Substance use disorders (SUD) are common in adults with ADHD. A co-occurring ADHD diagnosis is associated with poorer treatment outcomes for both the ADHD and the SUD and higher rates of relapse to substance use.

To explore the relationship between ADHD and SUD longitudinally to identify factors to help improve treatment outcomes.

Prevalence of ADHD symptoms was investigated in a national cohort of SUD patients one year after SUD treatment initiation. Factors at baseline related to ADHD symptoms were explored at follow up.

Five hundred and forty-eight individuals were interviewed in a multi-center study involving 21 treatment facilities at treatment initiation and one year later (n = 261). ADHD symptoms were measured by the Adult ADHD Self Report Scale (ASRS-v.1-1) at follow-up. Individuals who screened positively for ADHD (ADHD + ) were compared to those who screened negatively on baseline variables. Emotional distress was measured by Hopkin's Symptom Check List-25.

At follow-up 35% screened positively for ADHD. In bivariate analysis the ADHD+ group was older, was less likely to have children, reported lower educational level, had more frequent use of stimulants, cannabis and benzodiazepines, and experienced higher degree of emotional stress. When controlling for other significant variables in a logistic regression analysis, the ADHD+ group was associated with more frequent use of cannabis (OR 2.14; CI 1.08–4.23) and of higher psychiatric symptom burden (OR 1.79; CI 1.22–2.61).

A high prevalence of ADHD symptoms and associated challenges underline the importance of systematic screening of individuals entering SUD treatment.

The authors have not supplied their declaration of competing interest.

Study the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).

Case-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.

The beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.

The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.

According to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.

The authors have not supplied their declaration of competing interest.

Smoking is a serious health problem for people with mental illness like the bipolar disorder patients. The developmental of motivational tools such as brief intervention it is necessary in the context of community care.

Evaluating the change in motivational stage after brief intervention and evaluating the clinical and smoking factors in relation with this.

Two hundred and twenty patients diagnosed with bipolar disorder (according DSM-5 criteria) that were in the euthymic phase (defined as less than 7 points in YMRS and 10 points in HDRS) and attended the community care centers of three provinces of Andalusia (Spain). Patients who consumed in the last month qualified for the level of motivation for change (measured by URICA scale).

After brief intervention the 29.3% of the smoking patients change in their motivational stage. The results of the multivariate analysis showed three factors in relation with dificultar the progression of the evolution of motivation to change. The high punctuation in Hamilton anxiety scale (OR = 0.53; IC95%, P = 0.002), the high puntuation in the Fageström scale (OR = 0.56, IC95%, P = 0.01), and have high autoperception of the capacity of change (OR = 0.52; IC95%, P = 0.002).

The anxiety (measure with Hamilton anxiety scale) plus factors in relation with smoking, like the puntuation in Fagestrom scale and the autoperception of the capacity of change decrease the possibilities to change.

The authors have not supplied their declaration of competing interest.

Adults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.

This study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.

A systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.

Many studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.

Although low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.

The authors have not supplied their declaration of competing interest.

Prospective, parallel research was conducted, in which the sample of patients and employees of Specialized Psychiatric Hospital Kotor was tested with Montreal Cognition Scale (MoCA). There were 66 participants in the samples and they were divided on four subgroups: (1) patients with FGA; (2) patients with SGA; (3) patients with combined FGA and SGA; (4) Healthy controls.

All groups of patients had statistically significantly lower mean MoCA scores in the comparison with healthy controls. The fact that among 83.7% of patients was diagnosed significant degree of cognitive decline (MoCA score bellow 26) strongly speaks in favour of high sensitivity of MoCA test in detection of cognitive impairment among patients with schizophrenia spectrum psychotic disorders. In addition, the group of patients with FGA also had statistically significantly lower mean MoCA score compared to patients with SGA.

The mechanisms of explanation of these results can be additionally enlightened with further studies on larger samples of patients, which would investigate the correlation between extrapyramidal symptomatology, anticholinergic therapy and cognitive deficit.

The authors have not supplied their declaration of competing interest.

Research is lacking on possible subtypes of psychosis in difficult-to-treat patients that require long-term institutionalisation due to a combination of psychosis, substance abuse and problem behaviours after multiple failed treatments.

The aim of this study is to increase our knowledge of this group of patients in order to apply more targeted interventions.

To identify subtypes of psychosis among this group by cluster analysis and compare these subtypes on different clinical variables.

PANSS data was acquired for 117 patients. Separate clusters were identified by using Ward's method of hierarchical cluster analysis, replicating Dolffus et al., 1996 [1], who used this method in a cohort of schizophrenia patients. Subtypes of psychosis were identified using PANSS items. Clusters were compared on several clinical variables, f.e. course of admission.

Four distinct clusters were identified (Fig. 1): (1) a ‘positive cluster’, (2) a ‘mild cluster’, (3) a ‘negative cluster’, and (4) a ‘mixed group’. These clusters are similar to those found by Dolffus et al.

There was a significant association between cluster and co-morbid personality disorder, P < 0.05. No significant association was found between clusters and other clinical variables.

Among difficult-to-treat institutionalised patients four distinct subtypes of psychosis could be identified, comparable to those found in a cohort of schizophrenia patients.

The authors have not supplied their declaration of competing interest.

The aim of the present study was to evaluate relationship of severity of ADHD symptoms with the presence of psychological trauma while controlling the effect of impulsivity in a sample of university students.

Participants included 321 volunteered university students. Participants were evaluated with the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Adult ADHD Self-Report Scale (ASRS) and the Traumatic Experiences Checklist (TEC).

Age and gender did not differed between those with the history of psychological trauma (n = 271, 84.4%) and those without (n = 50, 15.6%). BIS-11-SF and subscale scores did not differ between groups, other than motor impulsivity, which was higher among those with the history of psychological trauma. ASRS score, inattentiveness and hyperactivity/impulsivity subscale scores were higher among those with the history of psychological trauma than those without. Severity of ADHD symptoms, particularly inattentiveness score, predicted the presence of psychological trauma, together with the severity of motor and attentional impulsivities in a logistic regression model.

These findings suggest that the severity of ADHD symptoms may be related with the presence of psychological trauma, while severity of motor and attentional impulsivities may have an effect on this relationship among young adults.

The authors have not supplied their declaration of competing interest.

The aim of the present study was to evaluate relationship of high PTSD risk with severity of ADHD symptoms while controlling the effect of impulsivity in a sample of university students.

Participants included 271 volunteered university students. Participants were evaluated with the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Adult ADHD Self-Report Scale (ASRS) and PTSD Checklist Civilian version (PCL-C).

Age and gender did not differed between those with the high PTSD risk (n = 224, 82.7%) and those without (n = 47, 17.3%). BIS-11-SF and subscale scores, other than non-planning impulsivity (which showed no difference), and ASRS scores were higher among those with the high PTSD risk than those without. Severity of ADHD symptoms, particularly inattentiveness (IN) score, predicted the high risk of PTSD, together with the severity of motor impulsivity in a logistic regression model.

These findings suggest that the severity of ADHD symptoms is related with the high risk of PTSD, while severity of motor impulsivity may have an effect on this relationship among young adults.

The authors have not supplied their declaration of competing interest.

Substance use disorders (SUD) with psychiatric co-morbidity (dual diagnosis) represent a challenge for both mental health and addiction networks. Dual patients present greater disorder severity and worse prognosis than those with SUD or psychiatric disorders alone. There is a lack of consensus regarding which treatment model (sequential, parallel or integrated) is the most appropriate for them. Despite integrated treatment is seen as the model of excellence, it is a standard difficult to achieve.

To describe the presence of dual diagnosis and treatment model received in a sample recruited from a drug abuse community center in Barcelona (CAS Barceloneta).

Cross-sectional descriptive analysis of an outpatient center for SUD clinical sample regarding psychiatric co-morbidity (DSM-IV-TR criteria), social-demographic characteristics and treatment model received.

In the moment of this study, a total of 574 SUD patients are attended at CAS Barceloneta. Of them, 300 (52%) present a dual diagnosis, 64% men, mean age = 48 (SD = 11.29). Thirteen percent (n = 40) of dual patients have psychotic disorder (PsyD) diagnosis and their SUD comorbidities are: alcohol-UD (12.5%, n = 5), cocaine-UD (7.5%, n = 3), cannabis-UD (15%, n = 6), opioids-UD (17.5%, n = 7) and multiple SUD (47.5%, n = 19). Half of dual patients with PsyD (n = 20) are attended in parallel in community mental health centers.

Our results suggest there is an important percentage of SUD patients that present psychiatric co-morbidity treated in drug abuse community centers. Parallel treatment is mainly for PsyD patients and sometimes they get lost in the gaps. We would need to develop specific dual programs to give these patients an integrated assistance.

The authors have not supplied their declaration of competing interest.

A rich body of literature dealt with somatic comorbidities of psychiatric illnesses. However, relatively few explored the association of somatic and psychiatric comorbidities with psychiatric treatment success.

Objective of this analysis was to explore chronic somatic and psychiatric comorbidities association with the average number of psychiatric re-hospitalisations annually.

This cross-sectional analysis was done on the baseline data of prospective cohort study “Somatic comorbidities in psychiatric patients” started during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia. We included 798 patients. Outcome was the average number of psychiatric re-hospitalisations annually since the diagnosis. Predictors were number of chronic somatic and psychiatric comorbidities. Covariates that we controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of primary psychiatric illness, CGI–severity at diagnosis, treatment with antidepressants and antipsychotics.

Interaction of somatic and psychiatric comorbidities was the strongest predictor of the average number of psychiatric re-hospitalisations annually (P < 0.001). Mean number of re-hospitalisations annually adjusted for all covariates, was increasing from 0.60 in patients with no chronic comorbidities, up to 1.10 in patients with ≥ 2 somatic and ≥ 2 psychiatric comorbidities.

Somatic and psychiatric comorbidities are independently associated with the psychiatric treatment success. Further studies should look at possible causal pathways between them, and interdisciplinary treatment of psychiatric patients is urgently needed.

The authors have not supplied their declaration of competing interest.

Obsessive Compulsive Personality Disorder (OCPD) is a common, highly co-morbid disorder. Subjected to comparatively little research, OCPD shares aspects of phenomenology and neuropsychology with obsessive-compulsive spectrum disorders and neurodevelopmental disorders such as autism spectrum disorder (ASD). A greater understanding of this interrelationship would provide new insights into its diagnostic classification and generate new research and treatment heuristics.

To investigate the distribution of OCPD traits within a cohort of OCD patients. To evaluate the clinical overlap between traits of OCPD, OCD and ASD, as well as level of insight and treatment resistance.

We interviewed 73 consenting patients from a treatment seeking OCD Specialist Service. We evaluated the severity of OCPD traits (Compulsive Personality Assessment Scale; CPAS), OCD symptoms (Yale–Brown Obsessive Compulsive Scale; Y-BOCS), ASD traits (Adult Autism Spectrum Quotient; AQ) and insight (Brown Assessment of Beliefs Scale; BABS).

Out of 67 patients, 24 (36%) met DSM-IV criteria for OCPD, defined using the CPAS. Using Pearson's test, CPAS scores significantly (P < 0.01) correlated with total AQ and selected AQ domains but not with BABS. Borderline significant correlation was observed with Y-BOCS (P = 0.07). OCPD was not over-represented in a highly resistant OCD subgroup.

Disabling OCPD traits are common in the OCD clinic. They strongly associate with ASD traits, less strongly with OCD severity and do not appear related to poor insight or highly treatment-resistant OCD. The impact of OCPD on OCD treatment outcomes requires further research.

This work did not receive funding from external sources. Over the past few years, Dr. Fineberg has received financial support in various forms from the following: Shire, Otsuka, Lundbeck, Glaxo-SmithKline, Servier, Cephalon, Astra Zeneca, Jazz pharmaceuticals, Bristol Myers Squibb, Novartis, Medical Research Council (UK), National Institute for Health Research (UK), Wellcome Foundation, European College of Neuropsychopharmacology, UK College of Mental Health Pharmacists, British Association for Psychopharmacology, International College of Obsessive-Compulsive Spectrum Disorders, International Society for Behavioural Addiction, World Health Organization, Royal College of Psychiatrists.

Psychiatric comorbidities are shown to be very prevalent in patients diagnosed with Autism Spectrum Disorder (ASD), up high to 53% for mood, 50% anxiety and 43% for ADHD disorders in an European cohort of adults with HFA. Using a new approach, our study proposes to explore aspects of comorbidities in the largest French cohort of HFA adults (C0733/InfoR) by implying qualitative and quantitative clinical tools.

To explore: (1) the prevalence rates of psychiatric comorbidities; (2) the interplay between comorbidities and the ASD symptoms.

Diagnosis was made according to DSM 5 criteria. Dimensional evaluation used Social Responsiveness Scale (SRS), Systemizing Quotient (SQ) and Empathy Quotient (EQ). We used T-test, Mann–Whitney test and linear regression models.

We included 103 patients (mean age 29.3, sex ratio M/F: 3.4:1). Lifetime prevalence rates of 53.5% for depressive disorder 73.5% for anxiety disorders and 37.5% for ADHD were found. Subjects with psychotic co-morbid symptoms had a more severe social deficit (SRS score 66.2 vs 77.9 P < 0.05); patients with ADHD, lower cognition (mean IQ total 107.7 vs 99.0 P < 0.05). SQs (P < 0.05) were significantly higher in patients with co-morbid psychosis, dysthymia, suicide attempts, and depressive disorders and directly correlated with age (β = 0.35, P < 0.05). SQ and EQ were inversely correlated.

The results reproduce the high prevalence of comorbidities in other studies and explore its association with social functioning and cognition. Identification of associated psychiatric conditions in subjects with HFA is therefore a crucial clinical issue potentially guiding the treatment.

The authors have not supplied their declaration of competing interest.

Dual pathology is a term applied to those subjects suffering simultaneously from addiction and other mental disorder. Group psychotherapy can be used in people who have both diagnoses with good results in improvement of addiction and disease stabilization.

The purpose of this study is to analyse to efficacy of a group of psychotherapy for patients with alcohol addiction and other mental disorder, and analyse the presence of personality disorder in this group and how it affects its evolution.

The study was conducted on a sample of 16 patients diagnosed with alcohol abuse or dependence with psychiatric co-morbidity who attended a therapy group for 6 months from January16 to June16. The study was conducted in ambulatory care (outpatient), being an open and heterogeneous group.

Main diagnosis was unspecified personality disorder and mood disorder (25%) followed by borderline personality disorder and mood disorder (18.75%), attention deficit disorder and hyperactivity (18.75%), mood disorder (12.5%), substance use disorder without other psychiatric co-morbidity (12.5%), narcissistic personality disorder (6.25%) and impulse control disorder (6.25%). Regarding progress in the stages of change, results were as follows: 31.5% of patients progressed to the stage of preparation for action, 25% alternating periods of abstinence from alcohol with brief relapse, 25% advanced to the stage of action, 18.5% managed to stay alcohol withdrawn.

In our sample, we can conclude that a therapeutic group including patients at different stages of change and diagnoses is positive. At the end, improvement in mood and anxiety was observed.

The author has not supplied his/her declaration of competing interest.

The association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.

To assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.

PAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).

No statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.

The interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.

The authors have not supplied their declaration of competing interest.

Previous research on the prevalence of medical disorders among adults with dual diagnosis (DD) has been inconclusive.

The purpose of this study was to assess dual diagnosis and medical co-morbidity at the Brief Psychiatric Inpatient Unit of Marqués de Valdecilla Hospital, Santander in the period from January 2014 until March 2015.

Ninety-three patients were admitted at our hospital from December 2014 until March 2015. The simple was analyzed retrospectively. Sixty-two of the patients (66.7%) met criteria for Dual Diagnosis. We collected socio-demographic variables, drug abuse, mental pathology, and treatment received.

The mean age of the sample was 42.95 years (± 14 DS) with a male:female ratio of 1.8:1 (no significant differences by gender). Hypertension was more prevalent among patients without dual pathology (22.5%). Patients with dual diagnosis presented hypertension less likely (6.5%) (P < 0.005). This can be explained by the fact that patients without dual diagnosis had a higher mean age (47 years) than patients with dual diagnosis (42 years). We did not found statistically significant differences between both groups respect to diabetes mellitus, vascular brain disease, HIV and dyslipidemia.

Hypertension was less likely to appear among patients with dual pathology admitted to an ultra brief psychiatry unit. This could be explained for an earlier mean age at admission among these patients.

The authors have not supplied their declaration of competing interest.

Although studies show that those suffering from autism spectrum disorders (ASD) face an increased risk of exposure to trauma (bullying, physical abuse), the co-morbidity between autistic symptoms/traits and post-traumatic stress disorder (PTSD) was almost entirely neglected by researchers. The aim of this preliminary study is to explore the possible associations between these two conditions among typically-developing college students.

Participants were 39 students, recruited from 2 Israeli universities. Twenty-four participants were psychology students, and 15 were business administration students. Participants completed self-report questionnaires tapping sociodemographic background, trauma exposure, PTSD (the PTSD Checklist-5, PCL-5), and autistic traits (the Autism Spectrum Quotient, AQ).

Our preliminary findings revealed a positive association between symptoms of PTSD and autistic traits. More specifically, among those in the 3rd and 4th highest quartiles of AQ scores, 87.5% met the cut-off score for a probable PTSD diagnosis (χ2 (3) = 8.25, P < 0.05). In addition, t-tests comparing the PTSD and non-PTSD groups showed significant differences in 3 out of 5 AQ sub-scales: social skill (t(37) = –2.12; P < 0.05), attention switching (t(37) = −2.09; P < 0.05) and communication (t(37) = −2.80; P < 0.01). Thus, higher AQ scores were reported by those in the PTSD group.

ASD may serve as a significant risk factor for post-traumatic symptomatology. The associations between these two conditions may be mediated by a variety of potential shared vulnerabilities, including increased rumination, dysregulated emotion and impaired social cognition. Further research is needed in order to explore these mechanisms, as well as to assess co-morbidity in clinical samples of both ASD and PTSD.

The authors have not supplied their declaration of competing interest.

Diet and physical activity interventions are effective in psychiatric outpatients that suffer from obesity, namely those treated with antipsychotic drugs. However, there is less evidence related to these interventions in hospitalised acute patients.

To evaluate the effect of a diet and physical activity program on weight and BMI variation in acute psychiatric patients during hospitalisation.

Matched case-control study from January to September 2016. Inclusion criteria: patients with at least 15 days of hospitalisation in an acute psychiatry ward, evaluated by a nutritionist in the admission and medical discharge. The intervention consisted in a diet and physical activity program, with total restriction to visitors to bring food to the patients. Statistical analysis was done with T-student and multiple linear regression taking into account the effect of age, sex, daily dose of antipsychotics, and days of hospitalisation.

Sixty-six patients were studied (34 cases and 32 controls). Groups were statistically similar concerning the average of age, daily dose of antipsychotics, days of hospitalisation and sex. The differences of weight gain during hospitalisation were 0.088 kg (cases) versus 1484 kg (controls), P < 0.05. And the differences of the increased BMI during the hospitalisation were 0.041 kg/m2 (cases) versus 0.509 kg/m2 (controls), P < 0.05.

Obesity presents challenging health problems for individuals with severe mental illness that require inpatient treatment. This study provides evidence that individuals with acute mental illness can benefit from weight control interventions during their hospitalisation, in special a total restriction to visitors to bring food to the patients.

The author has not supplied his/her declaration of competing interest.

The World Psychiatric Association (WPA) is a world-wide association of national psychiatric associations, aiming to increase knowledge and skills necessary for work in the field of mental health and care of the mentally ill. It was suggested that Psychiatry's relationship with society should be seen as a contract [1]. This implicit understanding usually specifies the scope, principles, quality and outcome of this agreement. It also implies a series of reciprocal rights and duties, privileges and obligations, as well as expectations from both sides.

To investigate the extent of existing social contracting of WPA Member Associations (MAs) and WPA structures regarding:

– communities they serve;

– general public;

– medical institutions;

– other practitioner groups in the multidisciplinary team;

– administrations, managers and funders.

Include to describe the current scope of psychiatric practice across WPA regions and the content of existing social contracts.

A mixed–methods, explorative, descriptive, theory generating inquiry, with different phases, including a systematic review of literature and WPA documentation, electronic questionnaires to MAs and focus group discussions with WPA ZS chairs/representatives.

MA profiles and progress indicators were identified and summarised. A transcription of group discussions was made, while pertaining documents, questionnaires and in depth/focus group interview content was analysed.

This presentation will report on progress with this study to date.

The author has not supplied his/her declaration of competing interest.

This study aimed to determine the effect of Electroconvulsive Therapy (ECT) on serum serotonin level of patients with major depressive disorder (MDD).

In this experimental study, 36 patients (age: 20–65 years old) with MDD were allocated to ECT group (n = 21) and non-ECT group (n = 15). Serum serotonin level of the ECT group was measured before ECT, 15 minutes and two, six, and 24 hours after the first session, and 24 hours and 30 days after the last ECT session. Measurements were performed at the time of admission and one month after hospitalisation in the non-ECT group. Data analysed with t-tests, repeated measures analysis of variance by SPSS16.

The mean serotonin levels of the two groups were significantly different 24 hours and 30 days after the last session of ECT (P = 0.048 and P = 0.04, respectively). The difference of mean serotonin levels in the ECT group before & 15 min after ECT (P = 0.044) before & 6 hour after ECT (P = 0.015), before & 24 hour after ECT (P = 0.007), before & 24 hour after last ECT (0.002) was meaningful.

Altogether, our results showed that serum serotonin levels significantly increase following ECT in MDD patients.