Patients with schizophrenia have elevated rates of cigarette smoking, and difficulty in smoking cessation. Cigarette smoking may reduce plasma levels of antipsychotics up to 50%.

To investigate effects of cigarette smoking in olanzapine treatment of schizophrenia.

91 patients with schizophrenia, aged 18-51, were divided into four groups. Control group (25 patients) and experimental groups: E1, 1-20 cigarettes/24h (23 patients), E2, 21-40 cigarettes/24h (22 patients) and E3, 40+ cigarettes/24h (21 patients). Patients were observed for one year period. Patients were assessed by Positive and Negative Symptom Schedule Scale (PANSS) at baseline and after one year.

No significant differences were found for PANSS score at baseline (p = 0.535). PANSS reduction at study endpoint was significant in all groups (p < 0.001). PANSS reduction was highest in non-smokers group 65.5%, and lowest in group of heavy smokers (40+ cigarettes/24h) 39.2%. There is a statistically significant difference in PANSS reduction between nonsmokers group and all smokers groups (p < 0.001). There is a statistically significant difference in PANSS reduction between E1 and E2, and E1 and E3 group (p < 0.001), and no difference between E2 and E3 group (p = 0.414). There is a statistically significant difference in olanzapine average daily dose after one year between non-smokers group and all smokers groups (p < 0.001).

Olanzapine therapy is most efficient in non-smokers group. Smoking more than 20 cigarettes per day significantly reduces effects of olanzapine therapy. Average daily dose of olanzapine is significantly lower in non-smokers group than in all three groups of smokers.

Post-traumatic stress disorder (PTSD) is a stress-related mental disorder caused by traumatic experience. Some studies showed low hippocampal volumes in PTSD patients. Our previous research indicated apoptosis induced such atrophy in the hippocampus. Endoplasmic reticulum stress -induced apoptosis has been implicated in the development of disorder diseases.

Our study was to reveal whether apoptosis induced by single-prolonged stress (SPS) in the hippocampus involved in Endoplasmic reticulum-related pathway through observation expression of three important apoptosis-related indicators on ER pathway: Glucose-regulated protein (GRP) 78; calcium/calmodulin/CaM kinaseIIα and caspase-12.

Wistar rats were killed at 1, 4 and 7 days after exposure to SPS. The apoptotic cells in the hippocampus were assessed by TUNEL method and the free intra¬cellular Ca2+ concentration was measured. Immunohistochemistry, western blotting and RT-PCR were used to detection expression of GRP78, Ca2+/Calmodulin/ CaM kinase IIα and caspase-12.

Our results showed that apoptosis exactly occurred in hippocampus of SPS rats. Both GRP78 and Caspase-12 were significantly up-regulated during early PTSD. They reached peak in the 4 days and then returned to normal levels in 7 days after SPS. The free intra¬cellular Ca2+ concentration was significantly higher in 1 day after SPS and decreased in 7 days; However, CaM expression significantly increased, while CaMKIIα expression significantly decreased in the hippocampus 1 day after SPS.

SPS induced the change of GRP78, Ca2+ and caspase-12 in the hippocampus of PTSD rat, indicating that the endoplasmic reticulum pathway was involved in the process of SPS-induced apoptosis.

To estimate the heritability of personality of children by using a twin design method of quantitative genetic analysis. To analysis the influences of family environment on children personality.

EPQ(Eysenck Personality questionnaire) applying on twins children aged 6-16years to evaluate the children personality.

The general questionnaire, PSDQ Parenting Style and Dimension Questionnaire, FAD-GFS(The General Functioning Scale of the MacMaster Family Activity Device), SLE(stressful life events), FSQ(Family Stresses Questionnaire), FLQ(Family Life Questionnaire), EFQ(Everyday Feelings) were used to collect information about family environment from parents. Zygosity was determined by the DNA picked up from cheek mucosa of twins children. Holzinger analysis was employed to estimate the heritability of mental health.

122 pairs(244 children) of twins (103 twin pairs DNA were picked up successfully), including 54 MZ twin pairs and 49 DZ twin pairs.The heritability of personality:N(Extrovision-Introvision):0.71,P(Psychoticism):0.56,L(Lie):0.43,E(Neuroticism):0.07.

In twins family educated-year of father was significantly correlated with EPQ-E,EPQ-N(r = 0.167,0.145);educated-year of mather was significantly correlated with EPQ-N(r = -0.145);the score of FAD-GFS was significantly correlated with EPQ-E(r = - 0.235);FLQ was significantly correlated with EPQ-n(r = 0.356);the score of father authoritative parenting style was significantly correlated with EPQ-p r = -0.196 ;the score of mather authoritative parenting style was significantly correlated with EPQ-e r = 0.230. the score of family cohesion was significantly correlated with EPQ-n(r = 0.198).

Emotional problems were influenced by genetic factors most followed by inattention-hyperactivity problems and total difficulties environment factors play a main role in conduct problems and prosocial degree while peer problems were only influenced by environment factors. Each aspect of family environment, influence children personality and mental differently.

Parasuicidals behaviour is an urgent state in psychiatry and it occurs in different forms as the first or recidival attempt.

The aim is to prove the difference in frequency in presuicidal conditions together with sociodemographical and psychopathological predictors during the period from January 1st 2001 to December 31st 2010.

Subjects have been divided into two groups depending of the way they Parasuicidals behaviour: violent (N = 75) and nonviolent (N = 75) in multicentric prospective observation in Bosnia and Herzegovina (B&H). The following instruments have been premortally used: list of general data (ICD-10 criteria); personal features test (EPQ-Eysenck HJ); test of depressiveness (HDRS-Hamilton M); emotional index test (P.I.E. Plutchik R) and postmor-tally: SSIPA interview. Results were analysed using descriptive and multivariant analyses.

Multivariant analysis has showed the highest difference between groups in a violent group comparing to a nonviolent one (P = 0.001) in a treatment length [OR = 0.950 (95%), CI 0.710 -970], compliance [OR = 0.810(95%), CI 0.780 - 1.050], severity of depression [OR = 0. 825 (95%), CI 0.650 -1.340] and motivation [OR = 0.750 (95%), CI = 0.835-1.150].

Parasuicidals behaviour performance have not shown statistically significant difference. This study has shown the difference in the length of treatment (duration of disease), cooperation with therapeutic team, depression worsening regardless its origin and motivations for social adaptations and participation. Patients with more expressed mentioned predictors, were attempting suicide faster, regardless therapeutical treatment.

Families of individuals with schizophrenia and autism experience similar stressors in their everyday life. Research shows that working with families of people with schizophrenia is effective in reducing family burden and distress levels, through structured psychoeducational interventions. These interventions are delivered in individual family or group family design. However, psychoeducational interventions have not been widely implemented in standard clinical practice, while there is limited research on the effectiveness of psychoeducation in parents of children with autism.

Psychoeducational interventions are organized around two primary objectives:

1. a) provision of information about the nature and treatment of the disorder and

2. b) teaching family members problem-solving, communication skills and behavior management techniques.

The aim of this study was to compare and contrast the efficacy of group psychoeducational intervention in reducing family burden and in improving communication and problem solving skills, when applied to two groups of parents of individuals with schizophrenia and of children with autism.

Eight parents of individuals with schizophrenia and six parents of children with autism participated in two group psychoeducational programs. Twenty three group sessions were conducted for each group. Pre and post treatment measures included qualitative assessment of knowledge about the nature of the disorder of their offspring and social stigma, as well as psychometric measurement of family burden, family rituals, family communication and general family functioning.

Quantitative and qualitative data on the effectiveness of each group psychoeducational intervention, as well comparative data between the two groups will be discussed.

In primary care, difficulty to distinguish somatic syndromes from depression with somatic symptoms is recognised. In somatoform disorders co-morbid depression and anxiety have an additive detrimental effect on level of functioning.

To investigate role of depressive symptoms in somatic presentations and elucidate its impact on level of functioning.

Cohort is 106 consecutive patients referred to a specialist somatoform disorder clinic as part of a naturalistic follow- up study. Tools used included Hamilton rating scale for depression (HAMD), Patient Health Questioner (PHQ-15), Global Assessment of Functioning (GAF).

26% of cohort had only depressive disorder (ICD-10 F32-34, 38), 44% had a somatic syndrome (F 44-45, 48), 10% with anxiety or psychotic disorders and 20% had no mental disorders. 34% of somatic syndrome had co-morbidities, mainly depressive disorder. No significant difference in HAMD, PHQ-15 and GAF, seen between diagnostic groups. In the somatic syndrome group, HAMD and PHQ-15 scores negatively correlated with GAF (functioning) (t = -4.5, df = 1, p = 0.0001 and t = -2.3, df = 1, p = 0.04). When HAMD along with PHQ-15, age, gender, co-morbidity and medication-use entered in a multiple regression model, HAMD score was the only significant parameter (F = 17, t-4.2, df = 1, p = 0.001).

A considerable number of patients with severe somatic symptoms and functional impairment have depressive disorder. In patients with somatic syndrome, depressive symptoms (even sub-syndromal) appear to influence the level of functioning and mediate the effect of somatic symptoms on level of functioning. This finding may have implication in treatment and needs establishing.

To characterize connectivity patterns of brain default mode network (DMN) in lsTLE patients with and without anxiety and depressive disorders.

28 lsTLE patients, divided into two groups: patients with (“affective” group) and without anxiety- depressive symptoms. Beck Depression Inventory (BDI), Hospital Anxiety Depressive Scale (HADS), Hamilton Anxiety Scale (HAM-A) and Montgomery-Asberg Depressive Rating Scale (MADRS) were used to assess affective symptoms. All subjects underwent 9-min resting-state fMRI scanning session. Independent component analysis (ICA) was used to isolate DMN. The resulted maps were compared in groups using two-sample t-test. The results were considered as statistically significant according to threshold of p < 0.005 with a 10-voxel extent that has recently been shown to produce an optimal balance between Types I and II error rates in fMRI studies (Lieberman, 2009). The data were processed and analyzed using SPM8 and “GIFT” toolbox for ICA “GIFT”.

Mild depression and moderate-severe anxiety levels were observed in the "affective" group. Significantly increased functional connectivity was found in “affective” group in the right cerebellum (culmen), right gyrus fusiformis, dorsolateral prefrontal and midcingulate area, and in the left insula.

We found that brain DMN is altered by affective disorders associated with lsTLE. The observed regional pattern of difference can reflect the impaired levels of self-control often present in lsTLE patients with affective symptoms

The satisfaction with life scale (SWLS) is a brief five-item measure of global life satisfaction rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree). It is noted as one of the most popular scales in the measurement of life satisfaction.

To test the psychometric properties of SWLS.

To create a valid measurement, easy to use for primary care and during treatment assessment in patients with diabetes mellitus (DM), emotional disorder (ED) and general population (GP).

Translation of SWLS was performed using the multiple forward and backward translation protocol. Life orientation test (GrLOT-R), Depression Anxiety Stress Scale (DASS) and Subjective Happiness Scale (SHS), was also administered to check construct validity of SWLS.

809 adults participated, 175 (21.6%) male, 634 (78.4%) female. The total scale of the SWLS had a coefficient alpha of .831. Item - total correlations where from .253-.783. Factor analysis has supported a unidimensional model with 1 factor explaining 68% of the total variance. Mean scores differed significantly between GP (M = 21 ± 6.3), DM (19.1 ± 6.2) and ED (M = 17.2 ± 6.9) (Mean differences = 1.847 and 3.723 p < .001 respectively). There was significant negative correlation with stress (r = -.297 p < .001), anxiety (-.297 p < .001) and depression (r = -.499 p < .001) and positive correlation with GrLOT-R (r = .499 p < .001).

The results of the current validation study suggest that the Greek translation of the SWLS is both reliable and valid, with good construct and discriminant validity and psychometric properties close to those reported in the international literature.

Major depressive disorder (MDD) is associated with low frustration tolerance, which is a risk factor for suicide. Hippocampal structural and functional abnormalities have been documented to play one of the crucial roles in the pathophysiology of depression. Recent studies have revealed functional differentiation of the hippocampus. Thus, activity of the anterior part was shown to be associated with negative affect mediation.

To investigate brain mechanisms of frustration, comparing its impact on anterior hippocampal connectivity in MDD patients and healthy controls (HCs).

14 MDD and 14 HC right-handed subjects were included in the study and underwent comprehensive clinical assessment. MDD was diagnosed during psychiatric interview according to ICD-10 criteria. The Hamilton Depression Rating Scale was additionally used to assess depressive symptoms. The original Stroop test was modified to evoke a state of frustration by administrering impossible task conditions and negative feedback during 10-min functional magnetic resonance scanning session. Psychophysiological interactions were used to analyze left and right anterior hippocampal functional connectivity changes in response to frustration. The resulted Z-maps were adjusted using Z > 2.3 threshold and a (corrected) cluster significance threshold of p = 0.05.

Increased functional connectivity of the left anterior hippocampus in response to frustration was significantly higher in MDD patients compared to HCs in the pars opercularis of the right prefrontal cortex and bilateral posterior cingulate regions.

The results revealed that depressed patients demonstrate abnormally increased anterior hippocampal response to frustration, suggesting that hippocampal-neocortical network impairment may contribute to decreased frustration tolerance associated with MDD

Intersubjective experience and phenomena addressed in psychiatric diagnosis are not available to standard scientific research. Many authors focused on intersubjectivity and the analysis of their work helps informing and clarifying how to address these facts.

This presentation aims to review the works of A. Shultz, C. Jaspers, F. Buytendijk, M. Heidegger, M Scheler (and others) on intersubjectivity in a phenomenological standpoint.

Approaching intersubjectivity from a phenomenological standpoint and its relations with current problems of psychiatric diagnosis and research.

Selective analysis of literature on phenomenological enquires of intersubjectivity in the field of Philosophy and Psychiatry

Research in psychopathology and psychiatry must neither treat intersubjective data as residuum nor try and reify data that resists reductionism and mechanistic explanations. Intersubjectivity is inherent to the meaning of psychopathological understanding and phenomena

There is need for new methods of enquire for many data in psychiatry. Researchers and clinicians must find new ways to deal with psychiatric objects and with relational data.

To illustrate the targets and the severity of the aggressive incidents in a forensic psychiatric setting.

The study was conducted in a forensic psychiatric setting at Psychiatric Centre Sankt Hans. It utilizes data from the three year period between 2008 and 2010. Staff Observation Aggression Scale Revised (SOAS-R) is used to examine all aggressive incidents during the period mentioned.

212 patients were admitted between 2008 and 2010. The majority being mainly men (98.6 %) with a diagnosis within ICD10 F20-F29 (79.7 %). In total there were 1507 recorded aggressive incidents of whom 63.2 % were registered with at least one aggressive incident. The most prevalent trigger of aggression was related to patients being denied something (45.9 %) and the staff is the primary target of the aggressions in 64.4 % of the incidents.

Mean severity score we found to be 10.12 (SD 4.84). According to the severity of the aggressions, we found 61.5 % of the reported incidents, with a severity score ≤ 9, symbolizing more severe aggression. We found abusive patient to be significantly more aggressive (OR 3.47 p = < 0.001), but no difference in the severity score between the abusive patient and the non- abusive patient was found (p = 0.28).

Aggression is a prevalent phenomenon in a forensic psychiatric setting in Denmark. The Majority of the aggressive incidents are characterized by being severe, but not necessarily related to abuse. The staff was the primary target of the aggressions.

To illustrate different perspectives on staff factors and aggression in forensic psychiatry.

The study was conducted in a forensic psychiatric setting at Psychiatric Centre Sankt Hans. It utilizes data from the three year period between 2008 and 2010. Staff Observation Aggression Scale - Revised (SOAS-R) is used to examine aggressive incidents during the period mentioned.

Out of 244 employees in a three year period and based on 1507 incidents, 91.6 % have registered at least one aggressive incident. The primary target for aggression was the staff in 64.4 % of the incidents.

74.8 % of the staff were women and the majority of the staff were RN and nurse-aids. According to gender differences we found no significant differences in reported incidents (OR 1.27 p = 0.818). Regarding the severity score there were no significant gender differences (p = 0.41). The length of employment has no impact on the severity score (p = 0.269). We found a minor but significant negative correlation (r = -0.262 p = < 0.01) between length of employment and the number of reported aggressive incidents.

Our findings show that the staff is the primary target of aggression, and the majority of the staff is experiencing aggression as part of the job. We found no significant differences related to the gender of the staff, but we found that length of employment has an impact on the numbers of reported aggressive incidents, indicating underreporting and possibly cultural adaptation to some extent.

Anxiety is a primary symptom in conditions of indefinite fear. Aim of the study is to objectivise the initial fear in patients who decided to take part in a chemo dialysis program because they suffer from chronic renal insufficiency (CRI) N:18.

In the study we examine 753 patients with CRI and who are in the program of chronic haemodialysis in Bosnia and Herzegovina (B&H) in the period 2001. g do 2010. g. The first group consists of patients with Balkan Endemic Nephropathy - BEN n = 348, and control group consists of n = 405 patients with other diagnoses of renal insufficiency (N18). The study is designed as a comparative study. Statistical analysis was done using descriptive and analytical methods.

Socio-demographic data show highly significant difference according to the place of residence between the BEN and N18 groups (c2 = 23.970) P < 0.01, difference in the incidence of renal comorbidity (c2 = 23.970) P < 0.01, family renal comorbidity (c2 = 23.970) P < 0.01, and migrations (c2 = 4.874) P < 0.01. BAI scale has highly significant differences between the two groups P < 0.001, and they are different by the degrees of incidence and significant by variables. HAMD scale has a group significance P < 0.001, and variables point to somatization, general anxiety and depression which is confirmed by general weakness of mental functioning - MMSE.

Anxiety appears in all tested dialysed patients. Structured anxiety with depression results in presuicidal risk

Using movies in psychiatric group therapy & rehabilitation classes provides ‘Entertainment, Education, Empowerment’ for the participants. We have provided such a setting where severely ill psychiatric inpatients. We aimed to describe the “Watching Cinema- Group Therapy” implementation for 500 inpatients in one year.

Selected movie clips were watched in the morning and group therapy session took place in the afternoon. The patients were instructed to watch the film closely, and if required, ask for certain scenes to be replayed for a better understanding. It was followed by review of the film.

We observed that these activities have encouraged the patients to talk about their beliefs, thoughts and feelings while discussing the characters and stories. We have also used as a reward for the patients who have therapeutic alliance. It motivated them to do something instead of being stayed in the room. Short movie scenes were more useful to follow up the films for the patients who have been administrated high doses of drugs.

It is the ingenuity and creative approaches of the educators and healers using movies in favor of behavioral health improvement. Movies are strong and important tools to be used for positive as well as productive means in treatment and teaching.

There currently are only a few clinical studies found in literature that assess acute psychosis in terms of its longitudinal clinical course, meaning whether it totally recovers, reappears later on or other types of psychotic episodes will appear.

To assess the clinical features of acute and transient psychosis after 10 years of evolution.

To emphasize the clinical stability of an onset diagnosis of acute psychotic disorder.

A sample of 40 subjects was assessed prospectively. They were admitted for the first time in Timisoara Psychiatric Clinic between 1999 and 2001 and have been diagnosed according to ICD 10 with acute and transient psychotic disorder (F23). The evaluation was performed at onset and after 10 years of evolution. Following parameters were analyzed: socio- demographic (age at onset, gender, educational, professional and familial status) and clinical (onset and current diagnosis).

After 10 years of evolution 67.5% of the subjects have experienced also other types of psychotic episodes and changed diagnosis during the illness course. 32.5% of the subjects followed a 1 to 2 years treatment and did not relapse so far.

Acute psychosis represent a heterogeneous group which can evolve to any other psychotic disorder.

Object of the study is self-destructive behaviour of young people in Bosnia and Herzegovina (B&H) in the period 2001- 2010. g. The aim of the study is exploration of the forms of self-destructive behaviour of young people in relation to poverty, adaptability and adolescence. Special aim is the analysis of self-destructive personalities.

Two adolescent groups from (B&H) were statistically processed. The test group consisted of n=125 subjects who had parasuicide before they were of legal age, and control group consisted of n=125 persons with somatic symptoms and parasuicidal behaviour. The design of the study is longitudinal. Statistical processing was done with: GDL, EPQ, HAMD, PIE, and the study is prospective, stratified by quality (number of attempts) of parasuicide.

Parasuicide has a growing trend of seriousness of self-destruction in the first group and increased somatization of anxiety and depression in control group. Parasuicidal destruction is reflected in suicide (7.7%), mental disorders (15.5%), social segregation (12.5%) and cases of good maturation (65%). Somatiform disorders are proven on Hamilton’s scale: body anxiety: t-test=0.78593, general body symptoms: t-test=0.73369, genital symptoms: t-test=0.8268, which are confirmed by Pluchic’s test.

Demonstrations of parasuicidal behaviour are found in both groups of respondents. Strong manifestations of self-destruction are clear in the test group, and in the control group they are expressed as masked forms of self-destruction. Both kinds of expression of the parasuicide are results of poverty, adaptability (PTSD), and personal difficulties in adolescence.

From adolescence, women have a 1.5 to 3 times higher risk than men of suffering from a depressive disorder. This risk increases in middle-aged of the life and even more in the transition period to menopause or perimenopause, when the depressive vulnerability becomes especially intense.

To know more about depression in perimenopause.

To provide practitioners with accurate information about this condition thus helping to better recognition and treatment.

a selective literature review on the topic is performed.

Hormonal, psychological and sociocultural factors have been suggested to understand the etiopathogeny of this condition. Treatment of depression in perimenopause is determined by the clinical severity and includes antidepressants, psychotherapy, and sometimes, hormone replacement therapy with estrogens.

Perimenopausal depression is an underdiagnosed and poorly treated problem, which generates a high level of suffering and deserves greater attention by clinicians and health systems.

Study followed appearance and treatment of depressive disorder at the patients with opiates dependency on methadone maintenance treatment.

Presenting frequency, time of appearance and pharmacology treatment of depressive disorder. Depression was verified by psychological testsing. Applied technics were: interview, MMPI, PIE, Mahover test, WAIS, Rorschach test.

The study covered 154 patients on methadone maintenance treatment. 45 (29%) patients had depressive disorder which required pharmacology treatment. Illness was more frequent at female patients comparing with male (35% to 27%). Patients mostly started to use antidepresive drugs approximately three months after they had stopped with heroine use. Sertaline was a drug of first choice used in 30 patients, then Fluoxetine in 7 patients. Improvement of patients’ condition has been indicated by patients’ own reports, higher level of their functionality (social, working functionality) and retest results (lower T score of D scale, MMPI; lower score of emocional dimension Deprivation, PIE).

Significant appearance of depression was noticed in heroine users on methadone maintenance treatment. Illness was usually diagnosed in period of stabilization, after establishing heroin abstinence. So it is recommended to pay attention on patients in period of stabilization and treat with antidepresives if it is necessary.

• Jeff W, Richard P. M, Wayne H. Methadone maintenance treatment and other opioid replacement therapies, 1997.

• Domenic A. C, Richard I S, Pharmacotherapy of Depression, 2008.