A depressive disorder (DD) is wide spread disease with severe burden and high suicide risk. Depressive disorders [DD] haven't got proper attention for a long time in the countries of Eastern Europe and the former USSR. Depression in Primary Care in Russian specific educational program does not exist yet.

To create educational Recognition of Depressive disorders Program (REDEP) to decrease suicides in Tomsk city and Tomsk Area (TA).

Educational Program WPA/PTD on DD (Russian version) was used as a basis of REDEP, comparative analysis of mortality ratio of suicides (MRS) during 2004-2013 among Russian Federation (RF), Siberian Federal Region(SFR) and TA. Also, we conducted analysis of suicide decrease in Tomsk city.

We conducted the comparative analysis of suicides in RF, SFR and TA; we also assessed the dynamics of suicides reduction in TA under the influence of Educational Program on DD. In 2004 MRS in RF, SFO and TA was 34,3; 47,6; 38,3 per 100000 accordingly. During 9 years there was the trend of suicides’ decreasing for all three population groups. The most prominent MRS decline was in TA (p<0, 03). MRS showed annual reduction in TA – 17, 5-23,7/100000 in 2012-2013. This model can be extrapolated to other regions of the country with high MRS. During 2008-2013 MRS is being hold below 10/100000.

The prevention of suicides is possibly provided with the persistent and continual education of doctors, clinical psychologists, social workers to recognize and manage depression and comorbid conditions with high risk of suicides.

Drop out of new patients on follow up visit are frequently seen in outpatient psychiatric clinic. It is very important to explore the reason for dropout as it affects economy, manpower, patient health and treatment process.

To assess and evaluate the reason for drop out in newly diagnosed psychiatric patient at urban psychiatric outpatient clinic of north India.

To explore and establish relation between the common factor for continuing the treatment or switching to some alternative options of treatment.

The newly enrolled psychiatric patients with established diagnosis has been included in study over a period of one month and followed up for next six months on their given appointment dates. The patients were followed up by telephone, e-mail or personal visit to their home by a psychiatric social worker with specific set of questionnaires to evaluate the reason for drop out.

180 newly diagnosed patients had been included in study in one month of inclusion period. 26 patients (14.4%) drop out the treatment after first visit. 14 patients (7.7%) dropped the treatment after second visit. Drop outs gradually decreased after every subsequent visit.

Maximum drop outs of patients were on first follow visit. There was gradual decrease in dropout rate after every subsequent visit. Trust, rapport, first dose effect, immediate response to patient query were most important factor to hold the patient in initial few visits. Later on, the old patients who had been already made 3-4 visits, dropped due to side effects, treatment response, economical factor, distance and timing of outpatient clinic.

Although accumulating evidence suggests that individuals with mental disorders have an increased risk of mortality from physical illnesses, the underlying mechanisms remain to be fully understood.

To examine the association between mental disorder status and self-reported treatment for major somatic diseases, including respiratory, cardiovascular (CVD), metabolic diseases, and cancer over a 12-year follow-up period.

To test whether people with mental disorders are less likely to be treated for somatic diseases.

In the large prospective French GAZEL cohort of 15 798 employees, mental disorder was defined as at least one sickness absence exceeding 7 days from 1989 – 2000 and self-reported treatment of somatic diseases was assessed from 2001 – 2011. Longitudinal logistic regression models based on generalized estimating equations were used to study the association.

In fully adjusted-models, a diagnosis of severe mental disorder was associated with an 18% and a 6% greater annual increase in the likelihood of receiving treatment for respiratory disease and CVD over time, respectively. Any mental disorder was associated with a 2% greater annual decrease in the likelihood of receiving treatment for CVD over time. Depressive disorder (3%), mental disorders due to substance abuse, and mixed mental disorders (2%) had similar patterns of decrease.

This longitudinal study suggests that the impact of mental disorders on treatment receipt for somatic disorders depends on the diagnostic categories. People with depressive disorder, mental disorders due to substance use, and mixed mental disorders may be at risk of not receiving treatment for CVD.

Recent studies have shown that cannabis use acts as a specific risk factor provoking the onset of psychosis in vulnerable individuals. Association of adolescent cannabis use and psychosis risk was studied after adjustment with prodromal symptoms.

To assess possible causality between cannabis use and the risk of psychosis.

To examine associations between cannabis use and the risk of psychosis in 10 years follow-up while taking into account the prodromal symptoms of psychosis in a prospective general population sample.

The sample (N=6258) composed of a prospective Northern Finland Birth Cohort 1986. Questionnaire on prodromal symptoms for psychosis (PROD-screen) and on drug use was conducted when the cohort members were 15-16 years old. The participants were asked if they had tried cannabis: never, once, 2-4 times, 5 times or more. Information on psychoses was gathered from registers until age 27 years.

In total 102 new psychoses emerged. The proportion of psychoses in the groups 'never”, 'once”, '2-4 times”, '5 times or more” were 1.5%, 2.8%, 3.6%, and 8.5%, respectively. The hazard ratio (HR) for risk of psychosis in subjects who had tried cannabis 5 times or more was 5.9 (95% CI 2.4-14.4) when compared to non-users. The association remained statistically significant when adjusted for prodromal symptoms and parental psychosis (HR 2.6, 1.0-6.6). When gender and smoking was taken into account association was no longer significant (HR 2.3, 0.9-6.0).

Adolescent cannabis use associates with increased risk of first-episode psychosis even after controlling for baseline prodromal symptoms.

Schizophrenia is a severe mental illness, requiring antipsychotic treatment. Relapses are associated with poor prognosis and treatment adherence is a major factor in relapse. Long-acting injectable antipsychotics increase adherence, can reduce relapse and improve long-term outcomes.

The aim of this study was to assess the effectiveness of paliperidone palmitate (PP) in terms of hospital admissions.

Patients were included in the study if they had been treated with PP for at least one year. The number of days during hospital admissions before and after initiation of PP was assessed in a mirror image design.

61 patients in the study had been treated for at least 1 year. The mean age of patients was 44 years old and 61% were male (n=37). The commonest diagnosis was schizophrenia (n=51).

In the year before initiation of PP, there were 64 admissions totalling 6089 days for all the patients, with an average of 99.8 days per patient in hospital. During the first year of treatment with PP, there were 22 admissions totalling 1412 days, with an average of 23 days per patient in hospital. 69% of patients had no admissions on PP.

In this naturalistic audit looking at admission data, treatment with PP resulted in a reduction in the number of hospital days by 76.8%. More than two-thirds of patients experienced no admissions during treatment with PP. This suggests that Paliperidone Palmitate can be effective in treating Schizophrenia as well as cost-effective treatment by reducing hospital admissions.

Cognitive impairment is a core feature of schizophrenia, associated with significant social and functional impairment. Schizophrenia has also been associated with inflammation and immune changes. Recently it has been showed that IL-6, a pro-inflammatory cytokine, was associated with cognitive impairment.

The aim of this study was to assess the associations between a pro-inflammatory cytokines (IL-6) and an anti-inflammatory cytokine (IL-4) with social cognition in a sample of stable patients with schizophrenia.

Social cognition was assessed using the Face Emotion Identification Task (FEIT) and the Hinting Task in 29 stable outpatients with schizophrenia. Blood was collected and cytokines (IL-4, IL-6) assays were realized (CBA method).

IL-6 levels showed a significant inverse correlation with FEIT global score (p = 0.019, rho = -0.475) and a trend of significant inverse correlation with the Hinting Task (p = 0.079, rho = -0.332). However, IL-4 levels showed no significant association with the FEIT or the Hinting task (rho = 0.079 and 0,121; respectively).

Elevated IL-6 levels seem to play a role in social cognitive impairment in stable patients with schizophrenia. These results should be interpreted with caution due to the limited number of participants in the study.

About a third of patients with schizophrenia have persistent auditory verbal hallucinations resulting in persistent distress, functional disability, and frequent loss of behavioral control.

To estimate the prevalence of persistent auditory hallucinations in a sample of schizophrenic patients, to specify their characteristics and to identify their clinical associated factors.

This was a cross-sectional, descriptive and analytical study carried-on 144 out-patients (101 men and 43 women, mean age 38.24 ± 10.58 years) followed for schizophrenia in the psychiatry department of the university hospital of Monastir. The assessment was consisted by the collect of epidemiological, clinical and therapeutic data and the use of the Hoffman's auditory hallucinations rating scale (AHRS), and the positive and negative symptoms scale (PANSS).

The prevalence of persistent auditory hallucinations (score of the AHRS ≥ 5) was 40.3%. The total mean score on the AHRS was 10.7 ± 7.8 for all patients and 19.4 ± 7.7 for patients with persistent auditory hallucinations. The items of the AHRS with higher sub scores were the number, the influence and the reality of the voices. The clinical associated factors with persistent auditory hallucinations after multivariate analysis were the family history of physical illness, the absence of tobacco consumption, the hallucinatory onset of disorders, the notion of prior hospitalization and continuous course.

Our results support the multidimensional nature of auditory hallucinations and confirm the existence of interindividual differences in these hallucinations. Persistent auditory hallucinations were associated with poor prognosis, requiring more effective therapeutic strategies.

25 suspected cases of suicide occurred in a 20 month period. A literature review revealed some differences in this sample that merited further study.

To summarise the demographics, risk factors and service contact history of a suicide cluster and identify specific risk profiles and to compare these findings with international data.

To produce a data set that informs suicide intervention and suicide prevention.

A case notes review of patients’ charts was carried out. Other variables were chosen because of their importance in the existing suicide literature. Recommendations from the UK National Confidential Inquiry (NCI) were also used to assess the data. Clinical perception of risk was also recorded.

In grouping risk factors together 3 profiles emerged. A chaotic pattern, a masking pattern and a recovered group whose response to relapse was increased suicidality.

This cluster have similarities and differences from the risk profile for patient suicides described in the existing literature. There was a large amount of substance misuse. Risk recognition for immediate risk of suicide was just as challenging in this group as in much larger studies. Questions regarding service provision and hypotheses about cluster occurrence are also discussed.

Cognitive deficit is a significant problem in schizophrenic patients. It cannot be attenuated by any antipsychotic drugs. It has been known that changes of neuronal density is correlated with learning and memory deficits. Bacopa monnieri (Brahmi), popularly known as a cognitive enhancer, might be a novel therapeutic agent for cognitive deficit in schizophrenia by changing cerebral neuronal density.

To determine the effects of Brahmi on attenuation at cognitive deficit and on the neuronal density in the prefrontal cortex, striatum and cornu ammonis subfield 1 (CA1) and 2/3 (CA2/3) of hippocampus in sub-chronic phencyclidine (PCP) rat model of schizophrenia.

Rats were assigned to three groups; Group-1: Control, Group-2: PCP administration and Group-3: PCP + Brahmi. Rats were tested for cognitive ability by using novel object recognition test. Neuronal density from a serial Nissl stain sections of the prefrontal cortex, striatum and CA1-3 of all rats were measured by using Image ProPlus software and manual counting.

Sub-chronic PCP administration resulted in cognitive deficits in novel object recognition task. This occurred alongside significantly increased neuronal density in CA1. The cognitive deficit was recovery to normal in PCP + Brahmi group and this occurred alongside significantly decreased neuronal density in CA1.

Brahmi can be a potential cognitive enhancer against Schizophrenia. It reduces density of neuron in CA1. The reduced neuron is possibly glutamatergic neuron, which results in neuronal toxicity and cognitive deficit. Therefore, Brahmi eliminates glutamatergic excitotoxicity in CA1 and cognitive function is then recovery.

The potential role of antipsychotic treatment in affecting suicide rates and in explaining the increased mortality due to somatic disorders is still debated. The aim of this study was to assess mortality in individuals who were prescribed typical and atypical neuroleptics in one voivodship in Poland.

We conducted a retrospective cohort study involving 84881 patients who had drug insurance benefits in Pomeranian voivodship and who began receiving a conventional or atypical antipsychotic medication between 2008 and 2012. Data on deaths in this population have been collected from National Death Registry. Age-standardized death rates were calculated in the adult population exposed population to any dose of atypical antipsychotic medication, in popualtion of users of atypical antipsychotics only, in population of users of conventional antipsychotic drugs only and in population of clozapine users.

In individuals who were prescribed conventional antipsychotic medication age-standardized death rate was significantly higher than in ever users of atypical medicatioons and people using only atypical drugs: 69.6 per 1000, 95% confidence interval (95% CI) 67.64–71.56 compared with 53.24 per 1000, 95% CI 50.8–55.69 and 48,38 per 1000, 95% CI 44.78–51.98. Mortality rate in clozapine users was also higher than in users oaf atypical medications (65,11 per 1000, 95% CI 50.8–55.69).

These results suggest that conventional antipsychotic medications are associated with increased risk of death compared to atypical drugs. Analysis based on administrative record linkage is the major limitation of this study. No adjustment has been made for confounding factors that may modify mortality risk.

The study focused on the level of expressed emotion of family members of schizophrenia patients prior to and during their long-term hospitalization and how that affected the course of treatment.

The retrospective study included 112 patients diagnosed with schizophrenia and their family members. The patients had been court-ordered to undergo psychiatric treatment for a crime they committed. The following scales were used to assess the level of expressed emotion: Five minute Speech Sample (FMSS), Level of Expressed Emotional Scale (LEE), Family Attitude Scale (FAS) and Perceived Criticism (PC). Socio-demographic parameters were also used in the research.

The results show that expressed emotion of family members was high before and during long-term hospitalization of 71.4% of patients who experienced clinical worsening. This is particularly true for parents (62.5%), and more frequently for mothers. Course of the illness was better in the group of patients whose family members had low expressed emotion.

Successful treatment and favourable outcome of schizophrenia depend on the quality of relationship between the patient and his family members. High level of expressed emotion is one of the risk factors for relapse in schizophrenia.

Impairments in facial emotion recognition observed among people with schizophrenia has received increasing attention over the past few decades, however the nature of this deficit is unclear. Researchers have attempted to identify mechanism explaining this deficit, focusing on such cognitive functions like abstract thinking, mental flexibility, attention, verbal and spatial memory, language abilities and executive functions. Communication skills are extremely important for good social interactions and its deficits are the core feature of schizophrenia. The purpose of the present study was to explore the relationship between emotion perception and complex language processing in patients with schizophrenia.

Subjects were 27 patient with diagnosis of paranoidal schizophrenia and 31 healthy people. Measures included The Right Hemisphere Language Battery in Polish adaptation (RHLB-PL), emotion discrimination test and control face recognition test.

Patients with schizophrenia performed worse than healthy subjects on RHLB-PL and the emotion perception task but not on the face recognition test. In healthy controls language abilities correlated with emotion perception and face recognition and, by contrast, in schizophrenic patients any correlation was observed.

The present study revealed that patients with schizophrenia have deficits in the ability to discriminate facial emotion expression and also selective communication skills impairments like humor or metaphor comprehension. Results did not indicate relation between emotion perception and language impairment in patients, suggesting specific nature of facial emotion recognition deficit in schizophrenia.

Substance use disorders are highly prevalent among people with schizophrenia. Dually diagnosed patients present with unfavorable course and poor long-term outcomes. Integrated, motivation-based treatment for both disorders in the same setting is considered the treatment of choice. However, integrated treatment programs are not readily available and effect sizes of the programs are modest.

To evaluate an integrated psychosocial treatment program for people with schizophrenia and substance use disorders in the setting of a community psychiatric hospital.

100 in-patients with schizophrenia and substance use disorders were randomized to Integrated Treatment (IT) or Treatment as usual (TAU). The IT group was initially treated in a specialized open ward; upon discharge they were offered treatment in a specialized out-patient program of the hospital. The TAU group was initially treated in another non-specialized open ward; upon discharge they were offered treatment in the non-specialized out-patient unit of the hospital. TAU included pharmacotherapy, medical treatment, supportive psychotherapy and further aids by nursing staff and social workers. IT included all elements of TAU plus manualized group therapy with motivational interviewing, psychoeducation and cognitive-behavioral approaches. Assessments were performed at baseline and after 3, 6 and 12 months.

The IT group had slightly less drop-outs in the follow-up period (non-significant). The IT group was more satisfied with treatment and they developed a higher motivation to reduce substance use. Both groups succeeded in reducing substance use during follow-up, whereas the IT group did slightly better (non-significant).

Hyperprolactinemia is a common adverse effect of typical and some atypical antipsychotics and can induce side effects associated with decreased quality of life and poor adherence to treatment.

Management options are limited and can lead to decompensation of the patient.

Aripiprazole is a recent antipsychotic with partial agonist activity over the dopamine D2 receptors which can be effective in reducing hyperprolactinemia in patients treated with antipsychotics.

Review the existing literature about the effect of adjunctive treatment with low doses of aripiprazole on antipsychotic-induced hyperprolactinemia.

Search for literature about the topic in PubMed and Goocle Scholar databases using “hyperprolactinemia” and “aripiprazole” as keywords.

We found 6 case reports with 8 patients treated with risperidone, paliperidone, zuclopenthixol and fluphenazine that, with 2,5-10mg of aripiprazole, showed a decrease in serum levels of prolactin. 4 open label studies, with a total of 69 patients, all treated with risperidone, also showed a decrease in prolactin levels for adjunctive treatment with 3-10mg of aripiprazole. Two double-blind and two single-blind RCT vs placebo was found, with a sample of 297 patients treated with risperidone or sulpiride and 5-10mg of aripiprazole, and showed decrease in serum levels of prolactin. In all studies treatment with aripiprazole was not significantly associated with an increase in adverse effects or worsening of clinical symptoms.

The antipsychotic-induced hyperprolactinemia could be partially or totally reversed after adding low doses of aripiprazole to current treatment. It seems to be an effective, safe and well tolerated option.

An epidemiological study in the field, in our territory, isinteresting from an operational perspective. The main objective of this presentation is to describe the socio-demographic characteristics of people who committed suicide in Romania.

Was performed a retrospective study based on data provided by the Romanian Institute of Statistics and “Mina Minovici” Institute. Suicide events occurring between 2009-2013 in Romania were analysed, focusing on age, sex, seasonality, marital condition, occupation status and religion.

Male / Female ratio = 5.52, mean age was 49.82 years, with a range between 8 and 97 years. Suicide is more common in men than in women under 60 years, but after this age the situation is reversed. Suicide was statistically significantly more frequently in rural areas, the retired and unemployed people. In terms of marital status, it is observed that suicide is more common among married people, followed a short distance from the unmarried. From the distribution of suicides according to marital status and sex are significant differences in favor of unmarried men and widows. A secondary level of education predominated, followed by professional and primary. Method suicidal prevalent in both men and women was strangulation.

The study provides a comprehensive analysis of socio-demographic who committed suicide in Romania in the last 5 years. Suicide is more common among rural men, unmarried, unemployed, professional training level.

The question of a continuum or a dichotomy between schizophrenia and bipolar disorders is not clearly elucidated.

The objective of the present study was to identify specific functional connectivity (FC) patterns in schizophrenia and bipolar disorders.

Therefore, the aim was to explore FC within the language production network in response to a verbal fluency task in patients with schizophrenia, patients with bipolar disorders and healthy participants. We hypothesized that prefronto-subcortical FC patterns within the language production network differ between the three groups.

Forty nine participants, comprising 15 patients with schizophrenia, 14 patients with bipolar disorders (DSM-IV) and 20 healthy controls were included in the study. FC was calculated using functional magnetic resonance imaging during a verbal fluency task between the activated pair-seed regions.

Firstly, patients with schizophrenia presented a significantly reduced FC compared to controls within two pair-seed regions (medio-frontal cluster – left subcortical cluster and left fronto-lateral cluster – left subcortical cluster) while bipolar patients were not significantly different from healthy participants. Secondly, patients with schizophrenia compared to patients with bipolar disorders exhibited reduced FC within one pair-seed region (medio-frontal cluster – left subcortical cluster).

Our results support the hypothesis of a specific medio-prefronto-striato-thalamic functional dysconnectivity implicated in the pathophysiology of schizophrenia. This fronto-subcortical dysconnectivity in schizophrenia could underlie language production symptoms observed in this pathology and could be a functional brain marker of schizophrenia.

Few studies focus on peripheral biological markers of personality. Melatonin (MLT), the main hormonal product of the pineal gland, has been used both as a diagnostic and therapeutic element and has been related with chronotype, depression and schizophrenia, among other psychiatric conditions. However, there is a paucity of studies on its use as a personality marker. The present work aims to determine whether serum MLT levels are related with the Eysenck's personality extraversion/introversion (E/I) dimension.

A sample of 100 healthy volunteers participated in the study. The E/I personality dimension was evaluated using the EPQ-BV (Eysenck Personality Questionnaire – Brief Version). Three blood samples were taken (at 09:00, 12:00 and 00:00 h) to measure MLT. MLT was analysed in serum by an ELISA. Serum MLT concentrations are expressed in pg/ml.

MLT levels displayed a clearly circadian pattern, with night levels being significantly higher than day-time levels (00:00: 35.78 ± 23.53 vs. 09:00: 7.78 ± 5.56, 12.00: 3.35 ± 1.94, p < 0.05). Serum MLT levels at 09:00 h were significantly higher than MLT levels at 12:00 h (7.78 ± 5.56 vs. 3.35 ± 1.94, p < 0.05). No significant correlations were found between E/I scores and serum MLT levels at 09:00 (r = – 0.06, p = 0.55) 12:00 (r = – 0.12, p = 0.25) and 00:00 h (r = – 0.01, p = 0.99).

There is no relationship between MLT levels and the E/I personality dimension. Future studies should examine the neuroticism dimension of personality.

Many psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), disruptive behavioral disorders, autism spectrum disorders, and some psychiatric characteristics, such as poor empathizing, are regarded to be related to elevated levels of androgens or androgen sensitivity. Idiopathic hirsutism (IH) is a disease characterized by an increased sensitivity of the pilosebaceous unit to circulating androgens in women. However, no studies investigated the potential association between IH and androgen-related psychiatric conditions.

The purpose of this study was to examine whether IH has a relationship with androgen-related psychiatric conditions.

Thirty seven females with IH and 33 healthy female controls were included in this study. Childhood and present ADHD symptoms of the participants were assessed using the Wender Utah Rating Scale (WURS) and the Adult ADHD Self-Report Scale (ASRS), respectively. The Autism-Spectrum Quotient (AQ) and the Interpersonal Reactivity Index (IRI) were used to assess autistic traits and different aspects of empathy. Hirsutism severity was measured by the Ferriman–Gallwey scoring system.

No significant difference was found between patients and controls on psychiatric questionnaire scores, except for a trend for subjects with IH to show higher levels of school-associated problems than controls according to WURS. The severity of hirsutism was strongly correlated with the WURS irritability subscore and the WURS total score, and moderately correlated with the WURS behavioral problems/impulsivity and attentional deficit subscores.

This study provides preliminary evidence that common etiological factors may be involved in both the development of IH, ADHD, and coexisting disruptive behavioral problems.