Chronic social isolation in the elderly may be related with diverse psychiatric disorders: chronic depressive episode, paranoia-type personality, and late non-schizophrenic psychosis.

In order to separate psychotic depression and non-schizophrenic psychosis with depressive mood, there is a need for more clearly defined criteria.

We report the case of a 68 yrs. women living alone at home for more than twenty years, with a complete social isolation for two years. This behaviour was found associated with severe delusion: she unreasonably felt persecuted by her flat's owner and she dissimulated an extensive basocellular carcinoma on her face threatening her life. A history of a short depressive episode at the time of her divorce was only found, as she demonstrated at initial assessment many paranoia personality traits. A review of literature on this disorders’ association was therefore undertaken.

Evolution after admission revealed the lack of effectiveness of antipsychotic treatment on delusion, but some efficiency of antidepressant. Nevertheless, personality traits remained unaffected by care. Literature on the association between mood disorders and non-schizophrenic psychosis is rare, and we suggest some criteria that may account for psychotic depression and be useful to treatment choice.

In the absence of a history of chronic mood or psychotic disorder, it is hypothesised that paranoia symptoms may account more for a psychotic depression than for late paranoid schizophrenia. This may have consequences for therapeutic strategy.

Severe depression after mid-life has significant clinical, cognitive or functional consequences. These related dimensions may have a different evolution under treatment, and their assessment may be useful to evaluate treatment efficiency.

To measure differential treatment effect on clinical, cognitive and functional dimensions in elderly severe depression.

The relation between these three dimensions has been examined from the inclusion through six weeks of treatment

Three different treatment (antidepressant, ECT and rTMS) were proposed to ten patients aged more than 60. The clinical, cognitive and functional dimensions were compared at inclusion and J42, and their evolution was also measured. At the end, we tried to assess trends for difference between the three types of treatment. Three types of evaluation were performed: clinical (depression, anxiety and apathy), neuropsychological (memory, attentional and executive functioning) and functional (activities of daily life, autonomy).

This preliminary study put in evidence a common pre-treatment profile of depressive symptoms (mood disorder), cognitive (executive difficulties) and functional (loss of autonomy, physical problems) abilities. Clinical improvement was associated with similar cognitive and functional progression, whatever therapeutic method was proposed.

Repetitive evaluation of symptomatology, cognitive performance and everyday life functioning seems to have a major importance in post midlife depressive episodes. It might be useful to determine if non-pharmacological treatment may result in a different evolution of these dimensions.

Tam et al. (2011)[1] recently reported the invariance of the one-factor model of the Chinese version of the Somatosensory Amplification Scale (ChSAS). The objective of this paper is to further examine the item-level equivalence of the ChSAS in a sample of Chinese adolescents across grade levels.

The ChSAS was administered to 500 Chinese adolescents. Differential item functioning (DIF) analysis was performed to identify any uniform and non-uniform differences on the 10 ChSAS items among adolescents across different grade levels.

After a Bonferroni adjustment of p value (=0.0007, i.e., 0.05/70), results of DIF analyses showed that there is no uniform (all Fs ranging from 0.17–2.15, ps > 0.09) or non-uniform (all Fs ranging from 0.47–1.76, ps > 0.02) difference on the 10 ChSAS items.

The four different grade level groups used the scale comparably, without showing any difference on item properties. These findings further substantiate the use of ChSAS as a valid and reliable instrument among adolescents across grade levels.

There is a dearth of literature on the effect of alexithymia on somatizing depression. Yet, the symptom manifestation of depression among people with alexithymia has not been well-investigated. The objective of this study was to examine symptom presentation in adolescents having high (HDA) or low (LDA) degrees of alexithymia.

A total of 590 adolescents aged 11–18 years participated in this school-based study. of 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15), 136 participants were selected and identified as either having HDA (n = 100) or LDA (n = 36). Confirmatory factor analyses (CFAs) tested the fit of a correlated two-factor structure (somatic and affective symptoms of CES-D) to the data. HDA adolescents were compared to those with LDA on somatic and affective symptoms of depression, negative affect and somatization symptoms.

Results of CFAs confirmed the two-factor model in HDA (CFI = 0.863) and LDA (CFI = 0.874) adolescents. HDA adolescents reported more somatic symptoms of depression (t = −2.97, p = 0.004) and negative affect (t = −3.53, p = 0.001) compared with LDA adolescents. No significant difference was observed between HDA and LDA adolescents on affective symptoms of depression and somatization symptoms (p > 0.05).

Our findings underscore that (1) HDA adolescents reported affective symptoms of depression in a similar manner to LDA adolescents, and (2) though the tendency toward reporting somatic symptom of depression is evident, HDA adolescents did not report significantly more somatization symptoms. These findings refute the notion that patients with alexithymia articulate their emotional and psychological distress primarily through physical symptomatology.

Research consistently has evidenced the association among alexithymia, somatosensory amplification (SA) and functional somatic symptoms (FSS). Yet, the underlying mechanism of such relationship has not been explored among Chinese adolescents. This study aims to evaluate whether SA exerts a moderating or mediating effect on the alexithymia-FSS link.

Analyses were based on 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15) recruited from a school-based study. They completed the Somatosensory Amplification Scale (ChSAS), the Somatic symptom subscale of CES-D and the Toronto Alexithymia Scale-Short form (TAS-9-C). Three facets of alexithymia (difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT)) were force-entered in each univariate regression model. Facets of alexithymia that were found significant (p < 0.05) were subsequently included in regression models to test the mediating and moderating effects of SA on FSS.

Results of hierarchical regression analysis found that both DIF (standardized β = 0.37, p < 0.001) and DDF (standardized β = 0.12, p = 0.043) were significant predictors of somatic symptoms. A moderate mediating effect was observed for SA on the DIF-somatic symptoms (Sobel test z = 2.13, p = 0.03). The results also showed a significant moderating effect of DIF×SA on somatic symptoms (standardized β = 0.49, p < 0.001).

SA qualifies as a mediator and a moderator between alexithymia and FSS. It indicated that adolescents with alexithymia are likely to report more FSS due to the tendency to amplify their somatic sensation. These results suggest that alexithymia-specific psychotherapeutic methods should be further developed using emotional validation and processing techniques.

Over the last decades, acupuncture has been seen as an acceptable primary detoxification treatment for opiate dependence, and currently used to relieve the severity of opiate withdrawal symptoms among MMT patient.

To investigate the effectiveness of electroacupuncture treatment in reducing opiate withdrawal symptoms among MMT patient.

This was a pilot study with randomized, single-blinded, and parallel. Recruitment of 22 subjects, 11 in methadone treatment + acupuncture and 11 in methadone treatment without acupuncture. The severity of withdrawal reaction was assessed by Objective Opiate Withdrawal Scale (OOWS) and Subjective Opiate Withdrawal Scale (SOWS) at baseline, third, fifth, seventh, tenth and fourteenth day of treatment.

One way Analysis of Variance (ANOVA) comparing the mean scores of the OOWS between treatment and control group has shown at tenth day of treatment p value is 0.026 and at fourteenth day p value is 0.022. One way ANOVA comparing the mean scores of the SOWS between treatment and control groups has shown at tenth day of treatment, p value is 0.015 and at fourteenth day, p value is 0.009.

The study has shown the promising results, where electroacupuncture treatment had an effectiveness in relieving opiate withdrawal symptoms among MMT patient.

Deceit and lie detection has been attracting attention of forensic psychologists and psychiatrists for several decades. Different polygraph and imaging methods are being thoroughly examined, usually without really doubtless results. Paul Ekman proposed an interesting theory on micro emotions that may be a demonstration of uncontrolled part of human behaviour and thus may represent an interesting way to detect lie or deceit. Currently there are available on the market several systems for automatic micro emotions detection. These systems show acceptable level of reliability and thus may be used for research purposes.

The aim of the study was to analyse if computerized system for micro emotion analysis (Face Reader) can be used for distinguishing liars from non-liars. For that purposes classical experimental double blind setting was established. The group of university students (n = 40) was divided into a subgroup exposed to a video scene and a subgroup not exposed (n = 20). The goal of further analysis was to distinguish there two groups using Face Reader.

In our pilot study, we identified 100% truth tellers and 90% of lie tellers.

Upon the presented study we may suggest that software analysis of micro emotion represents an interesting way for detecting lie and deceit. Although the current state of knowledge does not allow using this method in forensic setting, the possibilities and limits of the method should be properly examined.

Zinc is an immunomodulatory trace element suggested to be beneficial in the augmentation of antidepressant therapy. Cross-sectional studies have also demonstrated an association between low dietary zinc intake and depression. However, to the best of our knowledge, no long-term prospective studies have examined the impact of dietary zinc intake on the risk of depression.

To examine whether low dietary zinc in initially depression-free men associated with an increased incidence of depression during a 20-year follow-up.

The population-based Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study comprised 2641 Finnish men aged 42–61 years. Zinc intake was assessed at baseline by a 4-d food record and was also re-assessed for a random subsample (n = 50) on 1-year follow-up (correlation between assessments 0.68, p < 0.001). Depression was defined as having received a hospital discharge diagnosis of unipolar depressive disorder. The discharge data were derived from the National Hospital Discharge Register in 2010. Individuals who at baseline had elevated depressive symptoms or a history of mental illness were excluded (n = 345).

Altogether, 2169 (94.5%) participants reached the Finnish zinc RDI for men (9 mg/day), and 58 (2.5%) received a depression diagnosis during the 20-year follow-up. in Cox regression analysis adjusted for age, smoking, alcohol use, energy expenditure, dietary supplement use and education years, the energy-adjusted zinc intake was not associated with depression (RR 1.01, 95% CI 0.95–1.09).

A low dietary zinc intake may not induce an increased depression risk in middle-aged men.

To conceptualize the characteristics or traits of healthy acculturative self in a global and multicultural society. The self needs to be recapitulated in terms of globally adapting and dynamically changing environment.

A meta-analytic method is applied to this study by reviewing research papers, 1990 to 2012, via academic search engines, in the following key words: acculturation and health/self/personality/ identity. Also. the concept of “scientific analogy” (Gentner, 1983, 2003, 2010) is employed.

Six conceptual frames of healthy acculturative self are summed up as conceptual templates or modules.

1. 1. Resilient Self: The resilient self has the capacity to make best use of resource and to cope with emerging stressors and life crises during acculturation.

2. 2. Globally Adapting Self: The self is able to adapt oneself to globally changing environment.

3. 3. Holistic and Synchronistic Self: The self is able to comprehend cultural information of the past, in the present mode, as one actively confronts culturally different situations.

4. 4. Optimistic Self: The self strives to achieve one's goals and is able to overcome depression or life frustration.

5. 5. Spirituality-oriented Self: The self is open to other religious values or differences as one positively appreciates other religious values as well as tolerates diverse religious systems and world views.

6. 6. Multicultural Personality-oriented Self: The self is sensitive enough to learn culturally diverse life-styles or values.

The conceptual categories of healthy acculturative self are recommended to be used as meta-cognitive maps when mental health professionals and cultural psychiatrists conduct psychiatric assessment and diagnosis.

To contribute to cross-cultural studies, the research used the special cultural context in the Azerbaijani urban population. Despite often being bilingual and speaking two languages (Azerbaijani and Russian), this Azerbaijani urban population were divided into two distinctive language groups with either Azerbaijani or Russian as the first language. A selfreported Zung Self-Rating Depression Scale (ZSDS) is established to be a reliable and valid measure for assessment of depressive symptoms, applicable cross-culturally.

ZSDS was translated into Azerbaijani and Russian. Two pilot studies on small samples (n = 30 and n = 45) conducted to improve the scale's acceptability. Reliability study was conducted on a bigger sample of depressed subjects (n = 55) and healthy controls (n = 120). Chronbach's alpha for the total scale, Item-test correlations, alpha if item deleted, and sensitivity and specificity at various cut-off levels were calculated.

Drop-out rate was 83.3% at the first pilot study due to pure comprehension of item 5 and culturally unacceptable wording of item 6. After rewording of the items drope-out reduced to 20% on the second pilot study. on the reliability study Chronbach's alpha for the total scale was 0.8727, and item-test correlations for the most individual items were satisfactory. An optimal cut-off point was 45 pints with sensitivity = 90.91%, specificity = 80.83%.

Reliability of the Zung Self-Reported Depression Scale improved cultural acceptability of the scale in the particular Azerbaijani population context.

Tuberculosis and mental illness share common risk factors including homelessness, HIV positive serology, alcohol/ substance abuse and migrant status leading to frequent co-morbidity. We sought to generate a comprehensive literature review that examines the complex relationship between tuberculosis and mental illness.

A literature search was conducted in MedLine, Ovid and Psychinfo, with further examination of the references of these articles. 316 articles were identified. It was not possible to conduct a formal meta-analysis due to the absence of randomised controlled data.

Rates of mental illness of up to 70% have been identified in tuberculosis patients. Medications used in the treatment of common mental illnesses may have significant interactions with anti-tuberculosis agents, especially isoniazid and increasingly linezolid. Many medications used in the treatment of tuberculosis can have significant adverse psychiatric effects; others such as rifampicin may reduce the effective doses of anti-psychotics by their enzyme-inducing actions. Mental illness and substance abuse may also affect treatment concordance, with consequences for public health.

Due to the common co-morbidity of mental illness and tuberculosis, it is important that both psychiatrists and physicians are aware of the potential for interactions between the drugs used to treat tuberculosis and psychiatric conditions.

One of the most researched factors which contribute to the good outcome of methadone therapy is the dosage, but local studies which look into the factors associated with the dosage of methadone itself is lacking.

To compare clinical factors including level of motivation and the quality of life among the active male clients on high and low methadone dosage.

To determine the factors associated with high dosage of methadone in order to improve the services provided.

A cross sectional study of active male methadone clients who are on maintenance treatment attending the Methadone Clinic. It was conducted from early January to the end of March 2010. The questionnaires used include Mini International Neuropsychiatric Interview (MINI), Circumstances, Motivation and Readiness to Change (CMR) and WHO-Quality of Life (WHOQOL-BREF).

Those on higher dosages were noted to have significantly better urinalysis results and had a higher CMR score, but quality of life did not differ between the two groups. Motivational level remained significant after regression analysis was done.

This study also confirms previous findings of higher methadone dosage having better outcomes in terms of urinalysis results. As the high dose group were also found to be more motivated to change, the regular formal counselling sessions or motivational enhancement therapy was advocated to improve the services of methadone maintenance therapy.

Based on clinical impressions personality disorders (PDs) and psychiatric disorders characterized by body image disorder (BID) have been suggested to be relatively common in cosmetic surgery settings and closely associated with patient's post-operative dissatisfaction despite technically satisfactory surgical results, leading to problems for both patients and surgeons.

The study investigated the prevalence and the comorbidity between BID and PDs in patients seeking cosmetic surgery, as well as the impact of the following clinical variables on patient's post-operative dissatisfaction: number of pathological personality traits, severity of body uneasiness and worries about particular body parts and intensity of these concerns.

Two hundred fifty patients scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals (90% F; Mage = 31.5 ± 4.0) completed the Body Uneasiness Test (BUT), the Personality Diagnostic Questionnaire-4+ (PDQ-4) before surgery and a measure of patient satisfaction 13 months after surgery.

18.9% of subjects, had at least 1 PD (cluster B and C's in particular). Using the BUT cut-off score as a marker of clinical significance, 48.8% of subjects had a BID, and all PD patients showed comorbidity with BID. The number of pathological personality traits, the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ post-operative dissatisfaction.

PDs and BID are common in cosmetic surgery settings. Our data suggest also that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction.

A retrospective study in India had showed high rate of comorbid disruptive disorders in children with Attention deficit hyperactivity disorder, but not depression and anxiety disorders as opposed to western literature. Studies using structured assessment tools are lacking in Indian population and thus valid data on prevailing pattern of comorbidities in ADHD children is lacking.

To study the pattern of co-morbidities in Indian children & adolescents (subjects) with ADHD and to compare the degree of functional impairment between ADHD subjects with and without comorbidities.

60 consecutive subjects aged 6 to 16 years diagnosed as ADHD based on DSM IV TR were recruited with informed consent, from a tertiary care centre during a period of 6 months. Kiddie-SADS - PL was applied to identify comorbidities in these subjects. Global functioning was assessed by Children Global Assessment scale (CGAS) in all these subjects.

55% of recruited subjects had comorbidity, the most highly prevalent lifetime disorder being Oppositional Defiant disorder (25%), followed by conduct disorder (13.3%), Bipolar affective disorder (13.3%), Major depressive disorder (10%), Communication disorder (10%), Substance use disorder (8.4%), Obsessive compulsive disorder (8.3%), Tic disorder (5.4%), Learning disorder (5%), Elimination disorder (3.3%), Social phobia (1.7%) and Separation anxiety disorder (1.7%). Subjects with comorbidities had poorer global functioning (41.58 ± 0.45) when compared to ADHD subjects without comorbidities (47.67 ± 8.57) (p = 0.018).

Our study points out that Comorbid disorders like anxiety disorders are not as low as projected by the earlier Indian studies.

The studying of particularities in clinical development of comorbidity in schizophrenia with sustained hypertension.

60 patients with paranoid form of schizophrenia accompanied with somatic pathology (sustained hypertension).

Clinical-catamnesis, clinical- psychopathology methods, psychometry scale (PANSS, HARS, HDRS, ESRS).

Clinical features of comorbidity in schizophrenia with sustained hypertension are characterized by structural particularities of productive and deficiency disorders. The depression with hypochondriasis and anxiety symptoms is more expressive. Neurocognitive symptoms and low quality remission are marked (p < 0,01). Male patients more often have negative symptoms of anxiety (46,7%),irritability and aggressive behavior (33,3%)were marked in comparison with the control group (p < 0,05). Were identified patients could endure psychic medications worse. Resistance and intolerance to psychotropic medicines were revealed. More corrector medicines in side effect of extrpyramid symptoms were given (p < 0,01) total polyfarmacy (p < 0,01) in patients with comorbidity in schizophrenia and sustained hypertension was marked.

Patients with comorbidity in schizophrenia and sustained hypertension developed more complex pattern of the disease. Patients were revealed to endure psychic medications worse. They were marked to have secondary resistance to psychotropic therapy.

According to meta-analytic review, body dissatisfaction (BD) is recognized as the strongest risk factor of all forms of eating disorders (EDs).Yet, it has been found that BD is so prevalent among adolescent girls and young adult women that it is “normative”. The present study investigates why only a minority of adolescents girls report severe levels of ED symptomatology, when so many are body dissatisfied?

Five theoretically relevant variables are investigated as potential moderators of the BD-ED symptomatology relationship (drive for thinness and bulimic behaviours).

A sample of 401 Italian adolescent girls completed questionnaire measures of BD, drive for thinness, bulimic behaviours, as well as the proposed moderating variables of body checking, perfectionism, appearance control beliefs, internalization of socio-cultural standards of beauty, and self-esteem.

Structural equation modeling with latent factor interactions indicated that body checking, perfectionism, appearance control beliefs and internalization of socio-cultural standards of beauty intensified the primary BD-ED symptomatology, such that BD was strongly related to drive for thinness and bulimic behaviours when levels of each moderator were higher. By contrast self-esteem buffered the deleterious effects of BD, such that when levels of the moderator were higher, the relationship between BD and each criterion variable representing female's ED symptomatology was weaker.

Several risk and protective factors have been found to interact with BD to influence its relation to ED symptomatology. The findings can inform the design and delivery of tailored prevention and treatments interventions for adolescent's eating disturbances.

Martinez Jambrina et al. (2010) developed the first research on the quality of assertive community treatment offered by Avilés ACT team to patients who were referred to this service with psychiatric diagnoses included in the group of severe and persistent. This research focused on the study of quality standards on internal organization, assistential activity, external coordination, accessibility and quality of care considered by the users and their families.

To analyze the quality of the interventions of the Avilés ACT team during one year (april 2011–april 2012) and compare it with results reached in 2010.

Descriptive Research - No experimental - Transversal.

ACT Team 11 members (2 psychiatrists, 6 nurses, 2 auxiliar nurses 1 social worker) and Users of ETAC: 110 users.

Variables- Internal Organization:- Assistential Activity- External Coordination- Accessibility- Quality of Care.

The results obtained are similar to our first research (2010) The ACT team of Aviles works with quality levels that can be considered optimal if referring to USA standards of quality in this intervention

Identifying at-risk mental states of psychosis can reduce the duration of untreated psychosis and the rate of transition. Meanwhile, it may improve prevention strategies of suicide, substance abuse and anxiety disorders comorbidities.

We aim to investigate the clinical symptomatology differences at baseline, especially in non-specific symptoms, between UHR (Ultra High Risk) patients who did or did not make a transition to psychosis. Sharpening UHR inclusion criteria may improve prediction of transition to psychosis.

The study included 85 young help-seekers (mean age= 20 y.o.) meeting UHR CAARMS’ criteria. 46 were followed up over a period of 30 months and 27 of them were assessed in a comprehensive clinical interview. Out of 46 finally included UHR subjects, 11 (40%) made a transition to psychosis. Psychopathology was investigated with the Comprehensive Assessment of At-Risk Mental State (CAARMS), BPRS and GAF-score. To identify the most predictive variables of transition, we applied a stepwise logistic regression on CAARMS’ criteria plus other variables (premorbid adjustment scale, cannabis use, subjective experienced life events, treatment and suicide).

At baseline, premorbid adjustment and severity of CAARMS’ Obesssive-Compulsive Symptoms (OCS) were found to significantly influence the transition: poor premorbid adjustment, associated with moderate level of OCS increased the sensitivity (72.7%) and the specificity (92.8%) of the prediction.

Premorbid adjustment and level of OCS were predictive of transition in subjects at UHR. These characteristics could increase the level of prediction of psychosis.