Neuregulin1 (Nrg1) is a candidate gene linked to schizophrenia. Cleavage of Nrg1 full-length (Nrg1-FL) precursor protein by BACE1 mediates activation of erbB receptors and triggers a cascade of downstream signalling events that lead to activation of GABA, NMDA, and nicotinic receptors. Studies with BACE1 knock out mouse models have demonstrated impaired Nrg1-/ErbB signalling leads to SZ-like phenotypes that can be rescued by antipsychotics.

We analysed frontal cortex brain tissue of schizophrenia (SZ) and healthy control (HC) subjects for expression of BACE1, Nrg1-FL and Nrg1 cleaved fragment.

To explore the possible mis-cleavage of Nrg1 by BACE1 in SZ as this may disrupt some neuronal circuits in the brain and trigger schizophrenia.

Samples from Brodmann area 6 region (40 SZ and 20 HC) were homogenized with TRIzol and proteins were analysed by western blotting. Also samples were analysed for RNA integrity and 18 SZ and 20 HC with high RIN were selected for qRT-PCR study.

About 50% decrease in Nrg1 C-terminal fragment (CTF) was observed in the SZ group compared to the HC group (p < 0.001). A strong correlation between Nrg-FL and BACE1 was observed (r = 0.82, P < 0.001). Results of qRT-PCR showed a significant increase in the expression of BACE1-432 splice variant in SZ compared to HC (P = 0.005). A strong inverse correlation was found between BACE1 activity and 432/501 BACE1 splice variants expression.

Our results suggest that altered expression of BACE1 and decreased cleavage of Nrg1 are associated with SZ.

Münchausen Syndrome by Proxy (MSP) is a form of child abuse in which a parent induces real symptoms of diseases in a child, even leading to hospitalization. It was described in 1977 by the Pediatrician Roy Meadow.

In Brazil, The Statute of the Child and Adolescent, passed in 1990, outlines the procedures for all abuse and neglect proceedings.

To show the symptoms and evidences of this Syndrome in order to provide an early recognition of those cases.

To prevent this kind of child abuse which can bring harmful effects in the child's life, even causing death.

Evaluation of a case report that was studied by Psychiatrists in Rio de Janeiro, in which the prosecutor wanted to know whether or not the children could be released from protected custody, considering the suspicion of MSP and the fact that one of the child had already died.

The woman didn’t show any Psychiatry Disorder by the time of the evaluation, but her behavior suggested psychological difficulties as being a mother. It was suggested that she and her husband needed psychological intervention and that the children still needed the Council of Guardianship's care and protection proceedings.

The MSP can be difficult to be diagnosed and is still considered a controversial phenomenon. It doesn’t have a clear cause but occurs because of psychological problems in the adult, and is generally an attention-seeking behavior. The syndrome can be life-threatening for the child involved.

Hizen Psychiatric Center has the first ward for Severe Behavior Disorder in Japan which has the highest number of severe cases. We have many specialized ways to intervene over the years, Habilitation, TEACCH Pharmacotherapy and Behavior therapy. On the otherhand, most of patients have traits (such as difficulty in communicating, severe self and other harming, pica) are easy to make their carer feel rewardless, conflict.

To have adequate understanding and give specialized supports for carer, we focus on experiences of care-giving, and analyze the process about formation of care-giving, what kind of rewards they acquire.

Half-constructed Interview with 10 Nurses at the ward and Qualitative Analysis based on Grounded Theory Approach.

5 Upper Categories are produced

(Shock) (Disgust) (Conflict) (Change) (Acceptance)

and those can be the steps. This process is not linear and each nurse has each pattern of achievement and time.

We found the steps of care-giving formation even there are difficulty of interaction. To achieve (Change) (Acceptance)

individually, we can suggest the way to make them feel rewarding. Carer (including Staff and Parent) are important environments for patients. It needs to empower them not to be anti-factor of care-giving.

Acculturation of aborigines of Siberia and Far East of Russia was characterized by destabilizing influence of migrants and adoption of alien traditions of alcohol use. Among migrants of new wave, number of socially maladjusted migrants with depression, suicidal and addictive behavior has grown.

To define factors of prevention of alcohol-related over-mortality of native population based on monitoring of medicosocial indices of substance abuse situation, clinical dynamic and prognosis of alcoholism in differentiated groups.

Clinical-epidemiological and clinical-psychopathological screening of revealed (ICD-10) alcoholic patients among arctic group (Evenks, Chukchi, Koryaks, Eskimos) of north-Asian mongoloids (n=735). Group of comparison - 90 patients (F10.2) male Caucasians from this locality.

Aborigines of Siberia show high frequency (50-65% in both sexes) of mental disorders. Men are characterized predominantly by alcohol dependence syndrome (maximum at age of 26-35 years), women - by affective disorders. Malign character of alcoholism determines high lethality of young men from suicide, alcohol-related accident, complications of comorbid somatic pathology with deformation of sex-age pyramid at 25—40 years. Severe degradation of personality (psychopath-like, cognitive defects) is typical; psychopathologic transformation of intoxication with aggression precedes development of withdrawal syndrome.

Marginalization of new migration wave promotes formation of various forms of mental desadaptation, hetero (homicidal) and auto-aggressive (addictions, suicides) behavior. Factor of prevention of negative consequences of acculturation is monitoring of mental health both of aborigines and migrants. Significance is acquired by ethnological expertise of possible consequences of current migration processes for ethnodemographic parameters of scanty ethnoses.

Internally displaced persons (IDPs) reach almost 6% of Georgia's total population. They were uprooted by the military conflicts in Abkhazia and South Ossetia in the 1990s and the brief but intensive war with Russia in 2008.

To examine the patterns of mental disorders and functional disability among conflict-affected populations in Georgia.

The study used a cross-sectional household survey design with multi-stage random sampling IDPs and “returnees” (IDPs who have returned to their original villages). Disorders of PTSD, depression, anxiety, and their co-morbidity, were measured, along with functional disability. A range of questions on exposure to violent and traumatic events and demographic and socio-economic characteristics were included. Descriptive and multivariate regression analyses were used.

Of 3600 respondents, 24% were recorded with PTSD, 14% with depression, 11% with anxiety. 30% of all respondents had ≥1 condition and 6% had all 3. Factors significantly associated with the mental disorders and their comorbidity included greater frequency of exposure to traumatic events, female gender, older age, displacement status, low levels of neighbourhood support, poor community conditions, and a bad economic situation. PTSD mediated the influence of traumatic events on outcomes of depression and anxiety. All 3 disorders significant influenced functional disability.

The study provides the most comprehensive data on mental health problems among conflict-affected populations in Georgia. It highlights the persisting burden of poor mental health and the associated characteristics, and the significant impact of mental disorders on functional disability. It calls for greater access to needs-driven mental health services.

The research aims to investigate the correlations between steroid hormones level alterations and aggression level among alcoholic patients under conditions of social isolation.

Serum levels of cortisol and testosterone were measured in alcohol dependent males with aggressive behavior (n=60) and in alcohol-dependent non-aggressive males (n=27) being under conditions of social isolation. The control group consisted of 24 alcoholic patients during alcohol withdrawal. The hormone serum levels were measured with ELISA method. Statistical processing of results was carried out with software package SPSS for Windows.

In comparison with the control group, increase of cortisol concentration in patients under conditions of social isolation has been observed. Patients with aggressive behavior have shown the trend toward cortisol level increase as against nonaggressive alcohol-dependent males. Concentration of testosterone in the investigated groups did not differ from the one of control group.

Increase of cortisol level in the investigated groups is apparently a consequence of influence of the factor of social isolation, but also it might be associated with aggressiveness tendency of alcoholic patients. Steroid hormones may play a significant role in aggressive behavior of alcohol-dependent patients in the conditions of social isolation.

Quality of Life Index (R. S. Eliot), Depressiveness Questionnaire (A. Beck), Meaning of Life Orientations (D. A. Leontyev), Tomsk Rigidity Questionnaire (G. V. Zalevsky), Coping-Strategies Rating (E. Heim), Thought Constructiveness Questionnaire (S. Epstein); Non-Complete Sentences Method by J. Nuttin; Statements’ Content Analysis Method, Methods of statistical analysis.

Complicated self-realization in respondents is manifested as: uncertain life values and principles, experiences of nonachievement of their aims and perception of themselves as losers, anxious thoughts about their future. Inability of planning and organizing their time, feeling of its constant lack; complicated self-control and their decision making; closeness in selfexpression; thought and behavior activity rigidity are typical for them. Their emotional state is characterized by tension of personal experiences, conflicts and crises for recent time that is accompanied by feelings of guilt, shame and anger. Indices of physical state testify to bad sleep, decreased physical activity. Professional self-realization of respondents has been represented by variants: uncertainty of professional self-identification, character of self-realization has been represented by reproductive type, associated with deficient values; presence of strives to professional self-development in absence of idea of their realization. Stress tension as a “blockade” of self-realization is conditioned by unity of image of world and image of life of respondents.

Identification of interrelationship immune reactivity with social adaptation types of schizophrenic patients.

We examined 38 schizophrenic patients (F20.00, F20.01, F20.02). The scale SASS (Bosc M. et al., 1997) was used to estimate the social adaptation of schizophrenic patients. The immunological examination included the definition of phenotypes of surface receptors of immunocompetent cells, immunoglobulins, circulating immune complexes and phagocytosis levels. The research was carried out in two points: first - at admission, second - in 6 weeks of treatment.

Three adaptation types have been revealed: normal type of social adaptation (15 patients, 39,47%), difficult social adaptation (18 persons), disadaptation (5 patients). By week 6 of treatment number of patients with normal social adaptation has heightened by 1,4 times (21 patients, 55,26%), improvement of indices of social adaptation was observed in 10 patients, type of social adaptation did not change in 28 patients. At admission T-immunodeficiency (CD2+, CD3+, CD16+-lymphocytes decrease), increase CD8+, HLADR+, CD20+- lymphocytes, IgM and phagocytosis decrease were diagnosed among schizophrenic patients. During therapy, features of psychoneuroimmunomodulation were as follows: the normal type of social adaptation is relatively favorable in the immunological context. Patients with low level of social adaptation were characterized by clinical-immunological resistance toward therapy with deepening of T-cellular immune deficiency. Improvement of indices of social adaptation was accompanied by positive dynamic of immunological parameters.

Thus, social differences between groups have been confirmed by data according to immune reactivity.

Different proposals of the staging model in bipolar disorder (BD) have been launched suggesting a progression from prodromal to more severe and refractory presentations. Biochemical variations in BD are receiving attention as they may help to understand the neurobiological correlates of the disorder and its neuroprogression.

Study pro-inflammatory factors, such as interleukins along the progression of the disorder.

To investigate a) the role of interleukin-6 (IL-6) in the model of staging and b) to detect clinical predictors of variations in IL-6 levels.

This is a case-control study matched for age and gender. Patients required the diagnosis confirmation by SCID, being in euthymia (HDRS, YMRS scores ≤ 7 in last month), and were classified in Kapczinski et al. clinical stages. At the end, 109 patients and 25 controls were eligible for the study. Serum IL-6 levels were determined by ELISA.

Seventy-six (69.7%) patients were female and the mean age was 44.2 (SD= 12.9) years. A significant increase in IL- 6 was found in patients compared to controls (t=2.33, p=0.02) and among the four groups of patients (F=2.85, p=0.04). Results from linear regression analysis revealed that number of episodes per year, age at first episode, and age were significantly associated with IL-6 (β=0.025, CI: 0.005-0.044, p=0.012; β=-0.016, CI:(-0.031)-(-0.001),p=0.033; β=0.042, CI:0.027-0.058, p=0.0001, respectively).

Interleukin-6 may be a useful biomarker in the model of staging in bipolar disorder and could be related to the number of episode per year and early onset of the disorder.

Discontinuation of anti-psychotic drugs in schizophrenia patients is a major concern, since it results in relapse and re-hospitalizations. Non-adherence is strongly associated with negative subjective response to antipsychotics which is composed of the subjective experience of negative drug effects and attitude towards the treatment.

To assess subjective experience towards specific drug-related adverse effects which leads to a generally negative subjective attitude towards antipsychotics.

Attitude and experience were measured in schizophrenia inpatients (n=84) on eight subscales: weight gain, sedation, sexual anhedonia, extra-pyramidal syndrome, affective flattening, excessive sleep, diminished sociability and metabolic syndrome. DAI-30 was used to measure attitude towards drugs, and PANSS to assess psychopathology.

Weak correlation was found between subjective experience and attitude on most of the sub-scales. The only strong, albeit inverse, correlation between experience and attitude that was found was with regard to affective flattening, experienced by 37% of the sample, and it also predicted negative drug attitude as measured by the DAI-30, RR: 1.87 (95% CI: 1.06-3.3, df=1, x2=4.525, p< 0.05).

Drug-related affective flattening should be evaluated routinely, since experiencing it may predict negative attitude towards drugs, potentially leading to poor compliance and relapse.

Mild Cognitive Impairment (MCI) is a transitional stage from normal aging to dementia. The objective of this study was to determine whether a source retrieval ERP is an effective neural marker for differentiating MCI from normal older adults while their behavioral performances were matched which may have implications for identifying seniors at risk for cognitive decline.

A source memory task was conducted on 16 aMCI and15 healthy older adults. Event-Related Potentials (ERPs) were recorded during retrieval phase. Memory performances were matched between the two groups by manipulating the number of items presented for each study session.

The behavioral results showed that both source memory and item memory performances were perfectly matched between aMCI group under easy condition and healthy elderly group under hard condition. While under such case, the ERP results showed remarkable differences between the two groups. First, the right-lateralized positive-going old-new effects significantly decreased for aMCI group compared to control group, especially on the parietal sites. Second, the negative leftlateralized old new effect extended to the posterior sites of right hemisphere only in aMCI group but not in control group.

The results showed that source retrieval ERP is an effective neural marker for differentiating MCI from normal older adults even when they have matched task performances. The results also suggested that MCI brain may involve more regions to compensate their reduced efficiency of dedicated circuits so that they could behave like normal older adults.

Atrial natriuretic peptide (ANP) is well known as a regulator of fluid and electrolyte homeostasis. However, studies suggest that ANP also plays an important role in the neurobiology of anxiety. Recent evidence suggests that ANP may be involved in the pathophysiology of addictive behavior. The present study aims to elucidate the effects of ANP on alcoholdependent patients’ anxiety, perceived stress and craving during alcohol withdrawal.

A sample of 59 alcohol-dependent inpatients was included in the analysis. A blood sample was taken at day 14 of detoxification in order to assess the concentration of ANP in plasma. In parallel, we assessed patients’ alcohol craving, using the Obsessive Compulsive Drinking Scale (OCDS), as well as their symptoms of anxiety (State-Trait Anxiety Inventory; STAI). Patients’ stress levels were assessed using the Perceived Stress Scale (PSS).

We found a significant negative association between patients’ ANP plasma concentrations and their anxiety, craving for alcohol, and perceived stress. Regression analyses suggest that ANP is a significant predictor both for patients’ perceived stress and for the severity of their anxiety during early abstinence. Additionally, we were able to show the association of patients’ ANP plasma levels and craving to be mediated by their perceived stress.

Our results suggest that the association of patients’ ANP plasma levels and craving is mediated by their perceived stress. For this reason, intranasal application of ANP may prove to be a new avenue for the treatment of alcohol dependence in patients exhibiting high levels of perceived stress.

Depression in women is supported by specific psychoendocrine factors. Neuroprotection is reduced in conditions of exposure to psychostress by increase of endogenous cortisol due to excessive HPA activity associated with somatic risks. Decrease of neuroprotection after hypercortisolemia due to excessive HPA activity is associated with somatic obvious risks that may cause an increase in social malfunction of women with depression.

Retrospective-prospective study on a sample of 206 female patients, with positive history for depressive disorder, hospitalized in the Mental Health Center (MHC) of Craiova, monitored between January, 1st 2012 and June, 31st 2012. At these patients we evaluated depression evolution, somatic comorbidities, cognitive impairment and psychosocial stress.

Somatic comorbidities (obesity and cardiovascular disease, 41 patients - 19.9%, obesity and diabetes and metabolic syndrome, 36 patients - 17.5%, hysterectomy, 35 patients - 17.5%) occurred during maintenance therapy emphasizes evolutionary risk of depressive disorder in women and cognitive impairment, especially in peri- and postmenopausal period (68.6%). Appeared in a large number of cases of the syndrome MCI (Mild Cognitive Impairment) (29 patients - 14.1%) and 4 cases of Alzheimer's disease also increase the predictive value of perimenopausal depression and psychostress conditions (13.1%).

Vulnerability to depression is correlated with peri- and postmenopausal ovarian steroid imbalance favoring the disruption of brain neurotransmission. Excess of serotonin activating substance therapy may promote the emergence of hypodopaminergy with risk of increased somatic and cognitive deficiency. Hypodopaminergy conduced to an increased glutamatergic activity, with significant decreases in neuroprotection and neurodegenerative risk.

Alcohol hangover is the most commonly experienced next day consequence of heavy drinking. The symptoms experienced during this post-intoxication state develop when blood alcohol concentration (BAC) returns to zero. The feeling of general misery can persist up to 24 h and can significantly affect planned activities and cognitive functioning.

To examine the effects of alcohol hangover on driving performance.

In N=47 healthy volunteers, driving performance was tested the morning following heavy drinking (alcohol hangover) and on a control day (no alcohol). Subjects performed a standardized 100-km highway driving test in the STISIM driving simulator. Primary outcome measure was the Standard Deviation of Lateral Position (SDLP), i.e. the weaving of the car. In addition, self-reported driving quality and driving style measures were scored.

Driving performance was significantly worse during alcohol hangover (ΔSDLP = +1.85 cm; p=0.005). Driving impairment during alcohol hangover was supported by subjective measures. During alcohol hangover, driving quality was rated as significantly worse (p=0.0001), less safe, less considerate, less predictable, and less responsible (p=0.001). Subject reported being significantly more tensed during hangover and more effort was needed to perform the driving test (p=0.001).

Driving is significantly impaired during alcohol hangover. The magnitude of driving impairment is higher than that observed after administering alcohol to achieve a BAC of 0.05% (ΔSDLP = +1.7 cm), i.e. the legal limit for driving in many countries.