Excessive problematic use of the internet has been a topic of discussion in the academic literature for many years. Problematic internet use (PIU) has been grown world-wide about 2 billion users.

The aim of this study is to explore the characters of internet use among the medical students, and discover the prevalence of internet mal use and its risk factors.

A cross-sectional study of 321 medical students at Assiut University Medical School using the Internet Addiction Scale was carried out.

The current study found that the most important correlates for Internet Addiction among Assiut Medical Students were mother's education, sex, residence, suicidal ideation.

Internet Addiction is an important behavioral disorder affecting medical students and may interfere with their normal life and studies.

Data on the process of mental health care is scant. Most studies focus on services at their inception when activity may be atypical and then usually present data only mean values for the reported variables over the whole study period. We aimed to test whether care delivery changes over time, and to describe any changes at the individual patient and team levels.

Process data on 272 patients in three new intensive case management (ICM) teams were collected over 2 years. Interventions were prospectively recorded using clinician-derived categories. Changes over time are described at both patient and team level.

The number of contacts and the proportion of face-to-face activity were remarkably constant after the first month at the patient level. The proportion of ‘psychiatric’ interventions (main focus on medication or a specific ‘mental health’ intervention performed) increased greatly after the first 6 months. The care activity received by individual patients varied considerably. Overall, teams varied significantly in the extent to which their activity rates were sustained over time.

New ICM teams deliver highly individualised care with more marked differences in treatment patterns between patients in the same team than mean differences between teams. The early ‘engagement’ period is marked by a greater focus on social care. There is evidence of differences in sustainability of the services by site.

The evolution of various pharmacological therapies for schizophrenia has given rise to several pharmacological models for the neuroreceptor targets of antipsychotics and the influence of various neuroreceptors on specific symptoms and side effects.

Experience in clinical practice affirms clozapine's position as the treatment of choice for patients with treatment-refractory schizophrenia. Unlike clozapine, risperidone has a more targeted profile of neurotransmitter binding, with particular predilection for dopamine and serotonin receptors. Risperidone is, to date, the most extensively documented clozapine augmentation agent.

The aim was to evaluate clinical efficacy, safety and tolerability of augmenting clozapine with risperidone in patients with treatment-resistant schizophrenia.

In a randomized, double-blind, placebo-controlled 8-week trial, 10 patients unresponsive or partially responsive to 300 mg/day of clozapine monotherapy (n = 5) received a steady dose of 450 mg/day clozapine combined with or up to 4 mg/day of risperidone (n = 5). Patient psychopathology was assessed at 2-week intervals with the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) improvement scale.

From baseline to week 4 and week 8, mean BPRS total and positive symptom subscale scores were reduced significantly in both groups, but the reductions were significantly greater with clozapine/risperidone treatment. Reductions in SANS scores were also significantly greater with clozapine/risperidone treatment than with clozapine monotherapy group. Clozapine/risperidone treatment did not induce additional weight gain or agranulocytosis compared with clozapine monotherapy treatment.

Clozapine augmentation with risperidone appears to be well tolerated, safe and may provide additional clinical benefit for patients who are nonresponsive or only partially responsive to clozapine alone.

The authors have not supplied their declaration of competing interest.

Suicide is recognized as a social problem and the interest in preventive measures to diminish suicide risk is constantly increasing. But scientific research results that distinguish between those who have only suicidal ideation (SI) and those who have a history of Suicidal attempts (SA) are limited. Inhibitory control is regarded as an important ability related to the transition from suicidal ideation to suicide attempts. In event-related potential, patients with dysfunction of inhibitory control demonstrate a reduction in the no-go amplitude.

This study aimed to determine the association between the no-go event-related potential component and suicidal behaviors among suicide attempters and ideators who never attempted suicide.

Overall, 150 patients who visited the emergency room by suicide attempts or patients who visited the psychiatric department with suicidal ideation were recruited and instructed to perform a go/no-go task during electroencephalography recording. The Beck Depression Inventory, Beck Anxiety Inventory, Barratt Impulsivity Scale, Difficulties in Emotional Regulation Scale, and Acquired Capability for Suicide Scale were used. Individuals were divided into two groups: those with suicidal attempts (SA group) and with suicidal ideation (SI group) without SA. The psychological characteristics and event-related potentials of the two groups were compared. Correlation analyses were conducted to test the association between the clinical characteristics and event-related potentials.

The SA group had significantly decreased no-go P3 amplitudes at all electrodes compared to the SI group. In the correlation analysis between the clinical measurements and event-related potentials in all the participants, no-go P3 amplitudes in whole electrode sites were negatively correlated with the scores of the acquired capability for the suicide scale.

This study revealed that suicide attempters have dysfunction in controlling inhibition compared to suicide ideators reflected in the no-go P3. Our findings suggested that no-go P3 can be a biomarker associated suicide attempts in suicide ideators.

None Declared

To conduct a three-arm partial randomised controlled trail to evaluate the effectiveness of expedited regular supportive psychotherapy and assertive case management for patients presenting with suicidal ideation or self-harm to the emergency department (ED).

we expect expedited regular supportive psychotherapy plus assertive case management will reduce the suicidality and/or suicidal behaviour in patients by at least 20% at 4 weeks compared to patients receiving only assertive case management or routine care and these differences will be sustained at 6 months.

This will be a longitudinal, prospective, three-arm controlled single-rater-blinded partial randomized clinical trial with a recruitment period of 12 months and an observation period of 6 months for each participant. Patients in the intervention group will receive regular face-to-face or over the phone brief supportive psychotherapy during weekdays following presentation to the ED with suicidal ideation or self-harm until patients are actively enrolled in regular community mental health services with active case management by the therapist. Patients in the control and the assertive outreach arms will each receive the usual follow-up services offered routinely to regular patients and assertive outreach patients respectively who present to the ED with suicidal ideation or self-harm.

Recruitment will commence in February 2016 and we expect the results of the study to be available by September 2017.

If our hypothesis is proved correct, our intervention will be a new model for caring for patients with self-harm and suicidal ideation and is expected to reduce suicide rates.

The authors have not supplied their declaration of competing interest.

Cancer is a leading cause of death worldwide and India is no exception to this. The controversies and necessity of assessing the prevalence of psychological morbidity with validated instruments in cancer patients, which can have important ramifications, in service delivery led to the present study.

To study the Prevalence and correlates of psychiatric morbidity in cancer patients and find the factors associated with psychiatric illness in cancer patients in a tertiary care centre.

Patients admitted in Radiotherapy ward of Medical College Trivandrum who met inclusion and exclusion criteria were assessed using translated and validated MINI 6.0, delirium rating scale and Adjustment disorder questionnaire after obtaining informed consent.

Of the 384 patients assessed the prevalence of Psychiatric disorders was 41.7% with adjustment disorders contributing to 22.6%, major depressive disorders 10.9%, delirium 6.5%, and hypomania 1.6% and age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas were significantly associated with psychiatric disorders.

Cancer is associated with Psychiatric disorders and affects patients. Psychological interventions can alleviate the distress of these persons and provisions of psychological support should be is an important component in the care of these patients.

Previous studies in other countries have reported that cyberbullying was related to Information and Communication Technology (ICT) use. Helweg-Larsen, (2011) reported that knowledge about safe internet use did not decrease the prevalence of cyberbullying. Less is known about this relationship with family functioning.

To examine the rates of cyberbullying and their relationships with ICT use and family functioning in a sample of secondary students in the UK

To study 1) associations between cyberbullying and ICT use 2) associations between family functioning and parental controls with ICT-use and cyberbullying.

A cross-sectional questionnaire of 2218 secondary students was completed

included demographic data, ICT use (levels and nature), Olweus bullying questionnaire adapted for cyberbullying, General Functioning subscale of the Family Assessment Device and parental controls (type and levels).

Response rate 80%, 45% males, mean (SD) age 14.97 (1.9) years. Cyberbullying seems to be related to the time spent online and to the general family functioning. Bullies or bully-victims spend significantly more time online than those who are not involved. The majority of students have been told how to be safe online; however only a few have parental controls on their computers. There is a significant positive correlation between worse family functioning and time spent online and with being involved in cyberbullying, even after controlling for the time spent online.

Our results suggest that increasing family communication may contribute to reduce children involvement in cyberbullying

Despite the availability of an ever-expanding range of typical and atypical antipsychotics, a substantial proportion of patients with schizophrenia show a partial or total lack of response to antipsychotic mono therapy. This study was done to evaluate the effect of purslane on psychologic symptoms of schizophrenic patients.

This randomized clinical trial study was carried out on 60 chronic schizophrenic patients in Sina hospital Shahrekord, Iran during 2011-12. Subjects were randomly divided into intervention and control groups. The control group received Risperidone up to 6mg/day and Biperiden 4mg/day for 8 weeks. The Patients in interventional group received 1gr extract of purslane daily with the same regimen for 8 weeks. The scales for assessment of positive symptoms (SAPS) and assessment of negative symptoms (SANS) were recorded in prior and 8th weeks. In addition, CRP and MDA level of patients were assessed in two stage of study.

At the end of study, the mean score of positive symptoms were 47.93±18.56 and 57.1±14.83 in intervention and control groups, respectively (P< 0.05), and the mean score of negative symptoms were 40.83±11.03 and 46.13± 9.34 (P< 0.05).The CRP levels of patients in intervention and control groups were .53±.55 and 1.72±.73 at 8 week respectively (P< .05) and the MDA levels were 3.25±1.25 and 5.43± 1.76 respectively (P< .05).

According to findings of this study, the use of purslane as an adjunct to Respridone can improve psychological condition of chronic schizophrenic patients and decrease MDA and CRP levels of them.

The authors have not supplied their declaration of competing interest.

To explore the feature of functional connectivity of default mode network (DMN), central-executive network(CEN), and salience network (SN) in patients with schizophrenia during a resting state by functional magnetic resonance imaging (fMRI).

The SPM8, DPARSFA, conn, REST softwares combined with data-driven region of interest analysis were used to compare the functional connectivity (FC) of the DMN, CEN, and SN in 74 patients with schizophrenia(SZ) and 79 age- and gender-matched normal controls(NC). Medial prefrontal cortex(MPFC)was selected as seed region for identifying DMN and CEN; right anterior insula(rAI) for SN.

Compared with NC, SZ showed increased FC with bilateral dorsolateral prefrontal cortex(DLPFC) and bilateral putamen of the MPFC, and increased FC with left middle frontal cortex and precuneus/ posterior cingulate cortex(Pcu/PCC) of the rAI. SZ also showed enhanced interconnectivity strengths of CEN-DMN, CEN-SN, and DMN-SN(p>0.05). Correlation analyses showed that the increased FC between MPFC and left DLPFC significantly negatively correlated with PANSS-negative symptoms(r=-0.224,p=0.030) and increased FC between rAI and Pcu/PCC significantly correlated with PANSS-positve symptoms (r=0.243,p=0.020).

This study provides evidence for resting state functional abnormalities of DMN, CEN, and SN in schizophrenia patients. These aberrant functional connectivities in some key brain regions of the three network could be responsible for the schizophrenic symptoms.

It has been estimated that around 10-20% of all pregnant women suffer from antenatal depressive or anxiety symptoms. These symptoms have been associated with multiple adverse child outcomes including obstetric problems, e.g. preterm delivery, Apgar score and low birth weight. Therefore, considerable health gains may be achieved if depression and anxiety during the perinatal period are adequately treated. Nevertheless, to date, no previous trials have published on the effects of Cognitive Behavioral Therapy (CBT) during pregnancy on child outcomes.

The ´Pregnancy Outcomes After a Maternity Intervention for Stressful Emotions´ (PROMISES) trial is a randomized controlled trial, which compares the effects of CBT vs. care as usual (CAU) during pregnancy among a group of women with (sub)clinically depressive and/or anxiety symptoms (n=226) on both maternal and child outcomes. Child outcomes comprise a range of obstetric outcomes including birth weight, Apgar score, and gestational age. Independent samples t-tests were performed to investigate differences in mean values.

No significant differences were found between the CBT- and the CAU-groups, in gestational age (39+0 vs 39+2 weeks+days, p=.99), birth weight (3447 vs 3509 grams, p=.24), or Apgar score at 1 (8.6 vs 8.6, p=.99), 5 (9.5 vs 9.6, p=.31), and 10 minutes (9.7 vs 9.8, p=.26).

Although CBT as early treatment of antenatal depression and anxiety is most likely to be effective for prevention of postpartum depression, CBT seems to have no effect on major obstetric outcomes.

Homelessness is a problem which affects all the areas of those who suffer it, affecting their health seriously. These risks increase when the affected person has carried out a migratory process. Another risk factor, apart from immigration, is to be woman.

To analyse the gender demographic differences in a total cohort of homeless people in the city of Girona in 2006 and continued until the present day.

Prospective longitudinal study of the total population of homeless people in Girona. In 2006, a list was made of all the homeless people detected by both specialized and non-specialized teams which have been followed until the present day.

The total number of women in the sample is lower (n = 106, 11.2%). There are fewer immigrant than autochthonous women (Chi2 = 23,1, df = 1, P < 0.001).

After following the total homeless population in 2006, we can confirm that currently we can still identify 62 people in the territory (6.7%). In this subsample there are no differences between genders (man: n = 54, 6.5% vs. woman: n = 8, 7.5%; Chi2 = 0.21, df = 2, P = 0.89). That is, men and women remain in their homeless condition in a proportional way. This fact presents great limitations, since we do not know what happened with the other 93% of the initial sample.

The masculinisation of the homeless people from Maghreb has tended to increase the gender differences in the homeless population, in itself more masculine. This presents a risk of increasing the invisibility of homeless women.

The authors have not supplied their declaration of competing interest.

Pakistan is an Islamic country where religion is considered an important protective factor against suicide. Recent research and media reports identify that suicide and self harm behaviours are increasing in different parts of Pakistan.

To inform public policy debate and suicide awareness education interventions.

To study socio-cultural, political, interpersonal and religious factors that can influence suicide and suicide awareness.

Systematic search of Medline, Embase, PsychInfo, CINAHL, Pakmedinet, TRIP, and electronic searches of Pakistani Medical Journals, using terms Suicide, Self harm, Deliberate Self Harm, Self Poisoning, Non-Accidental Deaths, Undetermined Deaths. Focus Group Discussion, Aga Khan Medical University, Pakistan Consultation with experts in the field.

1. a. Epidemiological evidence confirms an increase in suicide rates with variable figures reported from different parts of Pakistan. Higher rates of suicide rates are reported for men with an association with unemployment and mental health problems. Marital Discord and domestic violence identified as risk factors in female suicides.

2. b. Religion is continued to be identified as an important protective factor against suicide.

However, Pakistan's legal system that criminalizes suicide and self harm is criticized for exercising negative influence through preventing early identification of high risk individuals. A variable pattern of suicide reported from different parts of Pakistan identifies the need for deep cultural understanding and examination of protective and risk factors that operate with in family structures and sub-cultures in Pakistan.

An increase in suicide rates in Pakistan has raised mental health and public policy awareness.