines and homosystien play role, both in ED and MDD.

Inflammation and its markers need to be considered in cases of co morbid ED and MDD.

To detect molecular chaperone calreticulin(CRT) expression on the hippocampus in the rat model of post-traumatic stress disorder(PTSD), and discuss the regulation of CRT on Ca2+ in hippocampus of PTSD rats, further provide the experiment basis for pathogenesis of memory anomaly in PTSD rats.

The single-prolonged stress(SPS) is one of the animal models was used to set up the rat PTSD models. Male Wistar rats were randomly divided into 1, 4, 7 days groups after exposure to SPS and a normal control group. The expression of CRT was detected by using immunohistochemistry, Western blotting and RT-PCR. The intracellular free calcium was examined by fluorescence spectrophotometer.

The expression of CRT in the hippocampus obviously increased after SPS stimulation, and reached the peak at SPS 4d. The intracellular free calcium level in the hippocampus obviously increased, and reached the peak at SPS 1d, then gradually decreased.

PTSD caused endoplasmic reticulum stress(ERS), calcium overload, up-regulated expression of CRT, activation of unfolded protein response(UPR), which maybe result in cell apoptosis and maybe the pathogenesis basis on memory anomaly in PTSD rats.

The prevalence of Social anxiety disorder (SAD) is believed to be underestimated, although it is a very common condition. The subjects suffering from it often have trouble to search for support. The onset occurs mainly in early adolescence.

The aim of this paper was to evaluate the impact of school and family background on the development of SAD.

Our questionnaire available on a popular social network site, was divided into 4 parts:

1. 1) demographic data (gender, age, site of residence),

2. 2) genetic and organic background (comorbid mental disorders, addictions),

3. 3) situation at school and in the family environment during adolescence,

4. 4) the part designed to define the group that may suffer from SAD with the use of the Mini-Social Phobia Inventory (Mini- SPIN).

226 people were recruited. The age range was 16–61, with the average of 25,8. 71% of the respondents lived in cities with a population of more than 100 000. Male to female ratio was 3:1. According to Mini-SPIN 26,5% of the interviewees might suffer from SAD (28.2% of women and 21.4% of men). Our study showed, that both family and school environment factors have an influence on the development of SAD.

The amount of internet community users that are likely to suffer from SAD, significantly exceeds the clinical data. Both family and school environment factors were shown to be risk factors for the development of this disorder.

Post-traumatic stress disorder is an important manifestation of mental and behavioral disorders after the disaste Single-prolonged stress (SPS) is an received established animal model for post-traumatic stress disorder.

To investigate endoplasmic reticulum apoptosis pathway and unfolded protein reaction plays an important role in medial Prefrontal Cortex of PTSD rats by Single-prolonged stress (SPS).

Determined by the change of free intracellular Ca2+ the glucose-regulated Protein (GRP)94 and apoptosis-related cacaspase-12 expression.

A total of 60 healthy, male Wistar rats were selected for this study,randomly divided into a normal control group and SPS groups of 1d,4d,7d,14day and 28day. Behavioral of learning and memory capabilities of rats was observed by using Morris water maze. The expression of, GRP94 and cacaspase-12 was detected using immunohistochemical,Western Blotting and reverse transcription-polymerase chain reaction.

In this study compared with control groups the intracellular free calcium level in mPFC was increased 1 day after SPS exposure (P< 0.05) decreased 7 days after SPS. The expression cacaspase-12 peaked at SPS 7d and then gradually decreased. GRP94 express in normal control group and increased 1 day after SPS exposure peaked at SPS 7d and then gradually decreased, at SPS 28d still higher than normal control group.

In SPS-PTSD rats the learning and memory capabilities of the rats decline;mPFC free intracellular Ca2+ may relate to endoplasmic reticulum stress;Endoplasmic reticulum stress launch unfolded protein reaction Endoplasmic reticulum apoptotic process which may relate to the pathogenesis of medial prefrontal cortex abnormal function in PTSD.

Opioid addiction is a serious health/social problem, associated with high morbidity and mortality.Several gene polymorphisms on the mu-opioid receptor gene(OPRM1), which plays an important role in reward system, have been related to opioid dependence (A118G, C17T, C2044A). A118G is the most studied and probably the most promising biomarker of better response in these patients, despite discrepancies has been manifested even in studies conducted on the same ethnicity.

Description of A118G, C17T and C2044A allele frequencies in an opioid-dependent population. Evaluation of the association of A118G gene polymorphism with opioid dependence.

Case-control Study.

Case group: 16 patients with opioid addiction, included in a Heroin Prescription Program in Andalusia, based on the protocolized individual prescription of diacetylmorphine. Control group: 32 non opioid-dependent subjects.Genotyping of A118G, C17T and C2044A was performed by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism.

Case group: 12 patients were AA homozygous (12/16;75%) and 4 patients were heterozygous AG (4/12;25%) for A118G. All patients were homozygous CC for C17T and C2044A (16/16;100%). The distribution of the genotype frequencies of OPRM1 gene polymorphisms in the case series were not statistically different from those reported for European populations in HapMap for A118G (p=0.6418) and the GENO PANEL for C17T. Control group:19 patients were AA homozygous(19/32; 59.4%) and 13 patients were heterozygous AG (13/32;40.6%) for A118G. This polymorphism was not associated to opioid addiction (p=0.3503).

Distribution of genotype frequencies in opioid dependants corresponded to specific frequencies from European population for A118G and C17T polymorphisms. OPRM1 gene polymorphisms were not associated to opioid addiction in this population.

Behavioral and psychological symptoms in dementia patients (BPSD), represent a strong predictor of dementia progression. Current interview-based assessment methods lack objectivity to ensure reliable early differential detection. Therefore, the use of Information and Communication Technologies (ICT) such as actigraphy and automatized video monitoring are of interest in addition to current assessment methods because they allow capturing the patients’ performances and actions in real time and real life situations.

To improve the quality of clinical assessments of BPSD by validating the use of objective measurements obtained by ICTs in dementia patients in an experimental design, undergoing an „ecological assessment“.

Demented and pre-demented patients (with and without apathy) and healthy controls underwent an experimental trial wearing an actigraph and being filmed over a free period of 15 minutes in a in 16-zone divided room. Apathy was assessed using NPI apathy subscore. Frequency of zone displacement, and of goal-oriented zones, object manipulation, mean motor activity and speed of walking were assessed with the help of ICT.

Significant differences were found between apathy and non-apathy AD patients for the parameter of object manipulation (OM) and OM in goal-oriented zones (GOZ) but not for frequency of zone displacement (FZD).

Moderate evidence for a reliable detection of apathy in dementia patients through data obtained by ICTs was found. Therefore, it represents a promising addition to conventional neuropsychological methods for future studies, focusing in particular on object manipulation and visuomotor deficits.

This research, conducted at Yale University with IRB approval, involved 12 in-depth qualitative interviews with community psychiatrists at a public mental health center. The main interview question - “What is a psychiatrist? - was followed by questions involving the themes noted above.

For the psychiatrists, psychiatry seems deeply embedded in medicine. If the biological model has been able to improve some parts of psychiatric practice, many psychiatrists will identify the limits of this model and feel frustration from its tendency to marginalize their role into one of medication management.

Regarding this lack of knowledge and understanding of mental illnesses, regarding the crisis that the health system is undergoing, it seems necessary to go above a simple definition of a psychiatrist as someone with skills for treating mental illness. With which skills can psychiatrists improve symptoms, the life context that contributes to patients’ symptoms, and the mental health delivery system that often misses people's needs? Or going further, how can psychiatrists best advocate for their clients?

Stress and reward processing are two of the principal mechanisms involved in the modulation of homeostasis in the body. According to neurobiological research, these two mechanisms overlap in the cortico-striatal-limbic circuit, which can be disrupted due to chronic stress and substance abuse. Stress is primarily modulated by the hypothalamic-pituitary-adrenal (HPA) axis, from which cortisol is an end-product.

The aim of the study was to investigate the effects of chronic stimulant abuse on the cortico-striatal limbic circuit. This was examined by relating cortisol levels with grey matter volume in brain structures associated with addiction and stress.

We hypothesised that stimulant-dependent individuals show increased cortisol levels and abnormalities in the corticostriatal- limbic circuit. We further hypothesised relationships between altered grey matter volume and increased cortisol levels in the patients.

Twenty-two stimulant-dependent individuals and 21 healthy volunteers (matched for age and gender) underwent an assessment session and structural MRI brain scan. Cortisol was assessed in saliva and blood plasma. Mood, impulsivity and compulsivity were measured by clinical instruments.

Stimulant-dependent individuals showed higher levels of cortisol in both saliva and blood, which were associated with distinct alterations in grey matter volume in fronto-limbic structures. Plasma cortisol was positively correlated with the duration of cocaine use. No relationships were found with current mood, trait-impulsivity and drug-related compulsivity.

The relationships observed between cortisol and fronto-limbic structures may, in part, be explained by HPA axis dysfunction and its downstream effects on brain structures involved in stress modulation in stimulant-dependent individuals.

Life events and accompanying psychological and behavioral reactions frequently have an impact upon people's daily lives and are believed to predispose them to disease. Psychological stressors impact many physiological and pathological disease outcomes, including mental illness. Positive social interactions have in turn been shown to exert powerful beneficial effects on health outcomes and longevity.

The Objective of this study was to analyze the relationships of Psychological Distress, Social Support, and Mental Fitness among patients of mental health services.

This article aims to discuss the evidence supporting the mediating effect of social support between psychological stress and mental health.

This study was performed on patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 patients were evaluated with Mental Fitness Scale, Kessler Psychological Distress Scale(KPDS), and Multidimensional Scale of Perceived Social Support(MSPSS).

Correlations among variables of psychological distress and social support on subordinate variable of mental fitness of patients were significant. The result of the regression analysis, psychological distress and social support have a positively significant influence on mental fitness of patients. social support showed mediating effects between psychological distress and mental fitness.

These results suggest that health care providers ought to seek social support for patients, in order to provide positive mental fitness of patients.

Torture survivors often present a complex clinical picture with mental and physical symptoms and illness in addition to social incapacities. Torture survivors can be subjected to deprivation of liberty in a variety of situations. Detention might remind the torture survivor of former torture experiences and thus add further to the strain of being detained.

To evaluate and discuss the present knowledge of mental health consequences of detention of torture survivors and to present and discuss practices relating to detention.

To focus attention on existing evidence and problematic practices in relation to this.

Results from key publications within the field will be resumed and discussed and implications outlined.

Research on the impact of detention on torture survivors is almost non-existent. A negative impact of detention on mental health of torture survivors can however be deducted mainly from the existing evidence on asylum seekers. Whether screening for torture experiences and following systematic monitoring of mental health are going on worldwide remains obscure, but from a Danish perspective it is likely that torture survivors are not identified.

Torture survivors constitute a vulnerable group mentally, physically and socially. A negative impact of detention on mental health can be deducted mainly from studies on asylum seekers. Identification of torture survivors is necessary before decision on detention is taken. Scientific evidence on the subject is missing. Research initiatives and monitoring of practices are necessary.