To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.

A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.

A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.

Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

This research aims to evaluate psycho-emotional challenges for older adults and the relevance of person-centered therapy (PCT) for older adults.

Forty senior adults, aged above 65 years (M = 71.7; SD = 4.6) were assessed with the the Self-Esteem Scale (‘SES’) and the Mini-Mental State Examination (MMSE). Socio-demographic data, including gender (57.5% women), marital status (37.5% married) and education (39.2% mandatory school) were also assessed. Bivariate associations were performed.

Results yielded a set of five descriptive categories that captured the distinct ways older adults perceived psychoemotional challenges and that reflected the individual's perceived importance of PCT: ‘time perspective’, ‘the aging body’, ‘autonomy and control’, ‘cognitive endurance’ and ‘loss and reminiscing’. Regarding bivariate associations, results indicated that ‘autonomy and control’ was associated with the ‘aging body’ (r=.552, p< .001) and ‘cognitive endurance’ with ‘time perspective’ (r=.425, p< .001). This latter was also associated with ‘loss and reminiscing’ (r=.616, p< .001).

This study highlights the importance of PCT for older adults facing psycho-emotional challenges in old age. Interventions with older adults may benefit from clearly understanding older adults’ specific issues as an important component for promoting successful aging and reducing health disparities.

In the growing research field of early psychosis detection in patients with an at risk mental state (ARMS), most studies focus on the transition to frank psychosis. However, the majority of ARMS patients do not go on to develop frank psychosis and reported transition rates are declining. Little is known about the long-term outcome of these non-transitioned patients (ARMS-NT).

To investigate in preliminary analyses the long-term outcome of ARMS-NT patients with respect to persistence of ARMS signs and symptoms and the rates of late psychotic transition.

The ongoing study “FePsy-BHS-NT” follows up ARMS-NT without transition during at least the first two years for up to 15 years after their initial assessment. ARMS status is ascertained with the Basel Screening Instrument for Psychosis (BSIP). ARMS remission is defined as the absence of attenuated psychotic symptoms or brief limited intermittent psychotic symptoms for at least 12 consecutive months.

In this preliminary sample of 51 ARMS-NT, the majority of patients (70.6%) have remitted from their at risk mental state, 13.7% remain at risk and 15.7% have made a late psychotic transition during the course of long-term follow up (median = 5.75, range 4–11 years after initial assessment).

The considerable rates of ARMS persistence and late psychotic transition indicate that longer follow-up durations than commonly recommended should be contemplated in ARMS patients. Potential predictors of favorable long-term clinical outcome, as well as psychosocial, neurocognitive and other outcomes of ARMS-NT patients will be further evaluated in the present study.

The authors have not supplied their declaration of competing interest.

Pseudocyesis is a rare condition in which a non-pregnant patient believes to bear a child due to psychological or somatic manifestations,or even both.Usually,there is a misinterpretation of body changes associated with emotional aspect of pregnancy or thought disorders(or chronic mental disorders),what makes pseudopregnancy a complex disorder to deal with,starting with its confusing classification in the DSM IV-TR.

To document epidemiologic aspects of false pregnancies in a Brazilian population, reporting the most prevalent psychiatric diagnosis and demographic features associated, and compare it to the literature.

Retrospective study of 20 patients diagnosed with pseudocyesis over a ten-year period in 3 hospitals of a Brazilian central region.Compare data with studies on sociodemographic, clinic, biological and evolutive correlates of pseudocyesis in PubMed.

The mean age was 33, with the majority between 20–44. The symptomology matches the literature.Of the women, 15 (83%) were in the reproductive age, but 8 (44%) of them were infertil. Two male patients with pseudocyesis had a typical psychiatric presentation. The psychiatric diagnosis were: 9(45%) affective disorders, 9(45%) psychotic disorders, 1 (2,5%) Huntington‘s Disease and 1 (2,5%) epilepsy.

In terms of Brazil, this is an unique study of the subject, with the greatest data collected so far. We found many similarities,including age, socioeconomic status, symptoms, underlying disorders and history. And we notted the frequency of psychiatric disorders in those patients (specially Bipolar Disorder and Schizophrenia)

The application of scientific evidence in clinical practice management of Major Depressive Disorder (MDD) is complex. Generally, the usual dissemination process and implementation of Clinical Practice Guidelines (CPG) induce modest changes. A computerized version of a Clinical Practice Guideline for Major Depression (e-CPG-MD) has been integrated in Electronic Clinical Records of Primary Care in Catalonia (Spain). It offers an opportunity to improve clinical results. The design allows access to precise help in the visit itself, improving diagnosis, treatment and follow-up.

To evaluate the effects of a multifaceted implementation process of e-CPG-MD, analysing their use and changes in MDD diagnosis.

A cluster randomized clinical trial was performed in 10 primary care centers (PCC) in Barcelona. In five of ten centers, a multifaceted implementation process of the e-CPG-MD was developed during 6 month. The active process includes: interactive training program, regular feedback audit, educational outreach visits and periodic reminders.

The multifaceted implementation of e-CPG-MD was associated with a significant increase in use during the first 6 months (4.1% + 3.1% vs. 52.7% + 7.3%, P < 0.001). In the active centers, the MD diagnosis increased significantly (rate quotient = 1.56, P < 0.001) and the proportion of moderate and severe MD increased (13.6% vs 41.1%, P = 0.002).

A multifaceted implementation method of e-CPG-MD increased significantly its use in active centers at 6 months. Diagnosis of MDD and the proportion of moderate and severe cases also increased significantly.

The authors have not supplied their declaration of competing interest.

Benzodiazepines impair cognitive function, especially in the elderly. The current analysis sought preliminary data on the effect of pregabalin on cognition in elderly patients with GAD.

Patients aged ≥65 years who met DSM-IV criteria for GAD, with HAM-A≥20 and MMSE≥24, were randomized to 8 weeks of treatment with flexible-dosage pregabalin (150-600 mg/d) or placebo. A subgroup (N=89; 81% female; mean age=70.4 years; mean HAM-A=27.3) completed a cognitive battery including the Digit Symbol Substitution Test (DSST) and the Set Test at baseline and endpoint.

At baseline, scores for pregabalin and placebo on the DSST were 13.75±3.51 vs 13.39±3.89 and on the Set Test 37.88±3.25 vs 37.63±3.69. There was significant (P<.05) inverse Pearson correlation between HAM-A item-5 (intellectual) and DSST (-0.32) and Set Test (-0.30) scores. There were also moderate inverse correlations between the DSST and HAM-A total score (-0.35) and age (-0.25). Weaker correlations (with the same directionality) were observed between the Set Test and these variables. At 8-week LOCF-endpoint, scores were comparable on the DSST (13.82 vs 14.54) and the Set Test (38.24 vs 37.95). Endpoint improvement in the HAM-A was moderately correlated with improvement in the Set Test (-0.23, P<.05) but not with DSST. Univariate and multivariate analyses showed treatment with pregabalin had no effect on endpoint cognitive function.

Pregabalin significantly improved the symptoms of GAD in patients aged ≥65 years and caused no impairment of cognitive function. A more extensive cognitive battery is needed to confirm this preliminary finding.

Auditory Processing Disorder (APD) is defined as a disorder in recognition, discrimination, separation, grouping, localisation or ordering of sounds.AP evaluation of children with learning disorders has two goals:1) to rule out an auditory processing disorder (APD) as a contributing factor for impaired cognition and 2) to diagnose APD in children with learning disabilities, in order to ensure appropriate remediation.

46 children were evaluated for Auditory Processing Disorders. 40 of them were fully assessed in 2 sessions each. 6 were lost to follow-up. We applied the: a) Peripheral hearing testing: Otoscopy, PTA, Speech audiometry b) AP battery:, Speech in noise, Duration Pattern Sequence (DPS), Pitch Pattern Sequence (PPS), Random GAP. C) Speech in noise: normative data from our lab. D) DPS,PPS, Random GAP: Standardized tests (Auditec, St. Louis). E) Learning Disability battery: WISC-III, Language tests (phonemic synthesis, non-words).

22 (of 40) 55% are diagnosed with Auditory Processing Disorders (at least 1 of the AP tests is pathological.) All 22 children with APD are already receiving appropriate treatment according to their auditory processing deficits and are being followed up for their progress. APD management strategies include: 1. Signal enhancement strategies 2. Specific Auditory Training 3.Linguistic, cognitive, metacognitive and educational strategies

Identification of underlying specific auditory deficits in the heterogeneous group of LD children may indicate what remedial action is appropriate, since appropriate management of the auditory processing deficits may lead to improved auditory as well as reading skills.

Psoriasis has a significant impact on the mental and emotional functioning.

It has been reported that the risk of psychiatric comorbidity increases with the severity of the disorder, and the most frequent associations appear to be those with depression and anxiety.

To analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. To investigate the differences between psoriasis patients and patients with other dermatologic diseases.

Participants were 242 consecutive patients (142 women and 100 men), 112 patients with psoriasis (46.3%), 77 with melanoma (31.8%) and 53 with allergy (21.0%). All patients were administered a structured sociodemographic interview and the following measures: the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). We also assessed current and previous suicidal ideation and previous suicide attempts.

Patients with psoriasis (compared to other groups of patients) more frequently had a comorbid mood disorder (16.1% vs 3.9% and 0.0%, respectively for patients with melanoma and patients with allergy; χ22 = 14.98; P < 0.001), past suicidal ideation (33.9% vs 15.6% and 18.9%, respectively for patients with melanoma and patients with allergy; χ22 = 2.05; P < 0.01) and attempts (6.3% vs 0.0% and 0.0%, for the other groups of patients; χ22 = 8.37; P < 0.05). Patients with psoriasis reported higher HAM-D scores than melanoma patients.

The clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routinely assessment of suicide risk.

The authors have not supplied their declaration of competing interest.

The relationship between immigration and mental health may in part be affected by factors related to social context in general and in relation to specific ethnic groups in specific social contexts. A growing body of research is exploring the impact of neighborhood context on the well-being of immigrants. The specifics, however, have yet to be identified.

To analyze the impact of social context on stress and acculturative stress in a hospitalised Latin American immigrant sample.

The study was part of a larger project concerning stress, coping, and psychosocial well being in Latin American immigrants hospitalised in both internal medicine and obstetrics in a large public hospital in Barcelona (Spain). 290 participants were evaluated with the PSS-10 for general stress, the BISS for acculturative stress and a sociodemographic questionnaire elaborated ad hoc for social context.

Neighborhood socioeconomic level is related to general stress and acculturative stress. A lower socioeconomic level is associated with higher levels of stress and acculturative stress. High levels of ethnic density of Latin American immigrants is moderately associated with lower levels of homesickenss and intercultural contact stress, but are not related with perceived discrimination.

Social context is an important factor that should be considered in the acculturative process of Latin American immigrants and its impact on their mental health status. A low socioeconomic neighborhood level increases levels of stress and acculturative stress, increasing the risk of psychosocial distress.

Own group ethnic density would appear to function as a protective factor.

Over the last decade a series of guidelines and recommendations have been published in the UK by the Department of Health, the Home Office, Professional and Non-Professional bodies. However, an optimal strategy and consensus in the management and care of opioid dependent pregnant users has yet to be established.

Determination of existing methods for identifying and managing pregnancy in opioid users prescribed methadone by NHS Treatment Services and regional differences.

To survey the management, treatment and follow-up of pregnant opioid users prescribed methadone by Drug Treatment Services in England and Wales.

In 2006 a POSTAL survey was conducted among 223 Community Drug Treatment Services (CDTS).

Sixty-six percent of CDTS responded to the survey (n = 154/233). A Chi-square, Mann_Whitney U Test and/or Kruskal-Wallis analysis revealed significant differences in the composition of CDTS and service provision across regions. Half of CDTS (55.3%) provided a methadone dosage regime lower than that recommended for non-pregnant drug users. There were also significant variations on how professionals approached the management of pregnant opioid users. CDTS with an addiction specialist were significantly more likely (p < .01) to advocate high doses of methadone whereas those with a midwife, obstetrician or social worker involved were more likely (p < .05) to suggest low dose methadone and/or detoxification.

Service provision for pregnant opioid users is comprehensive but there is still variability in some aspects of the treatment received. The way in which methadone is prescribed is not always optimal. Further work is required in this area.

The people who maintain close relationships with relatives suffering from addiction to psychoactive substances may become more sensitive to develop a physical, mental and emotional state, similar to an emotional addiction.

The aim of this study is to give a cross-cultural perspective to codependence and reveal the profile of female relatives of addicted persons in Greece and Bulgaria.

Thirty-nine Greek mothers of addicted persons from Greece (Mage = 43.97, SDage = 18.34, all high school graduates), a similar group of forty Greek female participants (32 mothers of non-addicted persons, Mage = 40.97, SDage = 17.22, all high school graduates), and thirty Bulgarian women (all mothers of addicted persons, Mage = 53.55, SDage = 5.58, all high school graduates) were examined with the STAI-state questionnaire, the ZUNG Self Rating Depression Scale and the Questionnaire of Establishment of Codependency.

Results indicated that there are statistically significant differences between the Greek and the Bulgarian female relatives of addicted persons on the scores ofZUNG (MGreek = 51.64, SDGreek = 2.07, MBulgarian = 73.63, SDBulgarian = 4.04) and STAI (MGreek = 53.89, SDGreek = 2.68, MBulgarian = 74.16, SDBulgarian = 4.84), but not for the Questionnaire of Establishment of Codependency. Statistically significant differences in all three questionnaires were found for the groups of Greek mothers of dependent and non-dependent persons (P < .005).

This research suggests that although there is more anxiety and depression reported by the Bulgarian mothers of addicted persons, no cross-cultural difference was found for codependence in mothers of addicted persons.

The authors have not supplied their declaration of competing interest.

The ageing process is characterized by a high level of complexity, due to theco-occurrence of multiple chronic diseases (comorbidity) that often resultsin the concomitant use of multiple drug therapies (polypharmacy) fortreatment and prophylaxis. Institutionalized elderly may be regarded as theparadigm of this complexity because of their multiple chronic diseases anddecreased functional and cognitive functions.

To explore and characterize the prevalence of comorbidity and polypharmacy ina sample of institutionalized elderly.

A cross-sectional study was conducted with an elderly sample recruited fromthree Portuguese nursing homes. Clinical information was obtained throughinterview and by review of residents’ medical records. The AnatomicalTherapeutic Chemical/ATC classification was used to indicate the main groupof medicines used, and polypharmacy was categorized into minor (2–4medicines) or major (≥ 5). Comorbidities were coded using theindividual body systems of Cumulative Illness Rating Scale forGeriatrics/CIRS-G.

The sample included 175 elderly with a mean age of 81 (sd = 10) years andinstitutionalized for an average of 7 (sd = 11) years. Residents presented amean of 9 (sd = 4) co-morbid medical conditions, mostly psychiatric (80.8%),vascular (76.7%) and endocrine/metabolic (70.3%). Major polypharmacy wasverified for 73.9% of residents. The mean number of medicines was 7 (sd =3), most commonly for cardiovascular (86.0%) and nervous system (79.1%) andfor blood and blood-forming organs (69.2%).

As in other studies in similar settings, polypharmacy was fairly common.These results convey an important message considering that polypharmacy hasbeen associated with negative clinical outcomes that could otherwise bepreventable by reducing the number of prescribed medicines.

The authors have not supplied their declaration of competing interest.

Excessive mind wandering is a common feature of ADHD in adulthood also referred to as mental restlessness and ceaseless mental overactivity. ADHD is a predisposing factor for many psychiatric symptoms, especially negative emotions such as depression and anxiety. Rumination is thought to be a mediator for depression in individuals with ADHD. The above-mentioned mental processes may reduce the ability of individuals with ADHD to be mindful.

This study investigates whether the mentation processes (excessive mind wandering, rumination, mindfulness) mediate the relationship between ADHD symptoms and anxiety, and depression in adults with ADHD.

Medication-free 175 individuals with ADHD who were referred to the Adult Neurodevelopmental Disorders Clinic, Department of Psychiatry, Selçuk University were invited to the study. After initial diagnostic examination including The Structured Clinical Interview for DSM-5 (SCID 5), all participants completed a test battery that included a sociodemographic form, the Adult ADHD Severity Rating Scale, the Hospital Anxiety Depression Scale, the Mind Excessively Wandering Scale, the Ruminative Response Scale, and the Freiburg Mindfulness Inventory. The data of 159 patients whose ADHD diagnosis was confirmed, who did not have any mood episodes and psychotic symptoms at the time of inclusion of the study, and who filled out the forms completely, were included in the analysis. The study was approved by the Selçuk University Local Ethics Committee.

Participants ages ranged from 18 to 39 (mean of 22.93 ± 4.36), and 57.2% (n = 91) were women. Also, their 48.6% (n = 77) reported that they alcohol use, and 21.1% (n = 34) had substance use history. According to SCID 5 interview, participants 64.2% had comorbid psychiatric conditions. Pearson correlation analysis revealed that ADHD symptoms, rumination, excessive mind wandering, anxiety, and depression scores were significantly positively correlated with each other, but all were negatively correlated with mindfulness. Linear regression analysis showed mindfulness association with rumination, excessive mind wandering, anxiety, and depression scores, but not with ADHD symptoms. Thereupon, a conducted mediation regression analysis showed that ADHD symptoms indirectly worsened depression and anxiety through increased rumination and excessive mind wandering, and decreased mindfulness ability (Figure 1).

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Adults with ADHD have distressing mentation patterns which worsened their anxiety and depression. Mindfulness-based cognitive behavioral therapy modalities may help improve excessive mind wandering and rumination in ADHD. Our findings should be warranted in future studies of functional brain connectivity patterns that may serve as a mentation endophenotypes in ADHD.

None Declared

Attention deficit hyperactivity disorder (ADHD) is one of the sensory modulation disorders among others like autism, Asperger syndrome and Fragile X syndrome. Little is known about patients with ADHD and their sensory processing issues in Sri Lanka.

To investigate differences in sensory processing among children between (3–10) yrs with attention deficit hyperactivity disorder and those who are typically developing in Sri Lanka.

A descriptive cross sectional study of 75 children aged (3–10) yrs attending child guidance clinic at Lady Ridgeway Hospital (LRH) were compared with 75 age matched peers who were typically developing, using the Short Sensory Profile (SSP).

Out of the sample population of 150, there was a significant difference in sensory processing total score (P-0.001) (df-29) of children with ADHD when compared to the typically developing group. The greatest differences were reported on the tactile (P-0.013), taste (P-0.000), under responsiveness (P-0.002), auditory filtering (P-0.002) & low energy (P-0.017). Out of the raw items commonest sensory processing problems were difficulty standing in line, distractability if there is a lot of noise around, being unable to work with background noise & difficulty paying attention due to auditory deficits.

Majority of children in this sample were reported to have difficulties with processing and responding to sensory input on the SSP. Further studies are needed to assess sensory issues in children with ADHD, to carry out effective interventions.

The authors have not supplied their declaration of competing interest.