The authors have not supplied their declaration of competing interest.

Response styles theory postulates that rumination is a central factor in occurrence, severity and maintaining of depression. High neuroticism has been associated with tendency to ruminate.

To evaluate the relationships between rumination, neuroticism and depression in a naturalistic prospective cohort of primary care patients with depressive disorders with life-chart methodology.

We hypothesized, that rumination would correlate with severity and duration of depression and with concurrent anxiety, gender and neuroticism.

In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II. Of the 137 patients with depressive disorders, 82% completed the five-year follow-up with a graphic life chart. Neuroticism was measured with the Eysenck Personality Inventory (EPI-Q). Response styles were investigated at five years using the Response Styles Questionnaire (RSQ-43).

Rumination correlated significantly with Hamilton Depression Rating Scale (r = 0.54), Beck Depression Inventory (r = 0.61), Beck Anxiety Inventory (r = 0.50), Beck Hopelessness Scale (r = 0.51) and Neuroticism (r = 0.58). Rumination correlated also with proportion of follow-up time spent depressed (r = 0.38). In multivariate regression, high rumination was significantly predicted by current depressive symptoms and neuroticism, but not by anxiety symptoms or preceding duration of depressive episodes.

Rumination correlated with current severity of depression, but the association with preceding episode duration remained uncertain. The association between neuroticism and rumination was strong. The findings are consistent with rumination as a state-related phenomenon, which is also strongly intertwined with traits predisposing to depression.

The authors have not supplied their declaration of competing interest.

Today's, families of individuals with bipolar disorders are actively participating in the care of their relative. Successful management of bipolar disorder in the community relies significantly on family caregivers. The need and experiences of such caregivers have been little studies with respect to bipolar disorder.

The aim of the study was to identify of family caregivers needs of patients with bipolar disorder.

In a qualitative research of phenomenological methodology, the family member’s caregivers of bipolar disorder in farshian psychiatric hospital in Hamedanl were selected by purposive sampling in the year 2010. By reaching data saturation the number of participant was 12. Data were gathered through in-depth interviews and analyzed by “Van manen” method.

Five main themes were identified in this study analysis: educational needs, consult needs, economical needs, care and nursing needs and supports needs.

Identified the need of family member caregiver with bipolar disorder patient for mental health services to be helped and to identify the specific caring interventions that are effective in helping to sustain family caregiving.

Member Advisory board Lundbeck-Belgium.

Received grant from LOTTO- Belgium to conduct behavioural study that will be discussed in presentation

The aim of the present study was to describe the population of juvenile sex offenders in the Canton of Zurich by a retrospective analysis of a consecutive sample of the police and judicial records between 2000 and 2008. Offence characteristics have been studied and compared to demographic and psychopathological factors of the adolescent offenders. Reoffence risk was assessed by the Juvenile Sex Offender Assessment Protocol (J-SOAP-II) and compared to sexual and general recidivism.

A youth-adapted version of the Forensic-Psychiatric Documentation System (FDPS) has been used for data collection. Recidivism has been assessed by the official crime database of the Canton of Zurich until October 2009.

Preliminary results show that the population of juvenile sex offenders is of heterogeneous nature. Intensity of sexual behavior and violence varies significantly in the sample (N = 351). Mostly the juvenile offenders have been arrested after committing one criminal act (56.4%). With exception of pornographic offences (35.9%), sexual coercion (32.8%) and sexual assaults against children (27.4%) were the most frequent crimes. Psychiatric assessments of the most serious juvenile offenders found frequent behavioral (43.6%) and emotional disorders (18.1%) but only one case of paraphilia. Results of risk assessment and recidivism are in preparation and will be added to the final presentation.

Juvenile sex offenders are a complex population and can not been compared to adult offenders according to offence characteristics and crime motivation. Developmental factors have to be included when assessing and treating juvenile sex offenders.

The presence of depressive symptoms impacts negatively the lives of patients suffering from schizophrenia-spectrum disorders. Likewise, the treatment poses many challenges for clinicians.

To specify the profile of elderly with schizophrenia and to evaluate the prevalence of depression and its related factors.

A descriptive and analytic study involved 40 elderly patients aged 65 and over with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed to the outpatient psychiatry department of Hedi Chaker University Hospital, in Sfax, Tunisia, during the two months of September and October 2015. Positive and negative syndrome scale (PANSS) and Calgary depression scales were used to assess respectively the symptoms of schizophrenia dimensionally and depression.

The majority of our patients was male (62.5%), single (55%), with low school and socioeconomic level. The mean duration of disease was 45 ± 6.02 years and patients were mostly (90%) in classical neuroleptics. The scale of PANSS showed the predominance of negative symptoms (67.5% of cases). In addition, according to Calgary scale, depression was found in 25% of patients. Factors positively correlated to depression were: the female sex among single (P = 0.043), absence of family support (P = 0.001), treatment with conventional neuroleptics (P = 0.039) and negative symptoms (P = 0.001).

Depression in patients with schizophrenia is far from exceptional. It is often difficult to diagnose due to the recovery of other symptoms.

The authors have not supplied their declaration of competing interest.

Social anxiety disorder represents a substantial public health problem because is a relative common mental disorder and has a high prevalence and lifelong chronicity. The fact that serotonergic agents is considered to be effective for its treatment suggests that patients may have an abnormal serotonergic neurotransmission. Selective serotonin reuptake inhibitors are effective in the treatment of social anxiety disorder and are currently perceived as the pharmacotherapy of choice.

We investigated the efficacy and tolerability of escitalopram in the treatment of generalised social anxiety disorder.

Patients with generalised social anxiety disorder were randomised to receive placebo (n = 61) or10-20 mg escitalopram (n = 60) in a 12-week, double-blind study. The primary outcome measure was the mean change from baseline to last assessment in the Liebowitz Social Anxiety Scale (LSAS) total score.

The study showed a statistically superior therapeutic effect for escitalopram compared with placebo on the LSAS total score (p = 0.005).There were significantly more responders to treatment for escitalopram than for placebo (68% v. 28%; p < 0.005). The clinical relevance of these findings was supported by significant reduction in the work and social components of the Sheehan Disability Scale and by the good tolerability of escitalopram treatment.

These data suggest that escitalopram was efficacious and well tolerated in the treatment of social anxiety disorder. Further studies are needed on larger groups of patients to certify these results.

Instruments for diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in childhood are well validated and reliable, but psychometric assessment of ADHD in adults remains problematic. To date the Conners Adult ADHD Rating Scales (CAARS) are frequently used in the assessment of ADHD.

The CAARS were translated into German and a series of studies planned to establish psychometric properties of the CAARS-self and -observer rating scales.

To evaluate the German version of the CAARS.

We recruited 847 healthy German subjects and 466 adult ADHD patients to fill out the CAARS-self report and questions on socio-demographic variables. Additionally, 896 CAARS-observer reports were filled out by significant others and clinical experts. Factor analyses were conducted to obtain factor structure and to replicate the structure of the original American-model. Comparisons between patients and controls, and analyses on influences of gender, age, and education level were calculated. Additional analyses established psychometric properties.

Confirmative factor analysis based on the original American-model showed a high model-fit for both the German healthy control and the adult ADHD patient sample. Analyses of normative data showed significant influences of age, gender, and education level on the emerging subscales for the control sample only. Differences on all subscales were highly significant between patients and controls. Test-, test-retest-reliability was very high, and criterion validity could be established with DSM-IV based clinical interviews. Sensitivity and specificity ratings are overall very satisfying.

The German version of the CAARS is a cross-culturally valid instrument for the assessment of adult ADHD.

About a third of patients with schizophrenia have persistent auditory verbal hallucinations resulting in persistent distress, functional disability, and frequent loss of behavioral control.

To estimate the prevalence of persistent auditory hallucinations in a sample of schizophrenic patients, to specify their characteristics and to identify their clinical associated factors.

This was a cross-sectional, descriptive and analytical study carried-on 144 out-patients (101 men and 43 women, mean age 38.24 ± 10.58 years) followed for schizophrenia in the psychiatry department of the university hospital of Monastir. The assessment was consisted by the collect of epidemiological, clinical and therapeutic data and the use of the Hoffman's auditory hallucinations rating scale (AHRS), and the positive and negative symptoms scale (PANSS).

The prevalence of persistent auditory hallucinations (score of the AHRS ≥ 5) was 40.3%. The total mean score on the AHRS was 10.7 ± 7.8 for all patients and 19.4 ± 7.7 for patients with persistent auditory hallucinations. The items of the AHRS with higher sub scores were the number, the influence and the reality of the voices. The clinical associated factors with persistent auditory hallucinations after multivariate analysis were the family history of physical illness, the absence of tobacco consumption, the hallucinatory onset of disorders, the notion of prior hospitalization and continuous course.

Our results support the multidimensional nature of auditory hallucinations and confirm the existence of interindividual differences in these hallucinations. Persistent auditory hallucinations were associated with poor prognosis, requiring more effective therapeutic strategies.

The authors have not supplied their declaration of competing interest.

A challenging medicine dissertation: to design a psychiatric therapeutic community.

A medical student winning a grant addressed to architects and farm laborers aimed to convert a rural area through Social Innovation programmes, a group of young enthusiastic psychiatrists and a donor involved in psychiatric circumstances are the actors of the project for turning a rural building located in the small village of “Villa San Bartolomeo” (Reggio Emilia, Italy) into a psychiatric social-rehabilitation community.

The project started reviewing the literature concerning community-based psychiatry residential facilities. Later, a structured interview has been carried out with the village's inhabitants in order to investigate both their perception of stigma towards mental illness and the perceived needs of their city. The answers have then been used to organize the activities within the psychiatric community, ranging from recreational through sportive until occupational ones, such as farming vegetable gardens, breeding domestic animals, producing handiworks. These labors are intended both to satisfy the village demands and realize a greater integration of the community itself within the surrounding social network.

The therapeutic interventions that are going to be realized within the residential home will be aimed to promote patients’ personal growth and adapting capacity. These interventions are intended to allow the accomplishment of a greater housing independence of the hosts by restructuring their affective, relational and social backgrounds.

This is an ambitious project, started by chance, representing the desire and the hope for curing mental illness by establishing a contact with the natural environment.

The Altai Republic (AR) is the national subject of the Russian Federation where suicidal situation is unfavorable as the death rate from suicide exceeds the national rates by three times. The high level of suicide among adolescents and young people is especially alarming.

To analyze the dynamics of mortality from suicide among adolescents and young people in the AR for the period from 1990 to 2019.

Data on mortality of the population were obtained from the Russian databases of demographic indicators and analyzed in terms standardized per 100,000 population.

The highest mortality rates from suicide are recorded in the 20-24 age group. The suicide rate, compared to 1990, decreased slightly from 82.5 (in 1990) to 79.7 per 100 thousand (in 2019). The dynamics of mortality from suicide among adolescents aged 15-19 is also unstable. When comparing the indicators in 1990 and in 2019, one can verify the negative dynamics in the form of a 4-fold increase in the suicide rate – from 14.4 (in 1990) to 58 (in 2019). An analysis of the ethnicity of young people who committed complete suicide showed that the majority of suicides (90%) were indigenous Altaians.

In adolescents and young people of the AR, the death rate from suicide exceeds the all-Russian indicators from 7.9 to 9.3 times. Effective preventive measures are needed to improve the situation.

No significant relationships.

Neuropsychological deficits represent a core feature of schizophrenia that has been repeatedly associated with poor symptomatic outcomes. In recent years, there has been increased interest in higher-order cognitive biases (e.g. jumping-to-conclusions, liberal acceptance) as mediators of clinical symptoms, especially delusions, in patients with schizophrenia. So far, the impact of such cognitive biases on the symptomatic outcomes of the disorder has not been investigated.

The present study aimed to assess the contribution of cognitive biases and other well established factors, including severity of psychopathology and neuropsychological deficits, on symptomatic outcomes after an index hospitalization in patients with schizophrenia.

Participants were 160 inpatients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder, recruited from the inpatient units of two University hospitals (Hamburg and Heidelberg). Key exclusion criteria were current substance dependence, severe brain damage, and IQ < 70. Patients were assessed at baseline on measures of psychopathology and severity of illness (PANSS, duration of illness, number of hospitalizations prior to the index admission), cognitive biases (e.g., jumping-to-conclusions, overconfidence for memory errors), as well as attention and verbal memory. At six months after admission, patients were divided into a good- and a poor-outcome group based on their PANSS scores.

Good- and poor-outcome patients were compared on severity of psychopathology at admission, cognitive biases, and neuropsychological performance, by means of a multiple analysis of covariance, with age, gender, and premorbid IQ serving as covariates. Results will be discussed.

Psychoform and somatoform dissociation in anorexia nervosa (AN) and bulimia nervosa (BN) is yet to be studied in Portugal.

Explore the severity of psychoform and somatoform dissociation in ED; explore the differences between ED and other psychiatric disorders (PD), and between AN and BN.

From two psychiatric clinics, 29 women with ED (AN = 16; BN = 13) and 35 women with different PD (posttraumatic stress = 9; panic = 4; major depression = 4; obsessive-compulsive = 8, social phobia = 10), matched sociodemographicaly (mean age = 26.69 ± 7.31), were voluntarily assessed with the Dissociative Experiences Scale (DES), and the Somatoform Dissociation Questionnaire (SDQ-20).

ED patients had higher scores on DES (M ± SD= 28.10 ±19.76, p < 0.05) and on SDQ-20 (M ± SD= 38.41 ±13.19, p < 0.05) than PD patients (DES: M ± SD= 19.27 ±12.84; SDQ: M ± SD= 38.41 ±13.19). Comparing with PD, BN had higher scores on DES (M ± SD= 31.13 ±21.25, p < 0.05), and on SDQ-20 (M ± SD= 42.45 ±17.36, p < 0.01). Finally, there were no differences between AN (DES: M ± SD= 25.65 ±18.80; SDQ-20: M ± SD= 35.63 ±8.98) and BN (p = 0.01).

Our findings point out to the need to of watchfully assessing ED for dissociative symptoms and, accordingly, include the treatment of dissociation.

The reclassification of PG as an addictive disorder is under debate for ICD-11. Data on psychiatric comorbidity and family history might provide the basis for a well-informed decision.

We compared 515 male pathological gamblers from inpatient treatment units with 269 matched controls. Patients were diagnosed by experienced clinicians. In a random sample of 58 patients clinical diagnoses were validated through SKID 1 interviews [1].

88% had a comorbid diagnosis of substance dependence (nicotine dependence 80%, alcohol dependence 28%). Only 1% of the gamblers had an impulse control disorder diagnosis. Compared with controls first degree relatives were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), PG (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%).

In addition to recent papers on the neurobiology (Fauth-Bühler et al., 2016) and genetics of gambling [2,3], our findings support the classification of PG as behavioural addiction in the ICD-11 [4].

The authors have not supplied their declaration of competing interest.

The association between economic crises and mental health problems can be attributed to a number of factors. Among these, age seems to be an important determinant.

The aim of this study was to assess whether mental health of the Portuguese population following the onset of the 2008 recession, differs by age groups.

A follow-up study (2015) on the population aged 18 to > 65 years old, using the National Mental Health Survey (n = 911). The age-group prevalence of mental health distress assessed by the ten-item Kessler's Psychological Distress Scale (K10) was calculated using Chi2 statistics and mental distress as a categorical variable (P < 0.05).

Mean mental distress score differed significantly according to age group, χ2(3) = 10.684, P < = 0.05. The results showed that the older groups (50–64 and 65 = years old) were more frequently under mental distress (17–19%) compared to younger people (18–49 = years old), which were less likely to report being distressed (8–12%).

Age seems to be an important determinant of distress levels during the economic crisis in Portugal. Older adults reported to be more distressed compared to younger individuals. There are several hypotheses for a differential expression of psychological distress between age groups such as working status and retirement, which can express differential access to coping resources under such contextual negative pressure of economic recession. Further research on age groups is thus needed to better understand how recession generates adverse effects on mental well-being.

The authors have not supplied their declaration of competing interest.

The Positive and Negative Syndrome Scale (PANSS) evaluates different psychopathological aspects of schizophrenic patients. Scores on the negative subscale of the PANSS have been associated with clinical and neuropsychological differences in these patients. Our aim was to study the relationship between PANSS negative scores and different clinical and neuropsychological variables in a sample of schizophrenic patients.

Our sample of 174 schizophrenic patients was split into two groups according to scores on the negative subscale of the PANSS: a group of 85 patients (55 male and 30 female; mean age 38.0 years, SD 9.3) with scores below the median (“low negative PANSS” group), and a group of 89 patients (58 male and 31 female; mean age 37.3, SD 8.4) with scores above the median (“high negative PANSS” group). The neuropsychological task used was the Wisconsin Card Sorting Test.

Significant clinical differences were found between both groups. In the “high negative PANSS” group a lower age of illness onset was found (p=0.030), as well as a lower age at first psychiatric admission (p=0.002) compared to the “low negative PANSS” group, without there being significant differences in current age (p=0.570). Regarding cognitive functions, “high negative PANSS” patients achieved fewer categories (p=0.005) and made more perseverative errors (p=0.031) than “low negative PANSS” patients.

Schizophrenic patients with higher scores on the negative subscale of the PANSS had an earlier age of onset of their illness and exhibited poorer cognitive functioning than patients with lower scores.