Previous research has linked OCPD with increased distress levels that may lead to differences in treatment response.

The present study aimed to investigate the influence of pre-treatment distress on patient's response to groupbased cognitive-behavioral therapy (CBT) for OCPD.

116 out-patients who met DSM-IV-TR diagnostic criteria for OCPD completed a pre-treatment assessment including BDI, STAI, STAXI-2, GRAI and Rosemberg Self-Esteem Scale. Pre-treatment distress was operationalized as depression and anxiety levels.

Intervention was comprised of ten group sessions including psychoeducation, specific CBT techniques and relapse prevention. in order to assess treatment response after intervention, the sample was divided in two groups:

1. 1) discharged patients -responders and

2. 2) patients who needed to continue treatment -non responders.

Assessment scores were compared using t test in order to analyze differences between groups. The extent to which potential predictor variables were related to treatment response was assessed using logistic regression.

Results showed statistically significant differences (p < 0.05) in depressed mood and state anxiety scores between responder and non-responder groups. Initial variable selection for logistic regression model included age, sex, depression, anxiety, anger, assertiveness and selfesteem scores. The final model included state anxiety as a significant predictor of treatment response.

Our findings indicate that responder patients had lower pre-treatment distress levels than non-responder patients and that state anxiety score is a significant predictor of group-based CBT response in OCPD. According to this, pretreatment distress levels might be considered for treatment planning, despite more research in this direction would be necessary.

Acupuncture, as complementary medicine, has been used since many years ago in china and many researches have proved its effect separately or combined with other treatment methods.

To compare therapeutic effects of Acupuncture plus estazolam and Cognitive - Behavioral Therapies plus estazolam on insomnia.

To determine the efficacy of acupuncture as complementary medicine in treating insomnia.

64 insomnia patients were randomly divided into an acupuncture group and a behavioral group, 30 cases in acupuncture group and 18 cases in behavioral group completed research. The acupuncture group was treated by administration oral estazolam before sleeping each day and needling, three times a week, the behavioral group received Stimulus control as Cognitive - Behavioral Therapy plus oral estazolam before sleeping each day. Treatment course was 3 weeks. The insomnia severity index (ISI) scores before and after treatment were observed in the both groups.

The total effective rate was 86.7% in the acupuncture group and 50% in the behavioral group with statistically significant difference (P < 0.05). The cured rate of 30% in the acupuncture group was significantly higher than 16.7% in the behavioral group (both P < 0.05).

The therapeutic effect of Acupuncture as a complementary medicine on insomnia is better than stimulus therapy as a Cognitive - Behavioral Therapy.

To evaluate severity of suicide intents and its connection to some clinical characteristics in men and women.

Clinical examination, The Pierce Suicide Intent Scale (SIS), Brief Psychiatric Rating Scale (BPRS), Beck Suicide Ideation Scale (SSI), Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), The Symptom Checklist 90 Revised (SCL 90 R), Global Quality of Life Self - Rating Scale.

Suicide attempters over 15 years admitted to the psychiatric hospital within one month after parasuicide (N = 264; 114 men, 149 women).

Based on SIS rating of intent to die patients were divided into three groups (low, intermediate, high intent). The scores of hopelessness (BHS), depression (BDI), SCL-90-R in general, suicide ideations (SSI) and intensity of psychosis (BPRS) increased with the severity of intent to die in the whole sample not taking into account gender.

In women separately general SCL-90-R score, suicide ideations (SSI) and intensity of psychosis (BPRS) correlated positively with increase of intent to die score. Besides, only in women elder age was associated with stronger intent to die.

Exceptionally in the sample of men the lower quality of life was associated with the higher scores on SIS scale. Other characteristics (general SCL-90-R score, suicide ideations and intensity of psychosis) were significantly higher in men with the stronger intent to die.

Our findings confirm that socioeconomic status is connected to men's pattern of suicidality. Psychiatric disorders together with the strong suicide ideation bring people to more dangerous suicide attempts.

Advance statements are expressions of wishes made by an individual anticipating future mental incapacity to express treatment choices, spiritual or cultural needs and to nominate someone to be consulted in the event of future incapacity.Advance statements about medical treatment are usually positively-framed treatment choices or requests. An advance statement could also inform the process of determining a person's best interests under the Mental Capacity Act 2005 procedure. Advance Directives project was initiated at Langdon Hospital(Regional Secure Unit with medium and low secure as well as open Forensic wards) in early 2011 and rolled out across site by late 2011.

To audit the opportunity for patients at Langdon Hospital to have Advance Statements in place and its recording on Rio electronic system.To find out areas within the procedure that need improvement and changes.

Data was collected from Rio electronic records of all patients of all wards at Langdon Hospital during a 3 week period.

Most wards had offered above 80% of patients a chance to make Advance Statements. 2 wards achieved 100%. The uptake by patients who were offered an opportunity was high at 70%. Most patients prefer to have a named advocate.In some cases patients specifically asked for a relative not to be involved.Improvement needed in using recommended format and uploading it to Rio. Some staff were concentrating mainly on physical health/end of life decisions. Improvement needed in including questions related to management of future aggression and violence.

Recent genetic findings suggest shared genetic risk between autism, epilepsy and schizophrenia. A sodium channel subunit gene, SCN2A, exhibits de novo stop-codon mutations in individuals with autism and a stop-codon mutation in an individual with a seizure disorder. Our recent exome-sequencing study of schizophrenia cases identified a de novo splicesite mutation at SCN2A and further mutations may exist.

To examine a role for rare, protein damaging mutations at SCN2A in the aetiology of schizophrenia.

We aim to show an excess of coding sequence mutations in schizophrenia cases when compared to controls.

Mutation screening of the coding sequence of SCN2A in 993 Caucasian individuals with DSM-IV schizophrenia. We employed High-Resolution Melt Analysis(LightScanner™), followed by dye- terminator sequencing to confirm allele carriers. We compared our results to an exome-sequencing dataset of 4300 Caucasian individuals (NHLBI Exome Sequencing Project).

34 variants were identified; 15 intronic, 13 synonymous and 7 non-synonymous. One of the non-synonymous variants introduces a stop codon at amino acid 169 (169 E>X). No stop-codon variants were identified in the control dataset. Burden analysis did not show an excess of protein damaging changes in the UK dataset when compared to controls.

A total of 4 stop-codon mutations have been identified at SCN2A; all in individuals with a neuropsychiatric disorder. Our data do not suggest a general role for protein coding mutations at SCN2A in the pathogenesis of schizophrenia; however there may be a role for very damaging alleles at SCN2A in several neuropsychiatric disorders.

Although patients with inflammatory bowel disease (IBD) are commonly described as psychorigid and scrupulous, studies about obsessive-compulsive disorder (OCD) in patients with IBD remain few.

To examine the links between OCD and IBD, in general, and Crohn's disease, in particular.

A case report and review.

A twenty-one-year-old man was referred to the psychiatric outpatient clinic for obsessive ideas mainly about dirt associated with compulsive washing as well as compulsive masturbation.

Since childhood, the patient was diagnosed with Crohn's disease that led to failure to thrive. His medication included azathioprine and sulfapyridine. He developed perianal complications as well as bronchiectasis.

Obsessive-compulsive symptoms gradually dissipated on fluoxetine 30 mg qd along with supportive psychotherapy.

This paper discusses the possible links between Crohn's disease and OCD. Obsessive-compulsive symptoms in patients with Crohn's disease might be due to immune-complex formation, but might also be explained from a psychodynamic point of view: association between fixation at the anal stage in OCD and lesions affecting the bowel and the perianal region in Crohn's disease.

The prescription of psychotropic drugs in the elderly is more common. Doses are increasingly high, with frequent recourse to a combination therapy.

Our purpose was to describe treatment strategies in elderly patients consulting in psychiatry, in order to confront them with the latest recommendations.

Our study was retrospective and descriptive. It involved all elderly patients aged more than 60 years, who had consulted for the first time in psychiatry since January 2010 until December 2011. We collected, for each patient, the sociodemographic data, the diagnosis(es), the treatment(s), the side effects and the illness evolution under treatment.

We collected 159 cases of elderly patients, representing 6.07% of all the consultants in psychiatry during the period of the study. Their average age was 73 with a sex-ratio (M/F) of 1.13.

Dementia and mood disorders were the most common diagnoses (respectively 40.2% and 34.6%).

As far as drug therapies are concerned, an antidepressant was prescribed to 95 patients (59.7%); an antipsychotic was prescribed to 55.3%. A tranquillizer was prescribed to 40.8%. A combination therapy made of at least two different families of psychotropic drugs was prescribed to 55.9% of the patients. None of the patients benefited from psychotherapy.

Our study showed that the treatment strategy of the elderly consulting in psychiatry in the area of the study was not in accordance with the latest recommendations.

Most eldery patients with dementia are cared for at their home by family members, usually elderly spouses.

Important mission at associations for help at dementia is to facilitate public access to the most credible and up-to-date information on home caring of patients with dementia.

To determine how much Slovenian community health workers and other adults know about home caring of patients with dementia.

Hundered and twenty adult Slovenian e-mail users participated in a survey using a questionnaire consisting of 12 questions regarding dementia during May and August 2009. Questionaires were filled-out by 60 community health workers (mean age = 40.00, SD = 11.77, range 22–67), and 60 other adults (mean age = 44.27, SD = 16.20, range 23–83; t = 1.651; p > 0.05).

Community health workers were more knowledgeable and the other adults were the least knowledgeable on the subject of home caring of patients with dementia (3.03 v. 2.18, p < 0.01). Differences in responses between community health workers in other adults are shown in order of significance:

1. (a) finding help and professional support (49.6% v. 35.6%);

2. (b) setting a positive mood of interaction (28.8% v. 33.9%); and

3. (c) responding with affection and reassurance (7.2% v. 11.6%).

Findings suggest that there appeared to be gaps in knowledge in dementia among the community health workers and general public. As care of eldery patients with dementia shifts into their home, education is needed to increase the public awareness of dementia.

A number of studies have investigated white matter abnormalities in patients with bipolar disorder (BD) using diffusion tensor imaging. However, tractography studies yielded heterogeneous results partly due to small sample sizes.

In this work we aimed to study white matter abnormalities using whole-brain tractography in a large multicenter sample of patients with BD I with and without psychotic features.

To compare mean generalized fractional anisotropy (GFA) along deep white matter tracts between patients with BD with a positive history of psychosis during illness phases, no such history and healthy controls.

We acquired diffusion-weighted MRI for 118 patients with BD I and 86 healthy controls using the same acquisition parameters and scanning hardware. We used Q-ball imaging tractography and an automatized segmentation technique to reconstruct 22 known deep white matter tracts and to obtain the mean GFA along each tract.

Patients with BD had lower GFA values than controls along the corpus callosum (body and splenium), the left cingulum and the left arcuate fasciculus, when controlling for age, gender and acquisition site. All results with an exception for the long fibers of the left cingulum were driven by patients with a positive history of psychotic symptoms.

We demonstrated a reduced integrity of interhemispheric, limbic and arcuate white matter tracts in patients with BD I. Further, interhemispheric pathways were more disrupted in patients with psychotic symptoms, underscoring the role of interhemispheric connectivity in the pathophysiology of BD with psychosis.

A challenging medicine dissertation: to design a psychiatric therapeutic community.

A medical student winning a grant addressed to architects and farm laborers aimed to convert a rural area through Social Innovation programmes, a group of young enthusiastic psychiatrists and a donor involved in psychiatric circumstances are the actors of the project for turning a rural building located in the small village of “Villa San Bartolomeo” (Reggio Emilia, Italy) into a psychiatric social-rehabilitation community.

The project started reviewing the literature concerning community-based psychiatry residential facilities. Later, a structured interview has been carried out with the village's inhabitants in order to investigate both their perception of stigma towards mental illness and the perceived needs of their city. The answers have then been used to organize the activities within the psychiatric community, ranging from recreational through sportive until occupational ones, such as farming vegetable gardens, breeding domestic animals, producing handiworks. These labors are intended both to satisfy the village demands and realize a greater integration of the community itself within the surrounding social network.

The therapeutic interventions that are going to be realized within the residential home will be aimed to promote patients’ personal growth and adapting capacity. These interventions are intended to allow the accomplishment of a greater housing independence of the hosts by restructuring their affective, relational and social backgrounds.

This is an ambitious project, started by chance, representing the desire and the hope for curing mental illness by establishing a contact with the natural environment.

Chronic social isolation in the elderly may be related with diverse psychiatric disorders: chronic depressive episode, paranoia-type personality, and late non-schizophrenic psychosis.

In order to separate psychotic depression and non-schizophrenic psychosis with depressive mood, there is a need for more clearly defined criteria.

We report the case of a 68 yrs. women living alone at home for more than twenty years, with a complete social isolation for two years. This behaviour was found associated with severe delusion: she unreasonably felt persecuted by her flat's owner and she dissimulated an extensive basocellular carcinoma on her face threatening her life. A history of a short depressive episode at the time of her divorce was only found, as she demonstrated at initial assessment many paranoia personality traits. A review of literature on this disorders’ association was therefore undertaken.

Evolution after admission revealed the lack of effectiveness of antipsychotic treatment on delusion, but some efficiency of antidepressant. Nevertheless, personality traits remained unaffected by care. Literature on the association between mood disorders and non-schizophrenic psychosis is rare, and we suggest some criteria that may account for psychotic depression and be useful to treatment choice.

In the absence of a history of chronic mood or psychotic disorder, it is hypothesised that paranoia symptoms may account more for a psychotic depression than for late paranoid schizophrenia. This may have consequences for therapeutic strategy.

Severe depression after mid-life has significant clinical, cognitive or functional consequences. These related dimensions may have a different evolution under treatment, and their assessment may be useful to evaluate treatment efficiency.

To measure differential treatment effect on clinical, cognitive and functional dimensions in elderly severe depression.

The relation between these three dimensions has been examined from the inclusion through six weeks of treatment

Three different treatment (antidepressant, ECT and rTMS) were proposed to ten patients aged more than 60. The clinical, cognitive and functional dimensions were compared at inclusion and J42, and their evolution was also measured. At the end, we tried to assess trends for difference between the three types of treatment. Three types of evaluation were performed: clinical (depression, anxiety and apathy), neuropsychological (memory, attentional and executive functioning) and functional (activities of daily life, autonomy).

This preliminary study put in evidence a common pre-treatment profile of depressive symptoms (mood disorder), cognitive (executive difficulties) and functional (loss of autonomy, physical problems) abilities. Clinical improvement was associated with similar cognitive and functional progression, whatever therapeutic method was proposed.

Repetitive evaluation of symptomatology, cognitive performance and everyday life functioning seems to have a major importance in post midlife depressive episodes. It might be useful to determine if non-pharmacological treatment may result in a different evolution of these dimensions.

Tam et al. (2011)[1] recently reported the invariance of the one-factor model of the Chinese version of the Somatosensory Amplification Scale (ChSAS). The objective of this paper is to further examine the item-level equivalence of the ChSAS in a sample of Chinese adolescents across grade levels.

The ChSAS was administered to 500 Chinese adolescents. Differential item functioning (DIF) analysis was performed to identify any uniform and non-uniform differences on the 10 ChSAS items among adolescents across different grade levels.

After a Bonferroni adjustment of p value (=0.0007, i.e., 0.05/70), results of DIF analyses showed that there is no uniform (all Fs ranging from 0.17–2.15, ps > 0.09) or non-uniform (all Fs ranging from 0.47–1.76, ps > 0.02) difference on the 10 ChSAS items.

The four different grade level groups used the scale comparably, without showing any difference on item properties. These findings further substantiate the use of ChSAS as a valid and reliable instrument among adolescents across grade levels.

There is a dearth of literature on the effect of alexithymia on somatizing depression. Yet, the symptom manifestation of depression among people with alexithymia has not been well-investigated. The objective of this study was to examine symptom presentation in adolescents having high (HDA) or low (LDA) degrees of alexithymia.

A total of 590 adolescents aged 11–18 years participated in this school-based study. of 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15), 136 participants were selected and identified as either having HDA (n = 100) or LDA (n = 36). Confirmatory factor analyses (CFAs) tested the fit of a correlated two-factor structure (somatic and affective symptoms of CES-D) to the data. HDA adolescents were compared to those with LDA on somatic and affective symptoms of depression, negative affect and somatization symptoms.

Results of CFAs confirmed the two-factor model in HDA (CFI = 0.863) and LDA (CFI = 0.874) adolescents. HDA adolescents reported more somatic symptoms of depression (t = −2.97, p = 0.004) and negative affect (t = −3.53, p = 0.001) compared with LDA adolescents. No significant difference was observed between HDA and LDA adolescents on affective symptoms of depression and somatization symptoms (p > 0.05).

Our findings underscore that (1) HDA adolescents reported affective symptoms of depression in a similar manner to LDA adolescents, and (2) though the tendency toward reporting somatic symptom of depression is evident, HDA adolescents did not report significantly more somatization symptoms. These findings refute the notion that patients with alexithymia articulate their emotional and psychological distress primarily through physical symptomatology.

Research consistently has evidenced the association among alexithymia, somatosensory amplification (SA) and functional somatic symptoms (FSS). Yet, the underlying mechanism of such relationship has not been explored among Chinese adolescents. This study aims to evaluate whether SA exerts a moderating or mediating effect on the alexithymia-FSS link.

Analyses were based on 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15) recruited from a school-based study. They completed the Somatosensory Amplification Scale (ChSAS), the Somatic symptom subscale of CES-D and the Toronto Alexithymia Scale-Short form (TAS-9-C). Three facets of alexithymia (difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT)) were force-entered in each univariate regression model. Facets of alexithymia that were found significant (p < 0.05) were subsequently included in regression models to test the mediating and moderating effects of SA on FSS.

Results of hierarchical regression analysis found that both DIF (standardized β = 0.37, p < 0.001) and DDF (standardized β = 0.12, p = 0.043) were significant predictors of somatic symptoms. A moderate mediating effect was observed for SA on the DIF-somatic symptoms (Sobel test z = 2.13, p = 0.03). The results also showed a significant moderating effect of DIF×SA on somatic symptoms (standardized β = 0.49, p < 0.001).

SA qualifies as a mediator and a moderator between alexithymia and FSS. It indicated that adolescents with alexithymia are likely to report more FSS due to the tendency to amplify their somatic sensation. These results suggest that alexithymia-specific psychotherapeutic methods should be further developed using emotional validation and processing techniques.

Over the last decades, acupuncture has been seen as an acceptable primary detoxification treatment for opiate dependence, and currently used to relieve the severity of opiate withdrawal symptoms among MMT patient.

To investigate the effectiveness of electroacupuncture treatment in reducing opiate withdrawal symptoms among MMT patient.

This was a pilot study with randomized, single-blinded, and parallel. Recruitment of 22 subjects, 11 in methadone treatment + acupuncture and 11 in methadone treatment without acupuncture. The severity of withdrawal reaction was assessed by Objective Opiate Withdrawal Scale (OOWS) and Subjective Opiate Withdrawal Scale (SOWS) at baseline, third, fifth, seventh, tenth and fourteenth day of treatment.

One way Analysis of Variance (ANOVA) comparing the mean scores of the OOWS between treatment and control group has shown at tenth day of treatment p value is 0.026 and at fourteenth day p value is 0.022. One way ANOVA comparing the mean scores of the SOWS between treatment and control groups has shown at tenth day of treatment, p value is 0.015 and at fourteenth day, p value is 0.009.

The study has shown the promising results, where electroacupuncture treatment had an effectiveness in relieving opiate withdrawal symptoms among MMT patient.

Deceit and lie detection has been attracting attention of forensic psychologists and psychiatrists for several decades. Different polygraph and imaging methods are being thoroughly examined, usually without really doubtless results. Paul Ekman proposed an interesting theory on micro emotions that may be a demonstration of uncontrolled part of human behaviour and thus may represent an interesting way to detect lie or deceit. Currently there are available on the market several systems for automatic micro emotions detection. These systems show acceptable level of reliability and thus may be used for research purposes.

The aim of the study was to analyse if computerized system for micro emotion analysis (Face Reader) can be used for distinguishing liars from non-liars. For that purposes classical experimental double blind setting was established. The group of university students (n = 40) was divided into a subgroup exposed to a video scene and a subgroup not exposed (n = 20). The goal of further analysis was to distinguish there two groups using Face Reader.

In our pilot study, we identified 100% truth tellers and 90% of lie tellers.

Upon the presented study we may suggest that software analysis of micro emotion represents an interesting way for detecting lie and deceit. Although the current state of knowledge does not allow using this method in forensic setting, the possibilities and limits of the method should be properly examined.

Zinc is an immunomodulatory trace element suggested to be beneficial in the augmentation of antidepressant therapy. Cross-sectional studies have also demonstrated an association between low dietary zinc intake and depression. However, to the best of our knowledge, no long-term prospective studies have examined the impact of dietary zinc intake on the risk of depression.

To examine whether low dietary zinc in initially depression-free men associated with an increased incidence of depression during a 20-year follow-up.

The population-based Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study comprised 2641 Finnish men aged 42–61 years. Zinc intake was assessed at baseline by a 4-d food record and was also re-assessed for a random subsample (n = 50) on 1-year follow-up (correlation between assessments 0.68, p < 0.001). Depression was defined as having received a hospital discharge diagnosis of unipolar depressive disorder. The discharge data were derived from the National Hospital Discharge Register in 2010. Individuals who at baseline had elevated depressive symptoms or a history of mental illness were excluded (n = 345).

Altogether, 2169 (94.5%) participants reached the Finnish zinc RDI for men (9 mg/day), and 58 (2.5%) received a depression diagnosis during the 20-year follow-up. in Cox regression analysis adjusted for age, smoking, alcohol use, energy expenditure, dietary supplement use and education years, the energy-adjusted zinc intake was not associated with depression (RR 1.01, 95% CI 0.95–1.09).

A low dietary zinc intake may not induce an increased depression risk in middle-aged men.