Disruptive mood dysregulation disorders (DMDD) is new to DSM-5 and represents children with rage episodes. Medical treatment is critical but few randomized trials. DMDD may be a replacement for the diagnosis of Bipolar Disorder noted in DSM-IV with a heavy use of atypical neuroleptics. DMDD reflects a more moderate treatment of these symptoms.

Telepsychiatry referrals 6–9 year old children randomized into n = 12 = group A (11 males/1 female), n = 13 = group B (11 males/2 females). ANOVA not significant (NS) in age and gender. Group A received guanfacine (GUA) titrated to weight between 3–4 mg. Both groups received behavior support. Group B did not receive medications. Analysis by t-test comparison.

Group A showed significant improvement in frequency but not in intensity of rage episodes (P < 0.05). Major side effects include sedation and gastric irritation. Dropouts from original sample of 22 per group were based on inability to titrate, cost of drug, inability to swallow pills, worsening of symptoms with addition of an atypical neuroleptic.

GUA is a possible treatment for DMDD but there are limitations requiring further study. Group B did show improvement reflecting the utility of behavioral strategies (future studies require control groups) but GUA may provide a useful alternative to neuroleptics. Cardiovascular issues were not a problem and were assessed. Future studies are warranted.

The author has not supplied his declaration of competing interest.

In Europe, at discharge from a psychiatric hospital, patients with severe mental illness may be exposed to one of two main care approaches: personal continuity, where one clinician is responsible for in- and outpatient care, and specialisation, where various clinicians are. Such exposure is decided through patient-clinician agreement or at the organisational level, depending on the country’s health system. Since personal continuity would be more suitable for patients with complex psychosocial needs, the aim of this study was to identify predictors of patients’ exposure to care approaches in different European countries.

Data were collected on 7302 psychiatric hospitalised patients in 2015 in Germany, Poland, and Belgium (patient-level exposure); and in the UK and Italy (organisational-level exposure). At discharge, patients were exposed to one of the care approaches according to usual practice. Putative predictors of exposure at patients’ discharge were assessed in both groups of countries.

Socially disadvantaged patients were significantly more exposed to personal continuity. In all countries, the main predictor of exposure was the admission hospital, except in Germany, where having a diagnosis of psychosis and a higher education status were predictors of exposure to personal continuity. In the UK, hospitals practising personal continuity had a more socially disadvantaged patient population.

Even in countries where exposure is decided through patient-clinician agreement, it was the admission hospital, not patient characteristics, that predicted exposure to care approaches. Nevertheless, organisational decisions in hospitals tend to expose socially disadvantaged patients to personal continuity.

Losing one's spouse is a major life event which is associated to an increased risk of mental health problems as depression and sleep-disorders. There is also an increased risk of adverse effects on physical health, and even an increased risk of mortality. A phenomena called “the widowhood effect” Though this is well-known clinically, few studies have established the extent of the problem in old age.

This study aims to examine the risk of mortality associated to widowhood in old age, and adverse health effects both regarding physical and mental health.

A nationwide register-based case control study. All Danish people aged 65 years and above who became widowed in the period of 2000–2010 are included. A background population sample of 4:1 is matched on age and gender. By using the personal identification number a linkage between registers containing information regarding health service use, pharmacologic use and demographic information is made. Mortality is analysed using Kaplan-Meier estimate and the statistical comparison between the groups is done by Cox-regression. Adverse health effects are assessed by the health care use and pharmacological use, and are compared between the two groups by t-test, linear and logistic regression depending on the variables.

The study is under conduction, results will be presented.

Widowhood in old age has been associated to an increased risk of mortality and adverse health effects. This study assesses the outcome of this in a nationwide register-based sample.

The authors have not supplied their declaration of competing interest.

The Meeting Centre Support Programme (MCSP) is a community-based approach to support people living with dementia and their families. It was developed in the Netherlands and has been implemented in other European Countries (Italy, Poland and the UK) within the JPND-MEETINGDEM project.

To assess the relationship between background characteristics of people with dementia participating in MCSP, mood, quality of life (QoL) and experienced stigma, and to explore if and how the experienced stigma changed after 6 months of participation in MCSP.

A pretest (M1) post-test (M7) control group design with matched groups regarding severity of dementia was applied. In each country, a minimum of 25 participants using MCSP were compared with people with dementia receiving ‘usual care’. Data were collected with the Stigma Impact Scale, Cornell Scale for Depression in Dementia, Global Deterioration Scale and two QoL scales (QoL-AD & DQoL). Differences in background characteristics were taken into account in the analyses.

The preliminary analysis on 116 participants at baseline shows that the level of stigma was low to moderate. People felt more socially rejected in the UK than in Poland and Italy. The level of perceived stigmatization appeared negatively correlated with QoL areas and positively correlated with negative mood. Changes after 6 months will be presented.

It is expected that after 6 months people living with dementia participating in MCSP will experience less stigma, as in contrast with usual care MCSP promotes social integration of people with dementia and person-centered support.

The authors have not supplied their declaration of competing interest.

Internet is an important means of communication but its use must be monitored to prevent inefficiency in the working places and to become a behavioral disorder for workers.

The aim of this paper is to investigate the relationships between the use of Internet at work for non-work purposes (Cyberloafing) and factors such as gender, age, years of work at company, education, excessive use of Internet at home, company salary and certain psychological attitudes such as loneliness and lack of self-esteem.

A random sample of 409 workers (180 men, 229 women) was interviewed using a questionnaire with demographics, applications of Internet and Young's criteria of Internet addiction sections. We performed a binary logistic regression analysis using the SPSS 18 with depended variable the amount of time spent every day on using the internet at work for non-work purposes.

The following factors were found statistically significant predictors of the depended variable. Sex, Length of time for viewing Sports news at work, General Information, Buying pages, Playing games and Gambling. The mean age of the Cyberloafers was 35 years and the percentage of the workers who could use Internet at work for non-work purposes was 9.1%. The percentage of men who were using Internet at work for non-work purposes was 12.2%, whereas the analogues percentage for women was 6.6%.

Specific steps of monitoring the Internet use and organizing companies seminars for avoiding the dependence on the internet are recommended for maximum efficiency.

To evaluate the prevalence and associated variables of intentional self-poisoning in individuals from 8 to 17 years.

This study includes 4658 cases. Analyzed variables were gender, age, agent and time (month, week day and hour).

In total, 3759 (80.70%) were girls. The rate in 100,000 children and adolescents residents grown from 25.12 in 2005 to 35.24 to 2012. The biggest incidence was in the 15 to 17 age group (63.35%). The leading agent was medications (84.6%): 1093 (23.47%) antidepressant, 967 (20.76%) benzodiazepines, 708 (15.20%) antipyretics, 606 (13.01%) anticonvulsants, 460 (9.88%) neuroleptics and 382 (8.2%) anti-inflammatory non-steroids. The antidepressant more used was amitriptyline (7.26%), followed by fluoxetine (6.57%). Growing cases involving selective serotonin reuptake inhibitors have been seen, as a fall of self-poisoning tricyclic antidepressants cases. The majority of cases was in October (10.1%), on Tuesday (15.1%), and at 18:00 to 21:00 (29.46%).

The elevated rate of self-poisoning in children and adolescents in southern Brazil, growing each year, shows the relevance of this subject. It is important to considerate how easily these children and adolescents have access to psychotropics.

Despite efforts toward greater gender equality in clinical and academic psychiatry in recent years, more information is needed about the challenges in professional development within psychiatry, and how these may vary with gender.

A cross-sectional 27-item online survey was conducted with psychiatrists and psychiatric trainee members of the European Psychiatric Association.

A total of 561 psychiatrists and psychiatric trainees from 35 European countries participated representing a response rate of 52.8% for women and 17.7% for men from a total sample of 1,580. The specific challenges that women face in their professional development fall into two categories. One comprised women’s negative attitudes concerning their abilities in self-promotion and networking. The other identified environmental barriers related to lack of opportunity and support and gender discrimination. Compared to men, women reported higher rates of gender discrimination in terms of professional advancement. Women were less likely to agree that their institutions had regular activities promoting inclusion, diversity, and training to address implicit gender bias. Working in high-income countries compared to middle-income countries relates to reporting institutional support for career progression.

These findings are an open call to hospital leaders, deans of medical schools, and department chairs to increase efforts to eradicate bias against women and create safer, inclusive, and respectful environments for all psychiatrists, a special call to women psychiatrists to be aware of inner tendencies to avoid self-promotion and networking and to think positively and confidently about themselves and their abilities.

To explore the relationship between resilience and social support, coping style of students in middle school for providing some evidences for improving students’resilience.

Six hundred students were surveyed with the Connor-Davidson resilience questionnaire(CD-RISC), perceived social support scale(PSSS)and coping style questionnaire(CSQ).

Resilience had significant difference between male and female students.The resilience was positively correlated with social support and two factors of coping style:seeking help and solving problem, but negatively correlated with the other factors in coping style questionnaire.

Students with high score in Connor-Davidson resilience questionnaire are more tend to the positive coping style. Social support is an important factor of resilience in middle school students.

Alexithymia consider a cluster of cognitive and affective characteristics that include: inability of recognizing and describing emotions, difficulties in distinguishing feelings and physical sensations during emotional arousal, narrowed capacity for imagination and externally oriented cognitive style. Several studies links alexithymia with increased risk for physical and mental damage. Symptoms of alexithymia are documented in persons who develop PTSD in response to different types of traumatic events.

To examine alexithymia in war veterans.

To determine whether alexithymia is significantly more present in war veterans with PTSD.

Cross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and by Toronto Alexithymia Scale (TAS-20).

Out of 205 war veterans 89 (43.4%) of them have alexithymia. Significantly more veterans with PTSD (78 or 75%) than without PTSD (11 or 10.9%) has alexithymia (Chi2 = 88.955, P < 0.001) was found a statistically significant difference between the two groups in the total score of alexithymia (t-test = −10.676, P < 0.001) statistically significant difference was found in all three domains of alexithymia.

Alexithymia is significantly often in war veterans with than without PTSD.

The authors have not supplied their declaration of competing interest.

Climate change is one of the greatest threats to health that societies face and can adversely affect mental health. Given the current lack of a European consensus paper on the interplay between climate change and mental health, we signal a need for a pan-European position paper about this topic, written by stakeholders working in mental health care.

On behalf of the European Psychiatric Association (EPA), we give recommendations to make mental health care, research, and education more sustainable based on a narrative review of the literature.

Examples of sustainable mental healthcare comprise preventive strategies, interdisciplinary collaborations, evidence-based patient care, addressing social determinants of mental health, maintaining health services during extreme weather events, optimising use of resources, and sustainable facility management. In mental health research, sustainable strategies include investigating the impact of climate change on mental health, promoting research on climate change interventions, strengthening the evidence base for mental health-care recommendations, evaluating the allocation of research funding, and establishing evidence-based definitions and clinical approaches for emerging issues such as ‘eco-distress’. Regarding mental health education, planetary health, which refers to human health and how it is intertwined with ecosystems, may be integrated into educational courses.

The EPA is committed to combat climate change as the latter poses a threat to the future of mental health care. The current EPA position paper on climate change and mental health may be of interest to a diverse readership of stakeholders, including clinicians, researchers, educators, patients, and policymakers.

The extent and profiles of heterogeneity in cognitive functioning among participants in clinical trials of antidementia medication are unknown. We aimed to quantify and identify profiles of heterogeneity of cognition in Alzheimer’s disease.

Individual-level participant data were analyzed from five pivotal clinical trials of donepezil for Alzheimer’s disease (N = 2,919). Based on Alzheimer’s Disease Assessment Scale–Cognitive Subscale total scores from baseline up to week 12, a latent class model was used to identify heterogeneous groups. A logistic regression model was used to examine factors associated with group membership. Sensitivity analysis was conducted, restricted to the donepezil, and then the placebo arm.

The latent class model identified three classes labeled as low scorers (i.e., least cognitive impairment; N = 1,666, 76.04%), improvers (N = 27, 1.23%), and high scorers (N = 498, 22.73%). Logistic modeling showed that donepezil compared to placebo was significantly (p < 0.05) positively associated with membership in the improvers class (OR = 6.88, 95% CI = 2.03, 42.95), and negatively with high scorers (OR = 0.79, 95% CI = 0.64, 0.98). Sensitivity analysis restricted to the placebo, then donepezil arms replicated similar heterogeneity patterns.

Our results inform clinicians regarding the extent of heterogeneity in cognitive functioning during treatment and contribute to trial design considerations.

Autism and epilepsy often occur together. Epilepsy and other associated conditions have a substantial impact on the well-being of autistic people and their families, reduce quality of life, and increase premature mortality. Despite this, there is a lack of studies investigating the care pathway of autistic children with co-occurring epilepsy in Europe.

We analyzed the care pathway for autistic children with associated epilepsy in Italy, Spain, and the United Kingdom from the perspective of caregivers (using a survey aimed at caregivers of autistic children 0–18 years old), the autistic community, and professionals, in order to identify major barriers preventing caregivers and autistic children from receiving timely screening and treatment of possible co-occurring epilepsy.

Across all three countries, an analysis of the current care pathway showed a lack of systematic screening of epilepsy in all autistic children, lack of treatment of co-occurring epilepsy, and inappropriate use of antiepileptic drugs. A major challenge is the lack of evidence-based harmonized guidelines for autism with co-occurring epilepsy in these countries.

Our findings show both heterogeneity and major gaps in the care pathway for autism with associated epilepsy and the great efforts that caregivers must make for timely screening, diagnosis, and adequate management of epilepsy in autistic children. We call for policy harmonization in Europe in order to improve the experiences and quality of life of autistic people and their families.

The Beck Scale for Suicide ideation (BSS) has consistently been regarded as a strong tool for measuring cognitive and somatic aspects of suicide ideation symptomatology in both clinical and non-clinical population. There is no study until this date that examines the BSS within Kuwaiti College students.

The present study aims at identifying impact of gender (male/female) on suicide ideation.

The sample was consisted of (584) undergraduates students (284 of males and 300 females). The study applies Beck Scale for Suicide ideation (BSS) and suicide Ideation Questionnaire (SIQ).

Table 1 descriptive statistics for two standardized self-report measures means and standard deviations for these measures were within the expected ranges for college samples. The mean (BSS) score was 5.2 for males and 7.0 for females. The mean (SIQ) score was 11.3 for males and 13.7 for females.

BSS revealed significant gender differences in score indicated that females obtained higher scores than males on suicide Ideation although the magnitude of the difference was small.

Table not available.

The author has not supplied his declaration of competing interest.

The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization.

To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors.

Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP.

A total of 38 articles published from 1999 to 2019 and involving 10926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.

These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.

No significant relationships.

Loneliness is a common emotional distress experience and there is increasing evidence of associations with unhealthy lifestyle and adverse health-related factors. Little is known about age and sex as potential effect modifiers, and about the prevalence of loneliness.

To assess the associations of loneliness with behavioral, physical and mental health factors, taking sex and age into account and to examine the prevalence of loneliness in individuals aged 15+ years.

Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 were analyzed. The association of loneliness with lifestyle and health-related factors were assessed with logistic regression analyses. Wald tests were used to test for age and sex differences.

Loneliness was reported by 64.1% of individuals, and was associated with smoking (OR 1.13, 95% CI 1.05–1.23), physical inactivity (1.20, 1.10–1.31), non-adherence to the 5-a-day recommendation for fruit and vegetable consumption (1.21, 1.07–1.37), and more visits to a physician within the last year (1.29, 1.17–1.42). Loneliness was also associated with high cholesterol levels (1.31, 1.18–1.45), diabetes (1.40, 1.16–1.67), self-reported chronic diseases (1.41, 1.30–1.54), impaired self-perceived health (1.94, 1.74–2.16), moderate and high psychological distress (3.74, 3.37–4.16), and depression (2.78, 2.22–3.48). Age modulated the associations in BMI, smoking, visiting a physician within the past year, and self-perceived health. Sex did generally not modulate the associations.

Loneliness is associated with unhealthy lifestyle, and poorer physical and mental health. Associations were modulated by age, but not sex. Further longitudinal studies are needed to elucidate the causal relationships of these associations.

The authors have not supplied their declaration of competing interest.