The 2009 Quality Network for Inpatient CAMHS (QNIC) Service Standards states that every patient should have a multidisciplinary team (MDT) care plan, which should be developed in collaboration with, and accessible to the child and the parents/carers.

To complete an initial audit, followed by an education session and introduction of a ‘child-friendly' care plan template into the admission pack, and finally re-audit.

To increase the involvement of children and their parents/carers in the care plan.

This project was carried out between October 2013 and January 2014. Audit involved review of paper and electronic (JADE) case notes for all new and current admissions, and parents and young people were contacted in person or via telephone. Care plans were assessed for availability (i.e. presence in children's personal trays), and existence of a ‘child-friendly' version. The intervention consisted of an education session, and introduction of a ‘child-friendly' care plan template into the admission pack.

An education session and introduction of a template for completion of ‘child-friendly' care plans resulted in an increase in children's and parents'/carers' awareness of, access to, and involvement in their care plans. Further work might assess whether service users are equally involved in discharge planning.

Little is known about how to proceed to help HIV-infected adolescents who were referred to an adult outpatient clinic for HIV-infected to continue clinical follow-up. Studies done in other fields have shown a high risk of discontinuation of medical follow-up and also of antiretroviral treatment (ART). and an increase of neuropsychiatric disorders in this group of patients.

In order to ensure continuation of clinical follow-up, we have created a structured and standardized procedure to help adolescents to accept their referral to an adult outpatients clinic for HIV-infected patients. In the present poster communication, we describe the protocol we use in our centre,

During the last 12 months, about 36 patients were transferred to the adult outpatient clinic using our protocol. Only 3 patients had difficulties in continuing with the control visit in the adult outpatient clinic. One patient referred having fear to the oral intake of medication. The rest of the patients were adherent to the medical control visits and also to the ART.

The standardized protocol that we use in our center to transfer HIV-infected adolescents to an adult outpatient clinic has been shown to be effective in avoiding discontinuation of medical controls or ART in the HIV-infected young adults.

Suicide is the second leading cause of death among people aged 15-24 years in Europe. Several studies showed that more than 90% of youth with suicidality have at least one concurrent psychiatric disorder. Recently there is a growing interest in attention-deficit/hyperactivity disorder (ADHD) as a risk factor of suicide. However, the results are controversial: the main question is whether there is a direct association between ADHD and suicidality or ADHD increases the risk of suicide by increasing the prevalence of comorbid conditions.

The aim of the present study was to examine whether there is a direct association between ADHD and suicidality.

Treatment naïve children (n=418, aged <18 years) were enrolled in the Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. The modified Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid) was used to evaluate psychiatric diagnosis and suicidality. Multiple mediation analyses were applied in a moderated mediational model.

ADHD and current suicidality were fully mediated by the symptoms of comorbid conditions. Significant mediators were: 1) under 12 years: the symptoms of specific anxiety disorders, 2) above age 12: symptoms of major depressive episode, dysthymia and substance use.

The study was cross-sectional.

Our findings are consistent with those previous studies which stated that ADHD symptoms are associated with an increased risk of suicidality. The current study highlights that with the consideration of developmental factors early recognition and combined treatment of the symptoms of ADHD and also comorbid conditions can be important in suicide prevention.

The aim of the study was to search for correlations between the results of psychological tests and FDG-PET as well as spectroscopic metabolites from the posterior cingulate gyrus (PCG) in patients with amnestic (aMCI) and non-amnestic MCI (naMCI).

The study group consisted of 35 aMCI, 16 naMCI and 20 control subjects matched for age, sex and years of education. All subjects underwent a wide range of psychological tests including MMSE, CDR, TYM, DEMTEC, CDR, FAS, IADL and GDS as well neuroimaging brain studies including FDG-PET with the evaluation of glucose metabolism and magnetic resonance spectroscopy (MRS) with the evaluation of several metabolites such as NAA (neuronal marker), choline (marker of myelin turnover) and myoinositol (marker of gliosis). The results of FDG-PET and the levels of MRS metabolites obtained from PCG were compared between the subject groups and then correlated with the scores of psychological tests using Pearson’s coefficient.

Compared to CG, both aMCI and naMCI subjects showed significantly lower levels of glucose metabolism and NAA within PCG. In the aMCI subgroup the results of FDG-PET studies revealed significant negative correlations with the scores of TYM (p=0.17, r= -0.48) while in the naMCI subgroup lower levels of NAA correlated with lower scores in DEMTEC.

In both aMCI and naMCI metabolic changes within PCG such as glucose hipometabolism and decreased neuronal activity correlate with the results of single psychological test.

Growing evidence suggests that soluble amyloid-beta (Abeta) peptides play a pivotal role in Alzheimer’s disease(AD) pathogenesis by mediating synaptotoxic effects particularly at early disease stages.

We quantified the effects of different order Abeta assemblies on spontaneous firing dynamics ofneuronal networks cultured on multielectrode arrays ('neurochips”) as a read-out. We used naturally secreted, stable and conformationally highly homogenous Abeta monomers, dimers, and a mixture of different low-noligomers, derived from permanently transfected cell lines.

Abeta dimers promoted a dose-dependent suppression of overall activity and network synchrony and altered the burst structure already in the low picomolar dose range. By contrast, Abeta monomers exhibited no effect on overall activity, but only a slight effect on burst structure and a moderate effect on network synchrony. A yet different response pattern was seen for a mixture of various low-n Abeta oligomers. Thus, multiparametric assessment of electrical activity changes on neurochips revealed characteristic signatures of the network response for the different Abeta assemblies. Since alterations of Network function likely occur in initial disease stages, these results confirm the pivotal role of Abeta dimers in early AD pathogenesis.

Neurochip recordings of toxic dimeric Abeta species may serve as a valuable diagnostic read-out in early AD and may also be applicable for future testing of drugs, antibodies, or small molecules aiming at Abeta dimers.

We report a case of organic personality changes with mood symptoms in a patient who had two previous episodes of Anti-NMDA receptor encephalitis.

We report a single case report of a 28-year-old Indian lady who presented to our psychiatry unit with labile affect and disruptive behaviour with progressive changes in her personality over a three year period. She had a previous history of two episodes of Non Paraneoplastic Anti-NMDA encephalitis at the neurological institute with neuropsychiatric manifestations and was receiving immunosuppressive drugs.

Patient presented with labile affect, erratic behaviour, poor anger control and a bout of physical aggression and damage to property prior to hospitalisation. She required atypical antipsychotics to manage her behaviour to start with but later responded well to sodium valproate. Her mood and behaviour gradually improved albeit subtle residual personality changes.

This case report highlights the importance of recognising and managing psychiatric sequale following an episode of Anti-NMDA encephalitis. More follow up studies are required to understand the clinical presentation of patients following the encephalitis.

Ischemic stroke can lead to heart injury via dysfunction of the autonomic nervous system. QT intervals on electrocardiography (ECG) are susceptible to autonomic influences and their prolongation was associated with increased mortality after stroke.

We aimed to study QT intervals in patients with ischemic stroke in chronic phase with and without cognitive impairment.

ECGs were recorded in 50 patients with ischemic stroke. QT interval corrected for heart rate (QTc), QT dispersion (QTd), and QT interval variability (QTIV) were measured. The QTVI was calculated as the logarithm of the ratio between the variances of the normalized QT and RR intervals. Using Mini Mental State Examination and Hachinski's ischemic scale we identified vascular dementia (VaD) in 17 patients. Twenty age-matched healthy subjects were examined for comparison.

We identified QTc, QTd prolongation in patients with ischemic stroke. Comparing patients with ischemic stroke vs. VaD, QTc (412 ±75.2 ms vs 456± 115 ms, p<0.01) and QTd (64±14ms vs 154±69 ms, p<0.0001) were more prolonged in VaD. QTVI were generally increased in ischemic stroke patients compared with healthy subjects (p<0.05) but the differences with high statistical significance level were found in VaD patients (p<0.001). We found correlation between QTd, QTVI, hypertension, diabetes, arrhythmia and cognitive impairment.

Prolongation of QT intervals and increased QTVI occurs frequently after ischemic stroke but most significant changes were found in patients with cognitive impairment. Early detection of cognitive impairment in stroke patients provides better prevention of possible dementia.

Purpose of our study was to evaluate the incidence of atherogenic profile, heart failure (HF) and if there is any correlation between these and cognitive impairment (CI) in patients with vascular dementia (VaD).

This was a retrospective study. We analyzed 35 patients with VaD and 25 age- and sex-matched healthy controls. NINDS-AIREN criteria and Hachinski's ischemic scale were used to identify VaD. Mini Mental State Examination was used to classify CI into mild, moderate and severe. Clinical and biochemical features were investigated by means of standardized tests. Echocardiography was done for evaluate ejection fraction (EF).

Prevalence of atherogenic profile was increased in VaD compared with controls (72.2% vs 20%, p<0.001). High LDL cholesterol, triglicerides and low HDL cholesterol values were characteristic for VaD patients in the last 10 years. In present time we found low level for HDL cholesterol (34.1± 4.6 mg/dl vs 44.2± 5.8 mg/dl, p<0.001) and triglicerides (102.7± 7.5 mg/dl vs 154.2± 4.5 mg/dl, p<0.01) when compared with controls. 8 patients had mild CI, 2 of them had HF class II and 6 had class III NYHA, with EF in normal limits. 23 patients had moderate CI and low EF; 7 of them had HF class III and 16 had class IV NYHA. 4 patients with severe CI had very low EF and HF class IV NYHA. We found correlations between EF, triglicerides and CI.

The prevalence of atherogenic profile and heart failure were significantly higher in VaD and were correlated with cognitive impairment.

Neuroinflammation, is a final consequence of neuro-vasculo-metabolic uncoupling, common to all major neurodegenerative disorders, as sAD. One cause is brain insulin resistance (BIR).

Comparepreventive or therapeutic potentiality of vascular versus metabolic actingdrugs

Their ability to suppress CSF neuroinflammatory markers, in STZ-induced, rat model of sAD.

63 rats were injected i.c.v. STZ (3mg/kg/10ul) to develop BIR that induces sAD, then grouped into: 21 as untreated-sampled on (7th/28th/90th) days / 28 as preventive-sampled after receiving oral dailysildenafil (10mg/kg), telmisartan (10mg/kg), rusovastatin (10mg/kg), orpioglitazone (10mg/kg) from 1st till 28th days / 14 astreated-sampled after receiving telmisartan or pioglitazone from 28thtill 90th days. Sampled CSF from cisterna magna was analyzed for IL-6,TNF-a, TGF-b, MDA, and p-tau.

In untreated group; inflammatory markerswere detected on 7th while p-tau on 28th day. Theirsignificant elevation was more on 28th and 90th days respectively. By prevention; p-tau was not detected withany drug, while inflammatory markers were significantly reduced by telmisartanand pioglitazone > rusovastatin, tipping % reduction in favor of metabolicacting drugs. By treatment, % reduction in p-tau and neuroinflammation was moresignificant by telmisartan > pioglitazone, when compared to untreated group.

Neuroinflammation was bettercontrolled in prevention by the collectively used metabolic than vascularacting drugs but the reverse was detected by those selected for treatment; denoting thatfinal outcomes are rather delineated by the drug's inherent ability to targetneuroinflammation, irrespective of its primary vascular versus metabolic action.

comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results.

this is the only study to assess different aspects of WM with respect to psychosis dimension in these patient populations.

to determine whether these groups of patients can be classified on the basis of WM performance.

we applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ(n=23),psychotic BPD(n=19) and non-psychotic BPD(n=24), as well as to healthy controls (HC) (n=18) in order to compare the level of WM impairments across the groups.

with respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup.

our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems.

Alzheimer's disease (AD) shares Pathophysiological features with type 2 diabetes (T2D). The nuclear receptor peroxisome Proliferator- activated receptor GAMMA (PPARγ) is a ligand- activated transcription factor that regulates glucose and lipid metabolism and suppress inflammatory gene expression.

The potential therapeutic role of PPARγ on cognitive impairment and visuospatial memory in insulin resistance-induced AD using Pioglitazone; a PPARγ agonist.

AD was induced in 6 weeks old male rats by adding 6mg/L copper sulphate to drinking water for 8 weeks. Rats were randomly divided into 4 groups(n=10). (1) Normal control group on plain water, (2) AD control group, (3) Fructose drinking induced insulin resistance (IR) AD group, (4) Pioglitazone-treated group received orally (10mg/kg/day) at a volume of 2 ml/kg/day for the last 12 weeks of the 16 weeks period. Groups (3),(4) received 10% fructose solution in drinking water for 16 weeks after developing AD. Cognitive functions were assessed using discrimination index (DI) in object recognition test (ORT) and escape latency in Morris water maze(MWM) test. PPARγ was investigated for its role on γ-secretase and α secretes as well as glucose homeostasis.

PPARγ level was significantly elevated in IR-induced rats. However, Pioglitazone treatment was associated with restoration of PPARγ level to approximately normal values. Moreover, IR produced significant reduction in DI and prolongation of escape latency. Activation of PPARγ through Pioglitazone showed significant improvement in IR-induced dysfunctions in cognitive function and visuospatial memory in ORT and MWM tasks.

PPARγ agonists have a therapeutic potential in AD

Previous studies have shown that high total homocysteine levels are associated with Alzheimer’s disease (AD) and mild cognitive impairment (MCI).

In this study, we test the relationship between cognitive function and total homocysteine levels in healthy subjects (Global Dementia Rating, CDR = 0) and individuals with MCI (CDR = 0.5).

We have used a cognitive task that tests learning and generalization of rules, processes that have been previously shown to rely on the integrity of the striatal and hippocampal regions, respectively.

We found that total homocysteine levels are higher in MCI individuals than in healthy controls. We conducted further analysis after diving MCI subjects in two groups, depending on their Global Deterioration Scale (GDS) scores: individuals with very mild cognitive decline (vMCD) and mild cognitive decline. There was no difference among the two MCI and healthy control groups in learning performance. However, we found that individuals with MCD make more generalization errors than healthy controls and individuals with vMCD. In addition, interestingly, we found that total homocysteine levels correlate positively with generalization errors, but not with learning errors.

Our results are in agreement with prior results showing a link between hippocampal function, generalization performance, and total homocysteine levels. Importantly, our study is perhaps among the first to test the relationship between learning (and generalization) of rules and homocysteine levels in healthy controls and individuals with MCI.

A multitude of terms are used to describe delirium, including encephalopathy, acute brain failure, acute confusional state and post-operative or intensive care unit psychosis, essentially it is defined as a relatively acute decline in cognitions that fluctuates over hours or days. There are two broad clinical categories have been described -hyperactive and hypoactive subtypes;that are based on differential psycho-motor features. A possible neuro-inflammatory basis for delirium is emerging and low levels of IGF-1 have recently been found as a risk factor for delirium. Acute phase reactant C-RP has been used as a marker of inflammation may also be implicated in the cause and outcome of delirium.

1. 1) To study the prevalence of various subtypes of delirium in medically ill hospitalised patients.

2. 2) To test C-RP as predictor of delirium and recovery from delirium as part of preliminary observational study.

This is a cross-sectional study of descriptive and explorative design conducted at JSS Hospital, Mysore. A total of 113 patients were taken for the study and Patients who were admitted to ICU were assessed within 3 days of admission with

1. 1) A standard bedside test of cognitive function, the MMSE(Mini Mental State Examination)

2. 2) The Confusion Assessment Method(CAM) to determine the presence or absence of delirium.

3. 3) The acute physiological score of APACHE-2,to measure the severity of acute physical illness.

4. 4) Delirium Rating Scale.

5. 5) C-RP was measured routinely along with other routine ICU investigations in all acute admissions.

The study is still being done in the hospital. Hence, the results will be presented during oral presentation in the conference.

The objective of this study was to investigate protective potential of 17β estradiol (E2) treatment on the activity of monoamine oxidase, calcium homeostasis, membrane polarization, genomic DNA degradation, 4- hydroxynonenal and protein oxidation levels occurring in brains of female rats of 3 months (young), 12 months (adult) and 24 months (old) age groups, and to see whether these changes are restored to normal levels after exogenous administration of estradiol.

The aged rats (12 and 24 months old) (n= 8 for each group) were given subcutaneous injection of 17b-estradiol (0.1 μg/g body weight) daily for one month. After 30 days of hormone treatment, experimental animals of all the groups were sacrificed and brains were isolated for further study.

The results obtained in the present work revealed that normal aging was associated with significant increases in the activity of monoamine oxidase, calcium homeostasis, genomic DNA degradation, 4- hydroxynonenal and protein oxidation levels in the brains of aging female rats, and a decrease in membrane polarization. Our data showed that exogenous administration of E2 brought these changes to near normalcy in aging female rats.

It can therefore be concluded that E2's beneficial effects seemed to arise from its, antioxidant and antilipidperoxidative effects, implying a therapeutic potential drug for age related changes. Based on our studies and others, we conclude that E2 have therapeutic potential for adjunctive therapy along with dopamine replacement in Parkinson's disease.

There are some indications on the importance of focusing on resting state EEG and its possible links to cognitive symptoms in individuals with autistic spectrum disorder (ASD). Evidence points to disrupted neural oscillations inthese individuals, which can be seen in EEG power.

Since EEG studies on younger ages of children with ASD are sparse as well as contradictory, we have included a wide age sample of children with ASD, in order to examine possible electrophysiological pathological markers of resting state brain activity. At the cognitive level, resting state is associated with fluctuations of attention from internalized to externalized states of mind.

in the current study, we have examined whether differences exist in spectral power of resting state within the alpha band, as it is more directly linked to attentional processes.

We have extracted spectral power from resting state EEG within the alpha band over the frontal and sensorimotor regions, in a sample of 45 children with ASD, compared to an age and gender matched typical sample.

preliminary results point to group differences in EEG power when lower alpha band is considered, both in frontal and sensorimotor brain areas in a wide age sample, between children with ASD and the typical population.

Results are discussed in light of EEG measures which could be used as diagnostic tools in clinical practice. Importance of mapping the link between attentional deficits and EEG measures in ASD is highlighted.

Lately the contribution of psychological factors to coronary heart disease (CHD), especially those related to personality dimension, has benefited from an increasing recognition by the cardiologists.

This study aimed to evaluate the effect of type D personality on clinical, angiographic and echocardiographic parameters on CHD patients.

The current research represents a nonconsecutive 2 year cross-sectional study involving the 161 CHD subjects admitted in Timisoara Institute of Cardiology and 84 controls. DS -14 scale for type D personality was applied to studied subjects. Several clinical, angiographic and echocardiographic data related to cardiac status of CHD patients were recorded.

The CHD patients with type D personality had a significantly higher Volume of Left Atrium (t = 3.041; p = 0.003), a lower Strain Global Longitudinal (t = 3.264; p = 0.001), a higher Early Diastolic Transmitral Velocity/Early Mitral Annular Diastolic Velocity ratio (t = 5.266; p < 0.001), and a lower Peak Systolic Mitral Annular Velocity (t = 4.390; p < 0.001). Also, these patients had a higher frequency of myocardial infarction (?2 = 11.508; p = 0.001) and a higher necessity for bypass surgical intervention (?2 = 5.272; p = 0.022) by comparison with those without type D personality. The Syntax angiographic score of severity had higher mean value in CHD patients with type D personality (t= 5.143; p < 0.001).

The presence of type D personality in CHD patients proved to be a reliable factor that indicated poor prognosis of disease.

the sample consists of 46 patients, including 22 women (47,8%) e 24 men (52,2%). Averageage of onset of symptoms is equal to 14,61 ± 12,46. High values ??of IL-6 (1,83 ± 3,9) and TNF-α (10,2 ± 27,5) were relatedwith severity of pathology .

levels of IL-6and TNF-α are in agreement with the increase in the number of attacks of HAE.

There is a relationshipbetween increased levels of IL-6 and high scores on Hamilton Depression RatingScale and on Hamilton Anxiety Rating Scale and a higher subjective perceptionof disease severity. The higher was the perceived stress, the greater will bethe subjective perception of disease severity and the presence of pathologicalattachment styles.