Excessive tobacco consumption among students has negative repercussions on their health and education. Medical students are no exception. Numerous studies have demonstrated the relationship existing between smoking and depressive disorders.

To study the relationship between depression, anxiety and students smoking.

We conducted a cross-sectional, descriptive and analytical study which included 80 students of the Faculty of Medicine of Sfax in Tunisia: 40 smokers and 40 no-smokers.

We used the Hospital Anxiety and Depression Scale (HADS) for screening depressive and anxious symptoms. The evaluation of tobacco dependence was performed by Fagerstrom test.

The average age of the participants was 23 years with a male predominance (SR=1,66). The smokers were in 80% of cases males and in 55% of cases dependents. Thirty-one percent (31%) of our population were depressed and 28.7% were anxious. A statistically significant correlation was found between smoking and the presence of depression (p = 0.025) on one hand, and anxiety (p = 0.022) on the other hand. Tobacco dependence was related to male sex (p = 0.04) and depression (p = 0.03). There was no link between the same variable and anxiety.

It appears from our study a statistically significant relationship between smoking and anxio-depressive disorders. The degree of dependence is particularly related with depression. This dimension has to be considered in the therapeutic withdrawal project.

Spices-use is continuously increasing in Western Countries, especially for legal reasons. Intoxication has been widely associated with psychotic symptoms.

Here we present a case-report that seems to highlight this possible association between canabimimetics and psychosis, stressing the use of 'Spices” as an instrument of auto-determination in the young patient's opinion.

Find if the supposed relation between certain Life Events and Spices use for people with a use consequent to a Dependent Personality traits can lead to an unmasking of a psychosis.

Clinical interviews, Eri-Raos, drug-use and literature revision.

Diagnostically, these patient presented right after a Spice intoxication psychotic symptoms like delusions, strong distress, the feeling of being observed and considered 'mad”, self-isolation that strengthened the need of Spice use and more difficulty (but self-reported need) to stay with others and to self-determinate herself in meaningful relationships. These symptoms have had a strong relief after the establishment of a relationship with our community mental health center (CMHC) and its multidisciplinary staff, that took care whit the patient of the whole life, in particular of the details that were stressful for her.

This report, being in accordance with others, suggests the necessity of further studies on the relation between Spice-use and psychotic symptoms, in particular for patients with a use that has roots to Dependent Personality Traits.

The study wants to identify the reasons for consuming psychoactive substances and the places where they usually do that. The research focused on higher educational students.

The students' opinion regarding the motivation revealed the following data: curiosity (30,04%), rebelliousness (12,56%), peer influence (23,77%), pleasure (30,72%), addiction (9,42%) and personal problems (25,11%). More than one third of the subjects saw consumers on the university campus (student apartments, clubs or discos on the campus or inside the faculty). This consumption is recreational. Four main factors which motivate it may be identified: the desire to experiment the sensations produced by the use of such substances, weakness, rebelliousness and peer influence. Life inside the university campus obviously reunites and reinforces these four factors.

The reasons are various: those who have used them at least once claim to have had external motivation (their peers and curiosity regarding a new experience), whereas the participants who declared that they have never used this type of psychoactive substances associate their consumption to internal causes (weakness and pleasure). The lower rate regarding the consumption in schools, schoolyards and university building prove that a possible motivation for non-consumption is the extrinsic motivation: prohibition and penalty applied by the educational environment.

Stress is one of major growing mental problems among highly educated professionals and it should not be ignored as it can cause many other health issues.

Assess the level of stress and anxiety among anesthesia staff and identify various stress factors.

Cross-sectional study, including 54 participants (16 medical staff and 38 paramedics) working in an anesthesia department. Data collection was performed using a form comprising: socio-demographic characteristics, Karasek questionnaire for the assessment of occupational stress and Hamilton scale for measuring anxiety.

Mean number of years of work 16.2. Psychiatric history reported in 13%.

Factors considered as generators of stress: important requirements 74.1%, fear of medical error 44.4%, low number of the staff 68.5% and harmful environment 72.2%.

Karasek questionnaire:mean scale of decision latitude 69 points, psychological demands 23.9 and social support 19.6.

42.6% were 'active”, 40.7% were in 'high job strain”, 13% estimated 'passive” and 3.7% were in 'low job strain”. 38.9% were in 'isostrain” situation.

The mean Hamilton scale 17.7 points, psychic anxiety 9 and somatic anxiety 8.7.

Anxiety was mild in 61.1% of cases, moderate 16.7% and severe 22.2%.

Hamilton scale was positively correlated to: age (p=0.019), number of years of work (p=0.003) and psychiatric follow-up care (p=0.022).

Anesthesia is a specialty in which the practitioner is often confronted by stressful situations, leading to a state of stress and emotional exhaustion. If this situation is poorly managed, it can cause a burnout. Hence, a better understanding of these stressful situations is a priority.

Generalized anxiety disorder (GAD) is a neurological anxiety disorder, characterized by excessive, uncontrollable and often irrational worry and its symptoms must last at least six months. This excessive worry often interferes with daily functioning, as individuals suffering GAD typically anticipate disaster.

According to researches the 80% of the patients, suffering from GAD, is treated by the primary health care with venzodiazepines. The research was to study the response of patients with GAD to escitalopram, paroxetine and alprazolam.

Material: In the research conducted from the 1st of January to the 31st of December 2012, it has been used material from the outpatient clinic of the Psychiatric Hospital of Corfu and analyzed the medical records and the medications of 36 patients with GAD.

The measurement of the efficacy of the medication was performed with the use of scale HAM-A for a period of 8 weeks for every patient and there have been studied the side effects of the taken medication.

During the research it was proved that the 3 above drastic substances are efficative in the remedy of the GAD and esitalopram slightly outweighs in the scale HAM-A, having lower side effects in comparison to paroxetine.

If we consider the dependence and the tolerance that is developed with the continuous use of venzodiazepines and the chronicity of the disease as well the cost price of the remedy by today's standards, it is suggested a change in the medication from venzodiazepine to selective serotonin reuptake inhibitors.

Modifying cognitive bias as a treatment of anxiety disorders has been suggested as an alternative to less accessible and more expensive pharmacological and psychotherapeutic methods. Since it has been shown that breathing dysregulations play an important role in pathological reactions to stressful stimuli we suggest an alternative to currently used attention bias modification treatments through the retraining of breathing during response to stressful stimuli.

We present the effects on attention bias following by a breathing retraining program using a breathing feedback monitoring device.

Subjects with anxiety disorder were asked to use a computer program at their home for 30 days, 10-minutes daily. The program would randomly select a threat-related image and the subjects were asked to blow into the breathing feedback device to observe the image on the computer screen fade away in accordance to their breathing. Pre and post-training attention bias was measured with the dot probe task. State and trait anxiety levels were measured with self reported State-Trait Anxiety Inventory before in the middle and after the training period.

In this study we present the effects of a breathing retraining program through a breathing feedback device on attentional bias and long term effects on trait anxiety measured at various time points with the Hamilton Anxiety Scale. Attention Bias Modification Treatment arises from the notion that cognitive biases cause pathological anxiety, which also underlies models of CBT.

TheBeck Anxiety Inventory (BAI) has consistently been regarded as a strong toolfor measuring cognitive and somatic aspects of self-reported anxietysymptomatology in both clinical and non-clinical populations. Thereis no study until this date that examines the factor structure of BAI within Kuwaitiand non-Kuwaiti from high school students.

The current study investigated the original four-factor structure of the (BAI) innon-clinical sample of young adults.

The sample consisted of 600 males andfemale students from secondary school of which 300 are Kuwaitis, and 300non-Kuwaitis. The Arabic version of BAI was administered to participants. Explanatory and conformity factor analysisof BAI were used in this study.

The results revealed three structures of BAI in the two samples of Kuwaiti andnon-Kuwaiti students. The first factor: Neurophysiological symptoms andsymptoms of Subjective, and the second factor comprised symptoms of Panic andSubjective, while the third factor included panic and Autonomic symptoms. Inaddition, the results revealed no significant gender differences in the factorstructure of BAI in the two samples of Kuwaiti and non-Kuwaiti students.

Theresults ofboth confirmatory and exploratoryfactor analysis indicated that the original four-factor structures of the BeckAnxiety Inventory do not provide the best fit for either the Kuwaiti or non-Kuwaiti sample. Three-factor model provided the best fit for the two samples. Implications andsuggestions for future research are discussed.

Anxiety disorders and depression are major world-wide health problems. In the US National Comorbidity Survey, lifetime prevalence of anxiety and mood disorders were 28.8% and 20.8%, respectively 1. High levels of comorbidity are seen between anxiety disorders and major depression (MD) 2 It is well reported that indi-viduals with comorbid generalised anxiety disorder (GAD) and MD are significantly more likely to remain symptomatic than individuals with depression or generalised anxiety disorder alone 3

To investigate the use of different pharmacological strategies in the management of GAD and MD.

To gain insight into the local current management of GAD and comorbid MD by Venezuelan psychiatrists, as well as comparing the correlation with international recommendations.

This survey was conducted recently at a National Psychiatric meeting in Caracas. A 27-item questionnaire, developed to investigate the different treatment strategies, was completed by 100 psychiatrists during a presentation of clinical cases, with the model of key-pad.

80% prescribed selective serotonin reuptake inhibitors (SSRIs). 70% prescribed an SSRI plus benzodiazepines (BZD); in addition, 80% favoured a combined approach, pharmacotherapy and psychotherapy. Cognitive Behavioural Therapy was the psychological treatment most commonly used (60%).

The survey shows that the majority of participants prefer a combination of pharmacotherapy and psychotherapy as first-line treatment strategy. Reported practice in this sample for the pharmacological approach, appears consistent with recent evidence-based treatment guidelines. The main drawback of the study is the small number of participants.

To present the treatment period of generalized anxiety disorder in a pregnant woman, and effects of psychotropic drugs in the newborn and infancy period.

A 33-year-old female who has eight weeks of gestation, is diagnosed with generalized anxiety disorder according to DSM-IV-R. Psychotropic drugs are decided to use. She had sertraline 100 mg/day, olanzapine 10 mg/day, quetiapine XR 400 mg/day and clorpromazine 100 mg/day as the final medication in her second trimester. Her anxiety symptoms have regressed in clinical follow-up period. No obstetric problem during the pregnancy period and no clinical problem during the prenatal follow-up period was observed. Drugs were decreased gradually at the last month of the birth and the patient was followed up without all drugs in the last two weeks prior to the birth. Birth was by cesarean section on term and the birth weight of the baby was normal. His APGAR score was 5 and he has either respiratory or any clinic problem to be monitored in the couveuse. According to the information obtained from her mother, the infant has normal motor and mental development during his two years follow-up in regional healthcare center.

When anxiety disorders are not treated during pregnancy, it is reported that, pregnancy and obstetric complications can arise, health status of newborn can be effected negatively, and can result in preterm birth, low birth weight and intrauterin growth retardation. Therefore, clinicians should prefer the most confident treatment options and track individualized treatment and patient follow-up strategies.

The purpose of this study was to estimate the general population life-time and point prevalence of visual height intolerance and acrophobia, to define their clinical characteristics and to determine their anxious and depressive comorbidities.

A case-control study was conducted within a German population-based cross-sectional telephone survey. A representative sample of 2,012 individuals aged 14 and above were selected. Defined neurological conditions (migraine, Menière's disease, motion sickness), symptom pattern, age of first manifestation, precipitating height stimuli, course of illness, psychosocial impairment, and comorbidity patterns (anxiety conditions, depressive disorders according to DSM-IV-TR) for vHI and acrophobia were assessed.

The life-time prevalence of vHI was 28.5% (women: 32.4%, men: 24.5%). Initial attacks occurred predominantly (36%) in the second decade. A rapid generalization to other height stimuli and a chronic course of illness with at least moderate impairment were observed. 22.5% of individuals with vHI experienced the intensity of panic attacks. The life-time prevalence of acrophobia was 6.4% (women: 8.6%, men: 4.1%), point prevalence was 2.0% (women: 2.8%; men: 1.1%). VHI and even more acrophobia were associated with high rates of comorbid anxious and depressive conditions. Migraine was both a significant predictor of later acrophobia and a significant consequence of previous acrophobia.

VHI affects nearly a third of the general population; in more than 20% of these persons vHI occasionally develops into panic attacks and in 6.4% it escalates to acrophobia. Symptoms and degree of social impairment form a continuum of mild to seriously distressing conditions in susceptible subjects.

Biochemical bases of interaction between monoaminergic systems and cortisol as one of the main component of hypothalamic-pituitary-adrenal axis in pathogenesis of anxious depression are investigated poorly.

Elucidate some biochemical aspects of interaction of monoaminergic systems and cortisol in pathogenetic mechanisms of anxious depression.

Patient's state (61 patients) according to ICD-10 criteria was defined as a depressive episode as an independent disease (F32.1) and in the structure of recurrent depressive disorder (F33.1). The anxiety in the structure of the depression was the main indication to inclusion in the investigation. According to Hamilton rating scale for depression and Hamilton rating scale for anxiety the total points were 21.83 and 18.00, respectively, that corresponded to severe depressive disorder and severe anxiety. 43 of 61 patients were investigated biochemically.

There were revealed significant increase of platelet monoamine oxidase activity and cortisol level. It means that patients with anxious depression are characterized by profound disturbances of monoamine metabolism and hormonal status that are the reflection of disturbed homeostasis as a whole.

There are revealed tight interaction between monoamines and cortisol. We hypothesize about biochemical mechanisms of disturbed balance between serotonergic and noradrenergic systems and cortisol in anxious depression.

Generalized anxiety disorder (GAD) is a common psychiatric disorder which may cause significant distress and disability. This study was done to estimate the effect of stressful life events on GAD in Erbil city.

A cross sectional descriptive study, was done on patients consulted a private psychiatric clinic from March 2012 to March 2014. A convenient sample of 123 patients, 86 females & 37 males, having GAD were taken after giving their informed verbal consent. The diagnoses were done clinically, and then checked according to DSM-5.

Mean age of patients was 31.2 years. Female to male ratio was 2.3/1. Mean age at onset was 26.9 years. Mean duration of illness was 4.4 years.

History of childhood separation from one or both parents was 15.3%. Regarding the stressful life events in last year prior to onset; in males, the changes in financial status was the most frequent (34%), followed by occupational problems (26%). In females, parenting stress was the most frequent 35%, followed by interpersonal problems (27%). As a whole, parenting stress formed the highest percent (31.1%), followed by changes in financial status (24.6%). Patients who faced two stressful life events formed 37%, while 25.2% of patients faced three, & only 2.4% of patients did not face any stressful life events in the last year prior to onset.

History of childhood separation from one or both parents & stressful life events in the last year prior to onset were an important factors in the development of GAD.

There is strong evidence that oxygen free radicals may play an important role in the pathophysiology of major mental illnesses such as schizophrenia and bipolar disorders.

To detect the difference in the level of total glutathione mainly in serum sample of schizophrenic patients compared to bipolar patients and healthy control.

A case-control cross sectional study, the sample included thirty schizophrenic patients, 30 patients with bipolar I disorder (manic, depressive, mixed episode) compared to 30 healthy controls well matched for age, sex, educational level and marital state.

Young Mania Rating Scale, Hamilton Depression Rating scale, Positive and Negative Syndrome Scale ., Serum sample for level of glutathione.

There are statistically significant differences between the level of glutathione in group of schizophrenia, and group of bipolar1 disorder in comparison to control group, but no significant differences between two patients groups. There is positive significant correlation between smoking and glutathione in control group. There is significant negative correlation between glutathione and both of negative symptoms and number of hospital admissions in schizophrenia. There is significant negative correlation between glutathione and duration of illness, significant negative correlation between glutathione and aging, significant positive correlation between glutathione and (manic-mixed episode) in bipolar group.

Decrease plasma level of glutathione in both schizophrenic and bipolar patients that indicates the role of total glutathione in pathophysiology of these disorders and it is considered as indirect bio markers for the oxidative stress theory in these patients.