Affective temperaments profoundly determine emotional reactivity and are the main precursors of major affective disorders. Having strong genetic and biological basis, they are relatively stable throughout life. Given the strong and multidimensional relationship between affective and cardiovascular disorders, temperaments may be effective predictors of future cardiovascular risks and events.

The assessment of affective temperament profile of hypertensive patients.

Explore affective temperaments, anxiety and depression in a hypertensive population in primary care settings.

214 consecutive hypertensive and 90 control subjects completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoqestionnaire (TEMPS-A), Hamilton Anxiety Scale (HAM-A) and Beck Depression Inventory (BDI). for comparisons, Mann-Whitney U test was applied.

Hypertensive patients scored significantly higher in both BDI (U = 6854; p = 0,002) and HAM-A (U = 6543; p = 0,004). Hypertensives also had significantly higher (U = 8214; p = 0,029) irritable temperament scores, while there was no significant difference in case of the other temperaments. Controlling for diagnosed depression rendered the effect of irritable temperament on hypertensives only marginally significant (U = 5836; p = 0,053).

Our results suggest that BDI and HAM-A could be effectively used in primary care for screening patients with high cardiovascular risk. the more marked presence of the irritable temperament in the hypertensive group reveals new information, since it may mediate susceptibility to behavioural risk factors and reaction to stressful life events known to play a role in cardiovascular risk. Exploration the relationship between irritable temperament and Type A behaviour needs further studies.

Work-related musculoskeletal disorders (WMSDs) are multifactorial in nature and the environment, work organization and work activity the most significant factors to their etiology. WMSDs appear in a wide range of professions, such as those involving work with repetitive movements or large postural immobilization. They presently represent an increasing concern, largely due to their association with seeking medical help, disability and absenteeism from work.

To study the work conditions and mental health involvement in WMSDs and psychiatric morbidity.

Cross sectional, correlational. the target population consists of workers in different sectors of a company that manufactures car components. the instruments of measure were the Work-related Musculoskeletal Disorder (WMSDs) Screening Scale and the Mental Health Screening Scale (ER-80), both adapted to the Portuguese population.

170 workers participated in the study. of these, 77.1% had some type of musculoskeletal disorders (MSD)-related complaints by repeated stress. the intensity of the complaints is related to neither age nor the number of years of work, but those who work shifts appear to suffer more from WMSDs than workers with regular hours. There is a statistically significant correlation between MSDs and the presence of psychiatric morbidity, which is greater in subjects with higher psychiatric morbidity.

The Delusional Misidentification Syndromes (MDS) are a group of monothematic delusions where the process of misidentification affects selectively people, objects and places. Their common denominator is a disturbance of the identification of the object, final stage of the mechanism of perception.

From the context of DMS, and specifically of the personal identification delusions (PID) whose main characteristics are recalled, the objective is here to study the basic elements of the concept of identity.

Two main basis for self-recognition are detailed: the body and the subject's name. the body is the privileged place where the identity of the subject appears in its singularity. Merleau-Ponty regarded it as the stable structure of existence, “place of appropriation of the world”, allowing the existence of objects. It appears in two ways as a support of the identity, while linking it on one hand to the subject about who feels it like its own, and on the other hand to others who recognize it as the one of the subject. the name acts as a “classifier of lineage” according to Levi-Strauss, by locating the subject and its family from the rest of the social group. It enrolls the individual in a temporality punctuated by the difference between generations.

The feeling of identity appears as an inner certitude which impregnates all experience. Mental illness can question it, like delusions centered on identity by referring to the fundamental question of the origin.

To describe influence of the associated venous and arterial cavernous brain angioma malformation in the right frontal brain lobe on the patients’ mental and psychiatric conditions.

A case report of 40 years old married, male merchant, has no children, who suffered from psychomotor epilepsy, headache, depressiveness, and suicidal attempts.

Authors described mental and behavioral changes and disturbances at a patient to whom associated venous and arterial cavernous angioma in frontal right brain lobe objectified with Magnetic Resonance imaging (MRI). Patient suffered from 1999 year because of depressive episodes with suicidal tendencies, headaches, temporary expressed psychomotor disturbances, cognitive impairments, transitory brain edemas, right pupil dilatation, and partial epileptic seizures. During this period he was hospitalized 13 times because of critical worsening of mental health conditions. in his family anamnesis he denies psychiatric illnesses. with application of psychopharmacology medicaments (anti edema, SSRI antidepressants, antiepileptic, antipsychotic and tranquilizer) he recovered temporary. During outpatient treatment he is working, he is functional temporary, but despite pharmacotherapy he relapses again and again. Neurosurgeons’ findings addressed operability with high vital risk, and neurosurgeons in Bosnia and Herzegovina and in Croatia are not ready to accept this risk.

Because of high vital risk for successful neurosurgeon operation of vascular malformation it is impossible eliminate organic cause of mental health problems of this patient. the question of establishing causal diagnoses of mental health problems is of high importance along with the question of therapeutic and prognostic success.

Attentional bias is an important psychological mechanism that has been extensively explored within the anxiety literature and more recently in chronic pain. Cognitive behavioural models of chronic fatigue syndrome (CFS) and chronic pain suggest an overlap in the mechanisms of these two conditions. the current study investigated attentional bias towards health-threat stimuli in individuals with CFS, compared to healthy controls. the study also examined whether individuals with CFS have impaired executive attention, and how it was related to attentional bias.

Two participant groups, CFS (n = 27) and healthy control (n = 35), completed a Visual Probe Task measuring attentional bias towards health-threat stimuli (words and pictures) presented at 500ms and 1250ms, and an Attention Network Test measuring alerting, orienting and executive attention. Participants also completed a series of standard self-report measures.

When compared to the control group, the CFS group showed greater attentional bias towards threat-words, but not pictures, regardless of stimulus duration. This was not related to anxiety or depression. the CFS group was also significantly impaired on executive attention compared to the controls. Post-hoc analyses indicated that only CFS individuals with poor executive attention showed a threat-word bias when compared to controls and CFS individuals with good executive attention.

The findings from this study suggest that CFS individuals show enhanced attentional biases for health-threat stimuli, which may contribute to the perpetuation of the condition. Moreover, the attentional biases in CFS are dependent on an individual's capacity to voluntarily control their attention.

Anxiety and depressive disorders may provoke its appearance and also lead to recurrence of psychosomatic diseases (PSD).

In 956 young people with psychosomatic diseases (bronchial asthma (BA), with peptic ulcer of the stomach and duodenum (PU) and arterial hypertension (AH)) investigated the clinical features of the structure and formation of emotional disorders in young persons with psychosomatic diseases.

pathogenetically substantiated system of forecasting and theirpsychological adjustment and medical and psychological rehabilitation of these patients, based on a systematic approach to evaluating the clinical features of the structure and formation of emotional disorders in young persons with psychosomatic illnesses.

Clinical-psychopathological, psychodiagnostical.

In the clinical structure of emotional disorders (ED) dominated depressive disorders (43,4 ± 2,2%) and anxiety disorders (25,1 ± 1,2%). in patients with asthma significantly more frequently met panic disorder, agoraphobia, isolated phobia in patients with hypertension in many cases found generalized anxiety disorder (p < 0,01). Identified pathogenetically significant clinical, biological, psychological and psychosocial factors in the development of ED in young people with PSD. Pathogenetic role of psychological characteristics in the development of EP in patients with PSD determined by a combination of psychological traits: aleksytymia, low productivity of psychological defense, low predictive ability, high levels of aggression and hostility (p < 0,05).

Developed and implemented in practice the system of psychotherapy and medical and social rehabilitation of patients with PSD, which confirmed the effectiveness of data of observation after 12 month.

The issue of quality of life (QOL) has received increased attention from the medical community due to its importance for patient rehabilitation. Measurement of QOL can be a comprehensive means of evaluating various aspects of care but research is still needed in terms of psychiatric patients.

To compare the self evaluation of QOL and well being in patients with a psychiatric disorder.

To reveille the significant gender differences in QOL and well being.

222 inpatients in a psychiatric department in Athens-Greece took part in the study 1 day before they left the department.134 of them were males and 88 females. the questionnaires that were used are the Short Form health questionnaire (12 questions; SF12) and the subjective well being scale (SWBC). Independent sample t test were performed with SPSS16.

Women had a significantly higher mean score (MWB = 14.9 ± 6.6) in well being (T = -2.604 p < .05) and mental composite score (MCS) (MMCS = 32.8 ± 9.4) (T = -2.760 p < .05) than men (MWB =14.9 ± 6.6) and (MMCS = 29.7 ± 6.6). Men on the other hand, had a significantly better physical component score (PCS) (M = 44.1± 8.1) (T = 3.298p = .001) than women (M = 40.2 ± 7.7).

Analysis shows that gender is a significant factor that affects the self evaluation of quality of life and well being among patients with psychiatric disorders. More research is needed in order to find out significant differences between different diagnoses of DSM and gender.

Fatigue is of great clinical and investigational importance. It is a prevalent symptom in general population and a central symptom in many diseases, for example, cancer, ischaemic heart disease and depression. Besides, it's a side effect of many medical treatments. Fatigue has been shown to have a substantial impact on patients’ self care activities and, overall quality of life.

To compare levels of the various aspects of fatigue in three different populations.

To see if diagnosis is a significant predictor for fatigue.

We conducted a survey in a random sample of 69 patients with diabetes Mellitus (DM), 114 psychiatric outpatients (PO) and 383 healthy adults (C), using the Multidimensional Fatigue Inventory (MFI-20). ANOVA test was used to reveille the statistical significance between the groups in all levels of fatigue.

The control group had a significant difference to the PO and DM patients in physical fatigue (MDPO = -3.835 p < .001), (MDDM. = -2.745p< .001), in reduced activity (MD PO = -3.719 p < .001), (MDDM = -3.155 p < .001) and reduced motivation (MDPO = -3.569 p < .001), (MDDM = -2.349 p < .001). Psychiatric outpatients had a significant difference with DM patients and control in general fatigue (MDC = -4.135 p< .001), (MDDM. = -3.835 p < .001) and in mental fatigue (MDC = 4.638 p < .001), (MDDM. = 4.346 p < .001).

Analysis shows that both psychiatric outpatients and patients with DM experience fatigue in all aspects of the measurement as expected, in a statistical significant level compared to the general population.

To investigate an effect of personality disorders dynamics on manifestation, clinical presentation and disease course of cardiovascular diseases (CVD). Materials and methods 307 inpatients (192 female, 115 male; mean age 58,3 ± 4,2 years) with Arterial Hypertension (AH), Coronary Artery Disease (CAD) and Atrial Fibrillation (AF) were examined. Main methods were clinico-psychopathological (including catamnesis data), pathopsychological and clinico-instrumental.

Two groups of patients were defined. in the first group (191 patients, 66,5% female, mean age 57,4 ± 2,1 years; mean CVD duration 9,4 ± 3,1 years) clinical course of CVD is subjected to the dynamics of personality disorder. Psychosomatic (synergistic) type of clinical course of CVD is characterized by reactive somatopsychic lability, CVD manifestation at the time of stressful situation, CVD symptoms redoubling carried out by somatoform disorders. CVD exacerbations correlate with psychogenic depressive phases andor climacterial period with involutional hysteria. in most cases (73,8%) further CVD dynamics is characterized by hypochondriacal personality development. in the second group (116 patients, 69% female, mean age 58,4 ± 1,5 years; mean CVD duration 9,1 ± 2,3 years) clinical course of CVD doesn’t correlate with dynamics of personality disorder. Alternating type of clinical course of CVD is characterized by hereditary and somatogenic factors.

Our findings allow to explain contradictory results received in studies of reciprocal influence of personality disorders and CVD. Obtained data is of great practical importance and show the necessity of differentiated approach in complex (somato- and psychotropic) treatment of CVD.

The objective of this study was to assess the nonpsychotic psychiatric disorders of stoma patients in Iran.

In this cross-sectional study, patients referred to the Iranian Ostomy Association from 2005 to 2006 filled the 28-item General Health Questionnaire (GHQ) in Farsi as a screening instrument to identify cases of nonpsychotic psychiatric morbidity.

A total of 155 patients participated in the study, of whom 79 (51%) were female and 76 (49%) were male. Fifty-five percent of the patients (n = 86) had psychiatric problems. the females' mean GHQ score was significantly higher than that of males (P = .001). Psychiatric disorder was significantly more frequent among patients with the following specifications: educational level of high school or lower (P = .001), mucosal hemorrhage of the ostomy (P = .03), stomal stenosis (P = .012), and history of psychiatric drug consumption (P = .000). GHQ score decreased as stoma age increased (P = .032; r = -.177).

Similar to other complications, psychiatric problems are prevalent in Iranian stoma patients. Our findings highlight the need for special support.

From Hippocrates to Freud and not forgetting Charcot and Janet, psychogenic disorders have intrigued generations of neurologists and psychiatrists.

The authors' aim is to present a clinical vignette of a 44-year-old female who suffered from a neurologic disorder with a psychogenic origin. A literature review about the diagnosis and management of psychogenic neurologic disorders was also made.

A 44-year-old female presented to the hospital complaining of increasingly frequent tremor of the upper limbs over the past month and pronounced weight loss (19 pounds in 3 months). She was discharged with a prescription of sertraline and oxazepam. One month later, she reported worsening of the symptoms, with tremor of upper limbs, chest and head and she was hospitalized to undergo a diagnostic workup.

Diagnostic testing included: brain cranial tomography and magnetic resonance imaging which were normal; laboratory tests with thyroid function, electroencephalogram, syphilis detection test and examinations of serum and urine, also normal. Neurologic examination was normal.

During the hospitalization, inconsistent characteristics of the symptom were found. the patient exhibited depressed mood and she stated that her symptoms had begun after the death of her mother, with whom she lived. the patient accepted psychiatric referral and the symptoms improved after she started psychiatric treatment.

Despite their psychogenic basis, neurologic disorders are generally truly disabling. the diagnosis and treatment of neurologic disorders of psychogenic origin are still a challenge in clinical practice, nowadays.

Although fundamentally a psychiatric disorder, factitious disorder challenges physicians of any specialty as it might simulate a wide variety of medical conditions. Insulin or sulfonylurea-induced hypoglycemia, in particular, might mimic insulinoma.

To examine the risk factors, to highlight the diagnostic difficulties and to discuss the management options for factitious hypoglycemia.

A case report.

A twenty-nine-year-old was admitted at the endocrinology department for recurrent episodes of “spontaneous” hypoglycemia resulting in several seizures and even in a deep coma state. Investigations concluded that the patient had factitious hypoglycemia due to surreptitious insulin and glibenclamide use. She was referred to the psychiatric outpatient clinic for examination and management. Psychiatric interview found no associated axis I disorder. Treatment included olanzapine along with psychotherapy.

Diagnosis of factitious hypoglycemia is often a daunting task, management remains difficult and long-term prognosis is unpredictable. Close cooperation between endocrinologists and psychiatrists can further clarify the diagnosis and help optimize the treatment.

Dr. Jules Cotard (1840–1889) was a Parisian neurologist who first described the délire des négations. Cotard's syndrome or Cotard's delusion comprises any one of a series of delusions ranging from the fixed and unshakable belief that one has lost organs, blood, or body parts to believing that one has lost one's soul or is dead. in its most profound form, the delusion takes the form of a professed belief that one does not exist. Nihilistic delusions were described by Cotard to refer to a special type of hypochondriacal delusion associated to melancholia. Although Cotard himself and other XIX and XX centuries' psychiatrists have considered it from different approaches a specific clinical entity, most of the authors estimate that nihilistic delusion is either a syndrome or a symptom which can appear in different psychiatric disorders.

To describe a case study of a patient diagnosed with Cotard's Syndrome and make a revision of the literature.

Search in the PubMed/MedLine and Medscape databases with the following key words: Cotard; depression; delusion; nihilism.

The same symptoms still persist and are shown the same way in our clinical practice as they were in the remote Cotard's times.

Mother-child interaction has been extensively examined by empirical and theoretical studies. Nonetheless, there is a dearth of data concerning the relationship between mothers and children with chronic conditions.

To test the hypothesis that the chronicity of the illness would have an adverse effect on the mother-child relationship for the asthmatic and chronic heart disease groups compared to the healthy children.

A factorial design was used, with three levels of child health status (asthmatic, congenital heart disease and healthy) and a sequence of three interaction episodes as the within-group factor (mother-child-1, stranger-child, and mother-child-2).The coding procedure used was the Response Class Matrix. It has been used extensively in the study of mother-child interaction

There were significant differences in the mutual interaction between mothers and the asthmatic child compared to the heart disease and healthy groups. Mothers of the asthmatic group were significantly more directive of their child in play compared to the other groups. There were no differences among the three groups of children when interacting with the stranger.

The findings suggest that there are specific dynamics associated with asthmatic child-mother dyads.

This research is justified by the need to provide scientific input to the development of interventions that can promote mental health in work places. There are few studies about assessment interventions in this area and rare are those using a Yoga intervention plan.

The objective of this research is to promote mental health in work places.

evaluation research design with a baseline pre-intervention compared with those measures obtained at the end of the intervention (pre-and post-test), using the coping style as a health indicator. the participants were 18 workers in two organizations, one of them fits in the educational services and the other in food services. Instruments: a) Coping Responses Inventory at Work, b) Yoga Intervention.

in general coping strategies increased and decreased the avoidance of stress. Mainly, Evasive rationalization decreased (p = 0.001) and increased Compensatory alternatives (p = 0.006) in the educational services. in the second organization changes occurred significantly in the Positive evaluation of stressful events (p = 0.001) and Search Support scores (p = 0.010) of workers. in addition strategies for coping with stress (17%) as well as avoidance strategies (14%) increased in this organization. in the qualitative aspect, the educational organization showed stressful situations as opposed to the greater flexibility of the second organization.

there was a change in health indicators after the Yoga intervention in both organizations. the results, although limited to a small sample, encourage further research with Yoga in promoting mental health in work places.

There is a lack of studies presenting the assessment of a health intervention plan with mental health students. Literature indicates that yoga benefits to cope with stress. the Yoga formed the basis of an intervention plan developed with mental health students.

To identify the relationship between the yoga practice and the coping style and the quality of life (QL).

To test the hypothesis that the Yoga practitioner would show an increase in coping strategies and a highest measure in QL at the end of the program.

It was used a base line and repeated measures. Participants were 22 mental health students (mainly medical and psychology students) enrolled in a university program. Measures: a) A questionnaire to identify the participants' health status and their quality of life; b) the Coping Responses Inventory (CRI) to identify coping styles; c) Yoga Intervention (YI) developed twice a week, lasting one hour during two months at the students' place. Results indicated the positive impact of YI over the students' health. in general coping strategies increased (35.63%) and decreased the avoidance of stress (20.46%). There was a significant difference (p = 0.007) in the degree of health status experienced by students at the end of the program. the QL measure also showed an important difference (p = 0.065). in addition participants reported the importance of the Yoga in their lives, including better school performance.

The results support the hypothesis of this study and encourage YI for promoting quality of life.

An insulinoma is a neuroendocrine tumor derived from pancreatic islet cells responsible for the secretion of exaggerated amounts of insulin. Consequently, they induce recurrent states of hypoglicemia and manifest clinically with a wide range of symptoms including confusion, behavioral disturbances and impaired consciousness.

To report a case of a patient with an insulinoma presenting with neuropsychiatric symptoms.

To highlight the diagnostic difficulties of medical or surgical disorders presenting with clinical features overlapping psychiatric syndromes.

Review of the scientific literature and the patient's clinical notes.

A 68-year old male, with a previous history of depressive episode, was admitted to the psychiatric ward following behavioral disturbances and neuropsychiatric symptoms with the provisional diagnosis of “depressive episode with hypochondriac features”. Despite some overall improvement with antidepressants and antipsychotics, unremitting episodes of weakness, sweating, tachycardia, palpitations associated with hypoglicemia were apparent. Complementary workup disclosed hyperinsulinism and a pancreatic insulinoma. Following surgical ablation of the tumor, the patient improved dramatically from the neuropsychiatric symptoms.

Neuropsychiatric symptoms are a common clinical presentation of an insulinoma. A high level of clinical expertise is crucial to avoid that patients are misdiagnosed with psychiatric illnesses before insulinoma is recognized.

Diabetes Mellitus is one of the common chronic illnesses, which endanger patient's mental health.

We think there is a meaningful relationship between Diabetes and occurring the Mental diseases.

The present study was planned to assess the relationship between diabetic patients' mental health and coping strategies.

In this cross-sectional study 193 patients who were referred to diabetes clinic of Imam Khomeini hospital of Ardabil city in north western part of Iran were selected by available sampling method and assessed by GHQ-28 and Folkman-Lazarus questionnaires. Data were analyze by SPSS version 13 software ,using logistic regression analysis and independent t tests.

Results showed that 54% of diabetic patients are suspected to have a mental disorder and need more diagnostic assessments .Escape-avoidance (P < 0.001), confronting (P < 0.001) and plan-full problem solving coping strategies could predict the mental health in diabetic patients.

Inappropriate and emotion-based coping strategies against medical illnesses-such as escape-avoidance method as a predictor of diabetic patients' mental health-throw patients in vicious cycle of medical and mental illness.