Biomarker studies showed that the diagnosis of Alzheimer's disease (AD) can be done already years before any clinical symptoms appear. Considering the lack of effective treatments, this scientific development becomes problematic in clinical practice.

To examine whether the level of knowledge about AD mediates potential wish for diagnosis to be revealed in a pre-clinical phase.

The Alzheimer's Disease Knowledge Scale (ADKS; Carpenter et al., 2009) has been completed by 68 healthy (with no cognitive impairment) elderly (age 62-75), 49 caregivers (close relatives) of AD patients (age 42-74) and 96 medical students sample. After ADKS completion all participants were presented a leaflet showing possible tests they could underwent (PET-based amyloid imaging, CSF-based amyloid and tau measurements and genetic tests) to establish a possible AD diagnosis in its pre-clinical phase. Attitudes about possible AD disclosure were measured using semi-structured questionnaire.

A wish to AD diagnosis disclosure, independently of the clinical scenario presented (presence of symptoms, close family member suffering from AD) and the group investigated, was higher among those who scored low on ADKS scale. AD relatives, although interested in possible prevention strategies, were highly hesitant about revealing they might have AD themselves.

The level of knowledge about AD may be associated with the decision to undergo diagnostic procedures to establish a pre-clinical diagnosis of AD. Lack of effective intervention probably determines potential patients attitudes.

Stressed workers are more likely to be unhealthy. However relation between professional stress and anxiety and/or depressive disorders remains controversial.

The aims of this study are to assess the degree of professional stress among nurses at the general hospital and to determine correlation between stress and anxiety and/or depressive symptoms.

70 nurses through a random draw according to the specialty had participated. Six medical departments and three surgery departments were selected from eighteen departments. We have used two self-administered questionnaires: the Perceived Stress Scale (PSS) and the Hospital Anxiety and Depression Scale (HAD).

The group mean age of was 33.7 ± 9.1 years.

PSS mean score in our group was 43.2 ± 6.9 and HAD mean score was 17.4 ± 4.2.

13% of nurses had pathological stress level (PSS Score > 50). We also noted that 33% of nurses had anxiety symptoms and 44% had depressive symptoms.

No correlation was found between PSS score and HAD score and between PSS score and the two sub-scales of HAD.

Variables such as female gender (p= 0.003), conflicts with colleagues (p= 0.016) were significantly correlated with high anxiety symptoms.

For depressive symptoms, we found that nurses working in surgery department are more depressed than those in medicine department (p= 0.03).

37% of nurses had criteria of major depressive disorder.

13% of nurses had pathological stress level. Third of them had anxiety symptoms and less than half had depressive symptoms.

Social support enhances a person's ability to cope and adapt to his environment, and has been found to bolster emotional and physical well-being. This may be especially true in collectivist cultures like Singapore and China, where Confucian values have strong influence over the peoples' behaviours. These values impact the way the society perceives mental illness and the way sufferers are supported. Despite cultural similarities, there are important differences between China and Singapore. Singapore is a highly developed country with excellent psychiatric facilities, while China is still developing with limited psychological resources.

To understand how social support impacts on the psychosocial functioning of sufferers with schizophrenia. It sought to examine and elucidate differences between both countries so similar in culture but different in developments.

Structured questionnaires were given to two groups of subjects (Patients and caregivers). Participants were recruited from Singapore and China (Shanghai). A total sample size of 200 participants was collected from both sites. This comprised of 50 patients and 50 primary care givers in each location.

Preliminary results indicated similar psychosocial functioning levels in patients with schizophrenia despite differences in means of social support. Chinese patients received more support from their families while Singaporean patients obtained support from the external environment such as mental health professionals.

In spite of cultural similarities, these sufferers obtained and perceived social support from different sources. More research in cultural psychology is recommended to better understand the relationship between social support and schizophrenia in Asian societies.

Psoriasis is a chronic disease with major importance for society. The extent of impaired functioning of patients with psoriasis is comparable with the extent of impairment of patients with cancer or heart disease. Patients with this illness show the highest intensification of various psychiatric disorders among patients suffering from dermatological diseases.

To estimate the prevalence of sexual dysfunction among patients with psoriasis compared with patients with other chronic dermatological diseases. An attempt to link sexual dysfunction with selected factors.

The study included 32 patients diagnosed with psoriasis. A questionnaire, consisting of four parts, has been used: I- used for the assessment of dermatological condition of patient, II - Questionnaire for the valuation of the indicator of the impact of skin conditions on quality of life (DLQI), III - Beck Scale - for the assessment of depression (BDI), IV - Mell-Krat Scale for the assessment of sexual disorders. Part I has been filled by the interviewer, other - by the tested person independently. The results were compared with the control group (people suffering from other chronic dermatological diseases), matched in terms of sex and age.

None of the persons belonging to the control or tested group has declared taking advice from a sexologist, despite the presence of sexual dysfunction in both groups (identified by Mell-Krat scale).

The above findings are results of a pilot study and it is needed to confirm them in a larger group of patients.

Depressive symptoms in schizophrenia are important not only because they contribute significantly to the suffering caused by the illness but also because they exacerbate deficits in psycho social functioning and commonly precede attempted and completed suicide.

It is important to define and clinically assess such symptoms accurately as there is now increasing evidence that they can be treated successfully.

The authors assessed the presence and severity of depressive symptoms, as well as their associations with other clinical and socio-demographic measures, in a group of patients with schizophrenia, who were not in a major depressive episode or diagnosed with schizoaffective disorder. And also possible differences in frequency of depressive symptoms in inpatient and outpatient group.

Thirty adult inpatients with schizophrenia and 30 comparison subject with schizophrenia in outpatient treatment were studied. Depressive symptoms were rated primarily with the Hamilton Depression Rating Scale. M.I.N.I. Screen and M.I.N.I were used to screen out other disorders and confirm the diagnosis of schizophrenia. Socio-demographic questionnaire that was used was designed specifically for this study.

Our results indicate significant presence of depressive symptoms in all study subjects. Mean value of total HAM-D score for the whole sample was 15,63±7,724, corresponding to mild depression. Average total score was significantly higher in the subgroup of inpatients (18.97±6,636) compared with (12,3±7,373) in outpatients.

The results indicate significant presence of depressive symptoms in patients diagnosed with schizophrenia. This should probably be reflected in guidelines for evaluation and treatment of these patients.

The growing concern about cannabis use, the most used illicit drug worldwide, has led to an increase in the number of cannabis studies using neuroimaging techniques to determine its effect on brain structure and function.

We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents.

Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered.

One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks also in both groups, which may indicate compensatory effects in response to chronic cannabis exposure. The results pointed out methodological limitations among studies and high heterogeneity in the findings.

Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent and multimodal methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. Grants: PNSD/2011/050, PNSD2006/101, SGR2009/1435.

Suicidal behaviour represents a main cause of morbidity in patients with bipolar disorder. Researchers estimate that between 25% and 60% of individuals with bipolar disorder will attempt suicide at least once in their lives. Although it remains a controversial issue, several studies have found that patients with bipolar-II disorder have a higher risk of suicide attempt than those with bipolar-I.

To investigate whether bipolar II disorder has different characteristics from bipolar I disorder among suicide attempters.

311 patients suffering from bipolar disorder, hospitalized after a suicide attempt, were interviewed by semi-structured interview, suicide attempt characteristics and a wide range of personality traits relevant to suicidal vulnerability.

There was no significant difference between BP-I and BP-II suicide attempters according to sociodemographic variables. BP-I and BP-II patients did not differ for intent and lethality of suicide attempt for both BP subtypes. There was no significant difference for other characteristics of suicide behavior such as number of previous attempts, age at first suicide attempt, use of violent mean. Personality traits such as impulsivity, aggression, emotional lability, and hopelessness were similar between BP-I and BP-II patients. There was no significant difference between the groups in rates of comorbid substance abuse, anxious disorder or eating disorder.

Retrospective study, lack of information about number of previous episodes and severity of acute episode of the bipolar disorder.

BP-I and BP-II subtypes have similar features of suicide attempt and personality traits relevant to suicidal risk.

Our batch was composed of 98 patients diagnosed with different forms of multiple sclerosis. The patients with relapsing remitting MS were free of acute neurological deficits during the examination. For every patient we performed neurological examination (EDSS) and the assessment of depression, of anxiety, of daily activities (activities of daily living-ADL and instrumental activities of daily living-IADL) and of the quality of life-score and grade (QOL score and QOL grade).

First we found strong correlations between neurological deficit (measured by EDSS) and HAM-A, HAM-D, ADL, IADL,QOL score and QOL grade (using Pearson method: p= 0.0001 for each. For different levels of EDSS score we tried to correlate HAM-A and HAm-D with ADL, IADL, QOL (score and grade). The correlations were all valid with a stronger connection in the groups with a higher EDSS score.

Anxiety and depression levels grow together with the EDSS score. Anxiety and depression spectrums are interrelated by increasing each other;s level regardless of MS severity.

Cholecystocinine is a neuropeptide which function in cortex has not yet clarified, although its relation with some psychic disorders has been noticed.

The aim of this study was a precise examination of morphology and typography of neurons which contain cholecytocinine in human cortex of inferior parietal lobule.

There were six human brains on which we did the immunocystochemical research of shape and laminar distribution of cholecystocinine immunoreactive neurons on serial sections of supramarginal gyrus and angular gyrus. Morphological analysis of neurons whicha are immunoreactive to cholecystocinine is done on frozen sections using avidin- biotin technique, by antibody to cholecystocinine diluted in proportion 1:6000 using diamine-benzedine.

Neurons that are immunorective to cholecystocinine were found in the first three layers of cortex inferior parietal lobule, and their densest concentration was in the 2nd and 3rd layer. The following types of neurons were found: bipolar neurons, then its fusiform subtype, Cajal-Retzius neurons (in the 1st layer), reverse pyramidal (triangular) and unipolar neurons. The diameters of some types of neurons were from 10 to 28 μm, and the diameters of dendritic arborization were from 80-201 μm.

Regarding the numerous clinical researches, in which it has clearly been evinced about the role of cholecystokinine in pathogenesis of schizophrenia, and according to the findings of the great number of neurons, which are immunoreactive to cholecystokinine in cortex of inferior parietal lobule, it is suggested that cholecystokinine has a significant role in pathogenesis of schizophrenia.

People with mental health conditions are at a high risk to experience occupational restrictions. Involvement in meaningful occupations contributes to health and well-being and appears to be an important component of recovery from mental illness. Today, various services are offered in hospitals; however, there is little evidence for occupation-oriented interventions for in-patient settings.

Development and initial establishment of a short-term intervention program for in-patient setting, targeting to promote everyday functions and participation in daily life of people who experience restrictions in occupational patterns due to mental health conditions.

Investigate initial intervention effectiveness for currently admitted people with psychosis.

The intervention protocol was developed based on theoretical and practical background, participants’ feedback and fidelity registration. Initial intervention effectiveness was evaluated using a small subject design (N= 10). The participants were approached during hospitalization period. They completed the evaluation battery at a base-line, participated in the intervention program as long as they were hospitalized and were re-evaluated at the end of the program.

After development of the intervention protocol with adequate documentation, the program was found to be contributing to the following parameters: number of participated occupations, enjoyment in occupation participation, functional capacity, functioning and schizophrenia symptoms (0.11< ES< 0.36).

The pilot study showed that the occupational issues may be approached with favourable results already during hospitalization. The future research should be directed toward further establishment of the occupation-oriented interventions in order to promote recovery and well-being of people with schizophrenia.

Links between endorphins and dopaminergic transmission have not been fully explored in schizophrenia.

Both endorphins excess and deficiency were postulated in schizophrenia. CGRP is probably involved in dopaminergic transmission.

Evaluation of β-endorphin and CGRP blood concentrations before and after treatment of severe schizophrenia.

70 patients treated with various antipsychotics, with severe symptoms of schizophrenia (51 with positive symptoms, 19 with negative symptoms), 15 first degree relatives and 44 healthy controls were included to the study. β-endorphin and CGRP blood concentrations were measured in severe schizophrenia and in stable mental state. The results were compared with relatives and controls.

β-endorphin and CGRP concentrations in patients with negative symptoms were higher than in relatives and controls. β-endorphin levels in patients with positive symptoms were lower than in patients with negative symptoms (p< 0,000005) and controls (p< 0,0006). No significant changes in CGRP concentration were found in patients samples. CGRP levels in these samples were independent of treatment but they were significantly higher than in relatives and controls. After the treatment β-endorphin levels decreased in patients with negative symptoms (p< 0.0001) and increased in patients with positive symptoms (p< 0,000002). No differences in β-endorphin concentration between patients in stable mental state, relatives and controls were found.

Effective antipsychotic treatment results in “normalization” of β-endorphin level. Specific changes in β-endorphin concentration could be involved in dopaminergic transmission and related to some symptoms of schizophrenia.

Several lines of evidence suggest that Clozapine is more effective than others antipsychotic drugs in treatment-resistant schizophrenia (TRS). It would therefore be extremely valuable if predictors of response to Clozapine could be identified.

The aim of this study was to evaluate the predictive factors of clinical responses to Clozapine in a group of patients with TRS.

We had studied 42 TRS patients (8 males and 34 females) receiving Clozapine. All patients inthis study fulfilled the criteria for refractory schizophrenia according to the UK guidelines for the for the National Institute of Clinical Excellence (NICE).

Psychopathology was evaluated before the initiation of Clozapine therapy and after 4 weeks using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment for Positive Symptoms (SAPS), and the Scale for the Assessment of Negative Symptoms (SANS).

Of the TRS patients on Clozapine, 61.9% achieved a clinical response, defined as at least a 20% decrease in BPRS.

There were no correlation between gender, age, educational level and Clozapine response.

The different subtypes of schizophrenia have shown no differences in therapeutic response.

There was no correlation between response and daily doses of Clozapine (relative to dose per kg of body weight).

A good Clozapine response was more likely when schizophrenia began at a later age (p= 0.007) and when negative symptoms were severe (p= 0.009).

In our study 61.9% of TRS patients on Clozapine had a clinical response. Priority should be given for patients with evident negative symptom.

ADHD is a common disorder with a prevalence rate of 3-5% in children, adults and older persons. In psychiatry, addiction centers and forensic psychiatry, the prevalence of ADHD in adults is estimated higher, around 20%. After careful assessment of ADHD and comorbid disorders, ADHD in adulthood can be effectively treated with psycho-education, medication, coaching and cognitive behaviour therapy.

To give an overview of the current state-of-the-art treatment of ADHD and comorbidity in adults.

Pharmacological treatment of ADHD usually comes after treatment of more acute or severe disorders like depressive or bipolar episodes, anxiety disorders and addiction. Because of the inattention problems of ADHD patients, antidepressant medication is usually preferred above cognitive behaviour therapy for anxiety or depression. Light therapy for seasonal affective disorder and melatonin treatment for the frequent delayed sleep phase syndrome are usually effective, though yet little studied. Available, but off-label medications used for ADHD in adults are stimulants (methylphenidate, dexamphetamine), atomoxetine, bupropion XL, modafinil and tricyclic antidepressants.

Based on 17 years of clinical experience and on efficacy and safety data in the literature, first and other choices of medication will be discussed, as well as common dosing schedules in adults, side effects, contra-indications and combined treatment of stimulants with antidepressants, mood stabilisers and melatonin.

All disorders must be addressed and treated in the right order, based on severity. Treatment of ADHD in adults is not just treatment of ADHD, but of a combination of disorders that cluster in our patients.

Evaluation of variables correlated to homicide is a fundamental issue for developing preventive and therapeutic strategies to deal with such criminal behavior.

The objectives of this study were to assess the characteristics of homicide in Tunisian patients suffering from schizophrenia and to determine the correlated socio-demographic, clinical and therapeutic variables.

The study included two groups of male patients with a DSM-IV diagnosis of schizophrenia who attended the university psychiatric hospital of Tunis “Razi”. The first group was composed by 36 patients hospitalized in the forensic unit between the first January 2000 and 30 may 2012 for homicide. The second group included 50 patients without any criminal record. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups.

No differences were found between the two groups regarding the different socio-demographic variables. Significant differences were found with respect to a duration of untreated psychosis equal to or more than one year (p= 0.048), shorter duration of psychiatric care (p= 0.002), lower number of hospitalizations (p= 0.026), antecedent of forced hospitalization (p< 0.001), low degree of insight (p= 0.001), poor medication compliance (p< 0.001) and higher antipsychotic doses (p= 0.001).

Demographic variables as suggested by other studies are less valuable predictors of homicide in patients with schizophrenia. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease and improvement of insight as well as medication compliance.

A recent study by Levine and Leucht described several kinetics of treatment response among schizophrenic patients with antipsychotics. We aimed so to test this methodology in a population of depressed patients.

2938 outpatients with major depressive disorder were included in a multicentre, non interventional study, assessing at inclusion, week 2 and week 6, mood (QIDS-C, CGI, PGI and VAS) and functionality (SDS). To identify homogeneous groups of patients on the evolution of QIDS criteria over time (D0, W2 and W6), the latent class linear mixed model was used. Then, the groups were described at each time by several clinical characteristics and scores using ANOVA or the chi-square test. All metrics at day 0 and week 2 were tested for their capacity to predict a kinetic of response, all patients being treated by Agomelatine.

1200 patients were drug naïve for the current episode; 3 types of response kinetics were found: early, intermediate et late responders. The principal factor in relationship with a later response was the number of past episodes. Among the 1700 patients with a previous antidepressant treatment, 6 types of kinetics were distinguished: early response kinetics, intermediate and late response, non response and a singular one with early response at W2 and relapse at W6. The principal factor in relationship with a bad response kinetic was the age at first episode of mood disorder.

Previous reports stressing the interest of an assessment at week 2 were reinforced by the present results.

High rate of suicidal behavior during adolescence draws the research attention. Numerous motives of suicide attempts were previously described; nevertheless most adolescents reported disturbed relationships with peers and parents. Family background seems to be important, especially the relationship between parents.

To examine suicidality in adolescents and recognize the risk factors, especially adolescents’perceptions of interparental conflict.

To explore risk factors associated with suicidality in adolescents, with regard to relationships within family, with friends and personality characteristics.

The sample consisted of 161 Czech students (14-16 years old) who anonymously completed four questionnaires: CPIC (Children’s Perception of Interparental Conflict Scale), IPPA (The Inventory of Parent and Peer Attachment), PAQ (Personality Assessment Questionnaire), CASPI (Child-Adolescent Suicidal Potential Index).

Very high level of psychosocial distress was found in 45 % of respondents, 25 % admitted suicidal ideation or a history of suicidal attempt. The perceived interparental conflict, not the divorce, was confirmed as the important aspect for higher suicidal risk in adolescents. The perceived threat (higher feelings of danger resulting from the conflict situation and inability to influence the conflict) is the main feature of interparental conflict responsible for child maladjustment. Statistically significant differences between suicidal and non-suicidal adolescents were also found in the level of felt security in relationship with their mother, father and with peers. These groups differed in some personal characteristics too (aggressivity level, negative self-perception, emotional instability, and pessimism).

Results highlight potential targets for intervention among adolescents. Further research is needed to find sensitive predictors.

Cancer is a leading cause of death worldwide and India is no exception to this. The controversies and necessity of assessing the prevalence of psychological morbidity with validated instruments in cancer patients, which can have important ramifications, in service delivery led to the present study.

To study the Prevalence and correlates of psychiatric morbidity in cancer patients and find the factors associated with psychiatric illness in cancer patients in a tertiary care centre.

Patients admitted in Radiotherapy ward of Medical College Trivandrum who met inclusion and exclusion criteria were assessed using translated and validated MINI 6.0, delirium rating scale and Adjustment disorder questionnaire after obtaining informed consent.

Of the 384 patients assessed the prevalence of Psychiatric disorders was 41.7% with adjustment disorders contributing to 22.6%, major depressive disorders 10.9%, delirium 6.5%, and hypomania 1.6% and age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas were significantly associated with psychiatric disorders.

Cancer is associated with Psychiatric disorders and affects patients. Psychological interventions can alleviate the distress of these persons and provisions of psychological support should be is an important component in the care of these patients.

The aim was to identify the relationship between sociodemographic characteristics of UAE women with diabetes and depression and to explore any differences between depressed and non-depressed patients in relation to depression glycemic control.

One hundred eighty two patients completed the Beck Depression Inventory-II. Glycemic control was assessed by glycosylated hemoglobin (HbA1c).

Ninety two of patients were diagnosed with diabetes mellitus. A statistically significant relationship was found between national status and level of depression among the diabetic sample. At least half of these women showed poor glycemic control (HbA1c levels >7.5). A statistically significant relationship exists between depression status and type of diabetes. There is also a strong relationship between HbA1c level and depression level.

Early detection of depression among UAE women with diabetes is crucial to enhance treatment regimen adherence and glycemic control.