Obsessive compulsive disorder (OCD) is characterized by the presence of obsessions and compulsions that cause emotional distress and affect different aspects of a patient's life which are clinically significant. Experts have developed an OCD model which involves hyperactivity in certain subcortical and cortical regions.

To study the differences in the cerebral activity between control and OCD group using Lempel-Ziv complexity (LZC) algorithm, specially focused in the presence of an interhemispheric asymmetry.

We analyzed the magnetoencephalographic recordings of 13 patients diagnosed of OCD (DSM and ICD) and 60 healthy controls, using the LZC algorithm. Statistical analysis, using SSPS 19.0, included Wilcoxon signed rank and correlation Tests.

LZC values were smaller in the OCD than in the control group. An asymmetry between both lateral regions was found in the OCD sample but not in the controls.

We studied the difference between the Pearson correlation coefficients (left and right values) between OCD and controls, which was statistically significant.

Although we know that in humans normal variation and specialization produce asymmetries of function and structure leading to an asymmetry between brain hemispheres, it seems to be more important in some mental disorders. The presence of an asymmetry between both lateral regions is a conclusion found in previous neurophysiological works and that must be integrated in the neuroanatomical model of the disorder.

Recent studies have suggested that the deficit of glutathione (GSH), a major antioxidant, seems to play a role in the pathophysiology of schizophrenia. Moreover, oxidative stress may contribute to the development of neurological abnormalities, including tardive dyskinesia and parkinsonism symptoms.

To determine plasma glutathione levels and to explore their association with neurological soft signs (NSS) in patients with chronic and first-episode schizophrenia.

A case-control study carried-out on three groups: sixty clinically stable patients with chronic schizophrenia, twentythree patients with first-episode schizophrenia and thirty matched healthy controls. Glutathione levels: total (GSHt), reduced (GSHr) and oxidized glutathione (GSSG) were determined by spectrophotometry. NSS were assessed in three groups by a standardized neurological examination (Krebs et al., 2000).

Plasmatic GSHt and GSHr levels were significantly decreased in patients with chronic and first-episode schizophrenia. All NSS scores were significantly higher in two groups of patients compared to controls. No association was found between NSS scores and glutathione levels in patients with chronic schizophrenia. However, in patients with firstepisode, a negative correlation was found between GSHt levels and involuntary movement sub-score (r= -0.62, p=0.008).

These results suggest that GSH deficit is not related to the stage of disease and may be an important indirect biomarker of oxidative stress in schizophrenia. The association between low GSHt level as a marker of oxidative stress and involuntary movements could suggest that oxidative stress may contribute to the brain damage which leads to an increased prevalence of these NSS.

Several studies have shown a glutathione (GSH) deficit in patients with schizophrenia. It may in part arise from a genetically compromised synthesis of GSH, the major cellular antioxidant and redox-regulator. First-degree relatives of patients with schizophrenia share many susceptibility genes of this disease.

The objectives of this study were to determine plasma glutathione levels in patients with schizophrenia and their unaffected first-degree relatives of compared to healthy controls and to examine the correlation between glutathione levels and schizotypy scores in unaffected relatives.

We included 60 patients with schizophrenia, 33 of their unaffected siblings and 30 healthy controls with no family psychiatric history. The blood glutathione levels: total (GSHt), reduced (GSHr), and oxidized glutathione (GSSG) were measured by spectrophotometry. Schizotypy scores were assessed by the schizotypal personality questionnaire (SPQ).

GSHt and GSHr were significantly lower in patients than in controls, whereas there was no difference in glutathione levels between unaffected relatives and healthy controls. Moreover, no correlation was found between glutathione levels and schizotypy scores in unaffected relatives of patients with schizophrenia.

These results reveal that unaffected relatives of patients with schizophrenia didn’t have a GSH deficit. in the same group, no correlation was found between glutathione levels and schizotypy scores which considered a vulnerability marker for schizophrenia. These findings disagree with our hypothesis that GSH deficit could be a biological marker of vulnerability to schizophrenia. However, further studies are necessary to explore this hypothesis.

Neurological soft signs (NSS) are minor or subtle neurological signs indicating non-specific cerebral dysfunction. They have been conceptualized as neurodevelopmental markers that mediate the biological propensity for the development of psychosis. Their interaction with the environmental factors such as cannabis use remains little studied.

To study the relationship between the NSS and the use of cannabis which is considered an environmental risk factor of psychotic disorder.

Sixty one in-patients (fifty three men and eight women; mean age: 28.9 ± 9.4 years) with a first-episode non affective psychosis according with DSM-IV were recruited. Neurological evaluations were carried-out by using the NSS scale of Krebs et al. (2000). We ascertained the use of cannabis with the cannabis subsection, included within the section of substance use, in the Composite International Diagnostic Interview (CIDI).

The prevalence of cannabis use was 16.4%. The mean NSS total score was 15.3 ± 6.7. Significant lower NSS total score was found in cannabis users: 11.2 ± 5.6 versus 16.0 ± 6.7 (p=0.04). There was also an inverse but not significant relation between the use of cannabis and the motor coordination and the involuntary movements sub-scores.

Similar results have been reported in patients with schizophrenia and first-episode psychosis suggesting the existence of fewer NSS in the cannabis user patients. The cannabis could enhance the effects of genetic risk factors for psychosis. More work in the area of genetic-environment interactions in predicting psychosis is necessary.

The DSM IV-R criteria for Developemental Coordination Disorder (DCD) involve a marked impairment in the development of motor coordination although visual-spatial, digital and visuo-motor perception, neuromuscular tone, qualitative and quantitative measures impairments related to of gross and fine motor coordination might be used to isolate three main subtypes of DCD/dyspraxia: Ideomotor, Visual-Spatial/Constructional, and a Mix group sharing common impairments with additional comorbidities. This study focus on isolating specific markers with high predictive discriminatory power from a wide range testing battery in a sample of DCD children.

Data were collected on 63 children with DCD aged 5-15 years (median 8.1), enrolled on DSM IV-R criteria. Children were free of previous assessment, medication, and therapy followup-up. Each subject underwent a neuropsychological, neuropsychomotor and neurovisual testing batteries comprised of 49 milestones assessment.

The most salient markers with respect to the three subtypes of dyspraxia studied in this sample are digital praxia, imitation of gestures, digital perception, visual-motor integration, manual dexterity, visual spatial structuration, coordination between upper and lower limbs, and lego blocks. Clustering results suggest Ideomotor patients define a homogeneous group of patients and Mix group with specific difficulties in coordinating lower and upper limbs or poor manual dexterity.

This study confirms the importance of some aspects of neurovisual processing of spatial information, and motor control in DCD. Less than 15 neurovisual, neuro-psychomotor and neuropsychological milestone tests might be required to provide a sensitive and specific diagnostic of DCD subtypes, and isolated markers allow a better understanding of DCD.

Attention-deficit hyperactivity disorder (ADHD) affects not only children but persists for up to 4.4% in the general population. Comorbidity is common among adults with ADHD, including substance abuse.

Assessment of impact of both childhood and adult ADHD on SUD.

The aim of this study was to estimate prevalence rate of past history of childhood ADHD and current adult ADHD among substance use inpatients and to compare between the two groups regarding onset and severity of substance use disorder.

This cross-sectional comparative study was conducted in addiction treatment center at El Maamoura psychiatric hospital. One hundred and two adult males were assessed using Arabic version of Wender Utah Rating Scale (WURS) for retrospective assessment of symptoms of childhood ADHD. Arabic version of Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. DSM IV TR criteria were used for final diagnosis.

Sixty Four patients of the total studied sample had past history of childhood ADHD. of which, only 36 patients fulfilled the DSM - IV TR criteria for adult ADHD. Presence of adult ADHD was associated with an earlier mean age of onset of SUD (13.22 vs. 14.86 years), larger number of hospital admissions, (4.21 vs. 6.83 times) and a shorter mean period of abstinence (124.53 vs. 271.50 days).

In comparison to childhood ADHD, presence of adult ADHD was associated with a more complicated course of substance use disorders and poorer outcome.

Gender differences in psychopathological symptoms have frequently been found in chronic schizophrenia and first-episode psychosis (FEP) patients. However, many of the existing studies suffer from methodological problems. Furthermore, very few studies have investigated gender differences in at-risk mental state (ARMS) individuals.

To investigate whether male and female ARMS and FEP patients differ in self- and observer-rated psychopathological symptoms when adjusted for potential confounders.

Psychopathological symptoms were assessed in 117 ARMS and 87 FEP patients by two observer-rated scales:the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS), and one self-report scale,the Frankfurt Complaint Questionnaire (FCQ). Gender differences were investigated by applying Analyses of Variance using the BPRS, SANS and FCQ subscales as dependent variables and, group and sex as between-subject factors. Furthermore, Analyses of Covariance were conducted by including age, antipsychotic, antidepressant and cannabis use as covariates.

No significant gender × patient group interactions were found, suggesting that gender effects did not differ between patient groups. Women showed higher scores in positive psychotic symptoms (BPRS Psychosis/Thought Disturbance) while men had higher scores in negative symptoms (BPRS negative symptoms, SANS total score, and subscales Affective Flattening, Avolition-Apathy and Asociality-Anhedonia). However, the differences did not withstand correction for multiple testing. Furthermore, these results did not change when corrected for potential confounders.

Our findings suggest that male and female ARMS and FEP patients do neither differ in self-report nor in observer-rated psychopathological symptoms when corrected for multiple testing and potential confounders.

Obsessive-compulsive (OC) symptoms may begin at any point of the life span. Comorbid psychiatric disorders in OCD is more a rule than an exception and can contribute to the OCD-related burden.

The goal of this study is to understand the trajectory of comorbid disorders in OCD according to the first manifested psychiatric disorder and their impact in the clinical manifestation of OCD and.

1001 consecutive OCD outpatients from the Brazilian Obsessive-Compulsive Disorder Consortium were evaluated. Inclusion criterion: OCD as the main psychiatric diagnosis (DSM-IV). Exclusion criteria: comorbid schizophrenia and mental retardation. The instruments applied were: SCID-I; Y-BOCS; DY-BOCS, YGTSS (significant level =5%). To investigate the age at comorbidities onset Bayesian approach was performed. Those distributions contain all the information obtained by the data for the mean age at onset.

OCD patients that presented separation anxiety disorder (N=175, age of onset SAD 5.35) as first diagnosis had higher frequency of social phobia, simples phobia, generalized anxiety disorder and panic disorder (78.3%; p=0.05), somatoform disorders (13.1%; p=0.05) and post-traumatic stress disorder (30.3% p=0.003). OCD patients that presented ADHD (N=50, age of onset ADHD 6.42; age of onset OCD 13.08) as first diagnosis had higher frequency of substance abuse (16.0%; p=0.00001). OCD patients that presented tic disorders (N=44, age of onset tic disorder 6.86; age of onset OCD 16.18) as first diagnosis had higher frequency of OC spectrum disorders (50.0%; p=0.03).

First psychopathological manifestation in OCD patients is associated with distinct long-term trajectory of comorbid psychiatric disorders.

The French nosological concept of bouffée délirante (literally “delusional flush or rush”) may define a subgroup of non-affective, acute remitting psychoses with an especially favourable prognosis. To date, relatively little published literature is available about this entity.

To discuss the concept, nosological status, diagnostic features and associated clinical characteristics of bouffée délirante.

A case report of bouffée délirante is described. The concept and clinical features of the condition are reviewed.

A case report is presented in detail and a literature review of the theme is surveyed.

The authors report a case of a 48-year-old woman with no psychiatric background until November 2011 when she developed a sudden onset of persecutory delusions concerning her colleagues and boss. She believed computers and televisions were under their control and that her daughter and husband were in danger. This information was given by the voices she believed to hear. During one week, she developed behavior disturbance that motivated her urgent evaluation. As she was admitted to our department, she showed herself defensive and hostile. During the first day in our ward she described a delusion of Capgras, but the symptoms were rapidly overtook with low doses of antipsychotic.

Bouffée délirante is a historic French diagnostic term used in the past to describe a short-lived psychosis. The term was substituted differently in ICD-10 (described as acute and transient psychotic disorders) and DSM-IV-TR (brief psychotic disorder). The key diagnostic features are acute, floridly psychotic symptoms with complete remission.

Hospital A&E departments are the most frequent access to healthcare among migrants, often accounting for improper admissions. This also impacts massively on delivery of psychiatric care and prevention, making it hard to provide a health program, and not just solving an acute situation.

To analyze admissions to the A&E by migrants, focusing on previous medical/psychiatric history and health program after discharge.

Electronic databases were searched for all migrants accessing the A&E departments of the two general hospitals in Modena, Italy, during 2010.

Of the patients evaluated in the A&E, 10.24% were migrants. For 5% of these, the reason for admission was psychiatric, for 36% non-psychiatric (mostly traumatic); for the remaining 56%, admission was due to mild somatic symptoms, possibly medically unexplained symptoms suggestive of somatization (i.e. 16.59% gastro-intestinal symptoms, 10.92% joint pains).

Only 32% of the migrants accessing because of explicit psychiatric reasons (attempted suicide, alcohol abuse, aggressiveness) were investigated by a psychiatrist. After the psychiatric consultation, 35% of patients were referred to community mental health centers, 20% to psychiatric wards, 22% to primary care, 6% to services for substance abuse.

Migrants in the A&E are referred to psychiatry only for severe psychopathology and disturbances, very rarely for symptoms suggestive of somatization, which are particularly difficult to recognize in the A&E: this may result in delay in diagnosis and chronicization.

In many cultures, weather and season have been thought to influence our physical and mental health. However studies of the effect of meteorological factors on suicidal behavior have yielded inconclusive and often contradictory results. Furthermore, little attention has been paid to weather is associated with suicide in Asian countries as shown in Western countries, even though suicide rates in Korea have increased steadily.

To study the effect of weather condition on suicidal behavior in Daejon, Korea. in this study, suicidal attempters who had visited the Eulji Medical Center were included.

The aim of this study is to further explore the differential effect of certain climatic factors on suicidal attempt probabilities in Daejon, Korea between 2009 and 2011.

Three-year data of suicidal attempts within Daejon, Korea were analysed in relation to meteorological data, which were measured at the Daejon Meteorological Administration. Data on suicidal attempt and weather were matched.

Our study indicates that temperature and duration of sunshine are significant associated with the suicidal attempts (p < 0.05). These correlation were independent of age and sex.

Within the interaction of biological and environmental influences in the development of suicidal ideation and behavior, some weather conditions may additionally contribute to the risk of suicidal attempt.

The practice of early interventions in psychiatry has became one of the most prevalent paradigms in modern psychiatry. in the routine care the dissemination remains frustratingly slow. However, little is known about the characteristics of training curricula.

To describe:

1. 1) characteristics of training on prevention and early intervention in psychiatry;

2. 2) organizational and clinical differences of early intervention services in the different countries;

3. 3) trainees’ satisfaction and management of patients with mental disorders.

Sixty early career psychiatrists have been invited to participate in the survey, recruited from the early career psychiatrists’ network of the World Psychiatric Association (WPA). Respondents were asked to provide the collective input of their trainees’ associations, and not the individual feedback of any officer of the association.

36 out of 60 invited countries compiled the questionnaire. University training programs in early intervention for mental disorders are provided in 21 out of 36 countries (58%). Half of early career psychiatrists feel completely or enough confident to provide specialistic interventions to patients during early stages or at the onset of the disorder. Fifty-three percent of respondents are not satisfied with training on preventive psychiatry. Early intervention services most frequently available are those for schizophrenia (76%). Informative campaigns on mental disorders are usually conducted in 33 countries (87%).

A huge variability exists as regards early intervention training and practice. Further efforts are needed in order to establish training programs according to the educational needs of trainees and early career psychiatrists.

The sample consisted of 123 war veterans who completed Suicide Behaviors Questionnaire (SBQ-R), Reasons for Living Inventory (RFL-48), General Health Questionnaire - subscale for suicidal behavior (GHQ), Hopkins Symptom Checklist Depression Scale (HSCL-25) and Harvard Trauma Questionnaire (HTQ).

Results indicated that suicidality is correlated with higher PTSD and depression scores, and negatively correlated with reported reasons for living. We discuss our results in terms of their use and applicability in everyday work with patients who are in suicidal risk.

The recent global crisis as well as the increasing crimes’ rates have been claimed to be a factor of mental distress and disturbance.

To describe the levels of insecurity and the fear of crime in a sample of patients with mental disorders with a sample of mental health professionals.

The study has been carried out in 24 Italian mental health centres. in each centre 20 patients and 20 mental health professionals have been recruited. Clinical status and social functioning have been evaluated with the Global Assessment of Functioning (GAF), the Hamilton Anxiety scale (HAM-A) and the Hamilton Depression scale (HAM-D). Fear of crime and insecurity have been assessed by Perceived Insecurity Questionnaire (PIQ).

The final sample consists of 426 patients. They are mostly female (70%), employed and married, with a diagnosis of mood disorder (52%). High levels of worries/insecurity at the PIQ are reported by 42% of patients. Perceived insecurity is associated with higher levels of HAM-A and HAM-D. Nearly all respondents report to have worries or fears about the future (93%), in particular as regards bereavement or loss (41%), economic difficulties (28%), mental or physical illness (26%). in multiple regression model, worries about the economic situation are more frequent in person who are male, young, married and with more than two children.

The results suggest an association between perceived insecurity with anxiety and depression. Further studies are needed to better understand this association and to develop educational programs on stress and mental disorders.

There are several studies evaluating the functioning in patients with schizophrenia. Nowadays, there are new tools and therapeutic alternatives to be considered.

Our hypothesis is administration of Depot antipsychotic improve patient adherence to treatment which reflect better social and personal performance, higher satisfaction with medication and less severity of the mental illness.

Sample of 68 patients with schizophrenia: 32 with Depot and 36 with oral antipsychotic.Scales: PSP assesses global function in terms of four functional domains: work/study, personal/social relationship, self care and disturbing/aggressive behavior. Other scales applied: CGI and MSQ.

PSP: Self care (t (67)=6.092,Pa=0.01),Personal Relationships (t(67)=3.368,Pa=0.05), Social Relationship(t(67)=5.0167,Pa=0.01) and disturbing behavior(t(67)=1.263,Pa>0.05).

Better response to the four areas studied in patients treated with Depot vs. patients treated with oral medication.The Global score of PSP in oral medication group was 68 which means barriers indentified by anyone but do not interfere with the role of the subject. and in the group of Depot the global score was 78 that mean mild difficulties indentified by relatives or close people to patient.

Very few cases have been reported in connection with excessive consumption of tianeptine. Tianeptine use can be a risk in terms of high doses especially for addicted patients.

A 28 year-old man administered after 5-years of medical prescription of the recommended dosage of 12.5 mg 2 times daily of oral tianeptine for an anxiety disorder. The patient spontaneously increased the dosage which after two months reached 120 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect for five-years but after his family realized that he was using 2 boxes of drug every day he was hospitalized for treatment.

Tianeptine is an antidepressant agent like the selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. The anxiolytic efficacy of tianeptine is similar to that of tricyclic and tetracyclic antidepressants. But in contrast to SSRIs and tricyclic agents, systemic administration of tianeptine modestly enhanced the mesolimbic release of dopamine (DA). It is told that abuse or dependence of tianeptine is an important issue in patients who have histories of alcohol or substance abuse. However, as in our case, the use of tianeptine in patients without a history of substance abuse might be also a risk for addiction.

Gynecomastia is a medical condition that affects men. Physical symptom is an abnormal enlargement of the mammary glands. Men who have this condition often end up feeling too embarrassed to be seen and it can greatly interfere with their personal life and social skills. This study attempts to evaluate the hypothesis that surgical approaches to correct simply the view are not enough to improve the quality of patients’ lives.

30 patients who were admitted to general surgery outpatient clinic with complaints of large breast and diagnosed with gynecomastia were enrolled in this study. Social Skills Rating Scale (SSRS), Body Image Scale (BIS), Coopersmith Self-Esteem Inventory (SEI) were applied preoperatively to patients with grade 1 and 2 gynecomastia. Scales were repeated postoperatively on the third month.

Preoperative and postoperative scores of BIS were significantly different. in a similar vein, preoperative and postoperative scores of Coopersmith SEI were significantly different, too. Coopersmith SEI and BIS scores were low in the preoperative period and higher in the postoperative period. However, in terms of SSRS there was not a statistically significant difference between preoperative and postoperative period.

Results indicate that presence of gynecomastia even at the level of grade-1 and 2 is effective on self-esteem, body image and social skills. The results also show that for the treatment of individuals diagnosed with gynecomastia surgical interventions alone can be inadequate. in these patients, after the surgical treatments, the addition of individual training programs to improve social skills may be useful.

The term boxer's fracture refers fifth metacarpal neck fracture. These people have problem with anger management and may be incapable of problem solving. in this study, it was aimed to determine their coping behavior and psychological symptoms and their relations with coping behaviors in patients with boxer's fracture.

36 male patients with diagnosis of fifth metacarpal neck fracture and 36 healthy male control subjects were included in study. Groups were evaluated with “Coping Orientation for Problem Experiences” (COPE) scale and Symptom Check List- 90 (SCL-90).

“Emotion-focused” coping strategies like “denial”, “substance abuse”, “use of emotional social support” and “avoidance” were seen to be used more often by patient group. in SCL-90 symptom check-list “obsessive-compulsive symptoms,” “interpersonal sensitivity”, “anxiety”, “anger-hostility” sub-groups were significantly different in patient group than control group.

Coping strategies are divided in two categories as problem-focused and emotion-focused. The first targets main source of the problem. and latter targets the emotional impact caused by the main source. This may be only realistic option when the source of stress is outside the person's control. Sense of control directly reduces psychological disturbance. Feeling like you have control over smaller aspects of life could lead to a greater sense of overall control. in these patients, it can be predicted that to punch the wall can increase “sense of control”. It is evaluated that the higher scores of “obsessivecompulsive symptoms” subscale of SCL-90 symptom check-list in patient group when compared with control group is consistent with this result.

Research on suicide method substitution between last attempted and completed suicide is scarce (five studies).

The results are conflicting (three studies report persistence and two studies report switch).

To investigate this topic studying a sample of suicide victims from Greece.

We studied all recorded cases of completed suicide of the period November 2007-October 2009 in Athens Department of Forensic Medicine. We performed phone interviews with relatives of the deceased focusing, among other topics, on the characteristics of prior attempts.

335 individuals were recorded as suicide victims: 250 men (74.7%) & 85 women (35.3%). Interviews were conducted with the relatives of 246 victims: 24% had history of prior attempts (59 cases), 39 men (66.1%) & 20 women (33.9%). Most frequent last attempted suicide methods were: self-poisoning (57.6%), jumping from a height (20.3%), wrist-cutting (15.3%) & hanging (6.8%). 74.6% of the attempters became completers using a different method (p=0.016). Individuals with previous attempt by self-poisoning or wrist-cutting died by hanging or jumping while attempters by hanging or jumping became completers primarily by the same methods.

Most of the suicide completers had never been attempters in the past. Those who had attempted with low lethality methods- committed suicide choosing a different, more lethal method. Restrictions in the availability of lethal means may result in more surviving attempters while some suicides could also be prevented because a particularly lethal method is not in hand.