The ability to maintain relevant information mentally while performing complex cognitive tasks, e.g. decision making, reading comprehension, and problem solving, memorizing a poem or even driving a car is conceptualized as Working Memory (WM), which became a workspace to general mental functioning. Nevertheless, as to yet, this topic is relatively ignored in literature in the Arab World.

The aim of the current investigation was to explore gender related differences in WM performance among Kuwaiti children.

The participants were 200 Kuwaiti pupils living in Farwaniyah governorate. The participants aged 128.76 ±6.75 months (100 girls aged 128.76 ±6.75 months and 100 boys aged 128.76 ±6.75 months. Moreover, the participants were identical in age, economic level and school grade. All participants in the two groups were compared on how they performed in the Automated Working Memory Assessment (AWMA), a computerized instrument developed by Alloway (2007). Independent Sample t Test was used to examine gender differences in WM performance.

The mean score for visuospatial WM boys and girls samples (13.95±4.43) and (9.23 ±4.07) respectively. It was significantly lower in girls (t=7.85, p< .001). Also, the mean score for verbal WM boys and girls samples (15.75±4.01) and (10.94 ±5.12) respectively. It was significantly lower in girls (t=7.40, p< .001).

Gender differences in working memory capacity exist. Results showed that gender contributed to the variations in WM resources, which were efficient among the Kuwaiti children. This warrants further investigation.

Providing of mental health service is the main task of every country. Its implementation obviously depends on the number of professionally active psychiatrists. So the issues of a great importance for current psychiatry are determinants and consequences of the decision of specialization in this medical domain.

The aim of our work was, most of all, the assessment of motives of the choice of specialization in psychiatry from the perspective of physicians-practitioners.

In order to do it, we prepared an original questionnaire, which contained 22 questions (some of them were of multiple choice) concerned with, i. e. sociodemographical and professional aspects. The study group was created from 132 psychiatrists (including 33 men), participating in international scientific-training conference in Wisla in 2011. Average age was 43 years (SD=9.7), and seniority in psychiatry - 15 years (SD=9.8). The obtained results were statistically analyzed using Statistica 8.0. Detailed results of our analysis will be presented during conference.

The results of our questionnaire may be used to improve the image of psychiatry as attractive path of professional career (almost 95% of questionnaired physicians do not regret their decision!).

The results may also become an essential argument during the discussion about current problems in psychiatry, for example problem of occupational burnout, and possibilities of their solution.

Schizophrenia (SCH) is one of the major and potentially severe mental illness that is characterized by both genetic and clinical heterogeneity. Thyroid hormone plays an important role in the development of the brain and nervous system both in the basic process of neurogenesis and of terminal brain differentiation. Type II deiodinase (DIO2) enzyme which has a critical role on thyroid hormone metabolism to convert pro-hormone thyroxine (T4) to the active hormone triiodothyronine (T3). Recently, DIO2 gene variations have been identified in association with mental disorders.

To investigate the potential genetic contribution of the DIO2 gene to SCH, we studied DIO2 Thr92Ala (rs225014) and ORFa-Gly3Asp (rs12885300) polymorphisms in a Turkish cohort of 290 unrelated SCH patients and 198 healthy controls. All subjects were genotyped by Taqman SNP genotyping assays.

Single marker analysis showed a positive association of SCH and rs225014. Particularly, Thr92Ala genotype frequency was significantly higher in patients with SCH than controls (p=0.045) and in male patients with SCH, both allele and genotype frequencies were significantly higher compared to male controls (p=0.03). Allele and genotype frequencies of ORFa- Gly3Asp polymorphism were no different within the study group.

These data show a potential role of DIO2 as a candidate gene for susceptibility to SCH and provide a strong evidence for a role of the DIO2 Thr92Ala allele and genotype in the etiopathogenesis of SCH with sexual difference.

Transition from adolescent to adult mental health services is extremely important since most mental illnesses start in late adolescence. Although often discussed, this issue is rarely studied.

The aim of this study is to gather information of how transition from adolescent to adult mental health services is yielded across Europe.

The study was conducted during the EPA and the IACAPAP conferences in 2012 as a joint project of the European Federation of Psychiatric Trainees and the Early Career Psychiatrists Committee. The survey contained 14 questions related to general data, situation of transition in participant’s country and participant’s opinion on the concept of transition process. It was given to the randomly chosen participants (N=397).

The questionnaire was completed by 166 European participants from 28 European Countries. They were mostly men (N= 88, 53 %) and specialists (N=107, 64.5%). Nearly half (N=76, 45.8%) have contact with transition issues at least once per month. Data analysis is in progress, but preliminary results show that more than half of participants think the transition process could be significantly improved (N=94, 56,6%), and they are manly from Italy, Portugal, Germany, Ireland and Spain. Only one fourth is quite satisfied with the current situation (N= 45, 27,1%). The latter group in mainly from the UK.

We plan to use these results to broaden the study and gather more details regarding this issue in every European country

Researches indicate that traumatized people besides development of mental and physical disorders can experience positive changes.

Investigate relationships between war trauma, social support, psychological distress and posttraumatic growth.

Determine the predictors of posttraumatic growth in war displaced persons in Bosnia and Herzegovina.

The test sample was composed of 71 refugees, who were due to war-related events been forced to leave the original residence, and their new residence is on the territory of Bosnia and Herzegovina. Subjects were recruited by snowballing method, and the starting point of inclusion in the study were acquaintances of the medical staff at the Clinical Hospital Mostar. The study used General Demographic Questionnaire, the Harvard Trauma Questionnaire-version for BiH (HTQ), Brief Symptom Inventory (BSI), Social Support Appraisals Scale (SS-A) and Posttraumatic Growth Inventory.

In the first predictive model (R2=0.053; F=4.889; P=0.030) that included BSI, HTQ and SS-A questionnaires, a linear regression analysis showed that a stronger social support leads to greater posttraumatic growth (standardized β coefficient=0.257; P=0.030), same as greater sensitivity in interpersonal relationships (standardized β coefficient=0.698; P=0.014), while growth in the number of positive psychological symptoms have a negative impact on posttraumatic growth (standardized β coefficient=-1.008; P=0.042). In the second predictive model (R2=0.043; F=1.226; P=0.299), of all demographic factors only the economic status was a significant predictor, where persons with stable economic status had greater posttraumatic growth (standardized β coefficient=0.337; P=0.040).

Social support is significant positive predictor of posttraumatic growth, which is also supported by sensitivity in interpersonal relationships.

Risk-taking (RT) and self-harm (SH) occur across the lifespan, but many types of RT and SH typically appear for the first time in adolescence. According to Vrouva, Fonagy, and Fearon (2010), it is important to measure RT and SH simultaneously because they are clinically, empirically, and conceptually linked.

1. (1) analyse the prevalence of risk-taking and self-harm behaviours in community adolescents, controlling the effect of genderand age;

2. (2) examine the link between RT and SH behaviours;

3. (3) investigate the relationship between attachment style and RT and SH behaviours.

346 adolescents (girls: n = 194, 56%) aged between 12 and 18 years (M = 15.10, SD = 1.77) completed a sociodemographic questionnaire, the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA) and the Attachment Questionnaire for Children (AQ-C).

RT behaviours more prevalent are taking chances while doing one’s hobbies, smoking tobacco and cheating. SH behaviours more frequent are self-demeaning thoughts and behaviours intentionally. Boys showed higher RT behaviours than girls. There is a positive association between age and both behaviours (RT and SH). Insecurely attached teenagers reported higher SH behaviours than did securely attached adolescents.

This study shows the prevalence of RT and SH behaviours in a community sample of adolescents, showing how gender and age can influence the expression of both behaviors. It seems that secure attachment may be protective to the engagement in SH behaviors, strengthening the important role of quality of relationships on psychological adjustment in adolescents

Barahona Fernandes (1907-1992) is considered one of the most distinguished portuguese psychiatrists and perhaps the most known outside the country. He did part of his studies in Germany, under orientation of prominent professors such as Carl Kleist and Kurt Schneider, and got contact with the philosophic theories of Karl Jaspers and Nicolai Hartmann. In Portugal, he leaded the Lisbon University Clinic where he developed his countless studies on mental health.

The authors shortly revisit the biography and some aspects of Barahona Fernandes’ works.

This communication points out the singularities of his personality and work, and draws attention to the importance of his contributions on mental health.

Review of the literature concerning the author’s publications and biography.

Through his whole work emerges the effort in a “converging view” that tries to integrate different influences and perspectives, in order to better achieve a coherent explanation of the human being. One of his theoretical models discusses the Personality - “Personalidade em Situaao” - in which he describes a complex organization based on comunicating hierarchical layers (from a biological foundation to a more noologic apex), subject to the interaction with the environmental features, in a homeostatic balance that can be disturbed.

The unique work of Barahona Fernandes constitutes an important material to apprehend the psychic experience. His “converging” theories try to capture a multi-dimensional structure of the human being and help clinicians to get a deeper understanding on the process of getting mentally ill

Collaborative care is a community based intervention which typically consists of a number of components. The intervention aims to improve the physical and/or mental health and health care of people with a severe mental illness (SMI).

• To explore how collaborative care is implemented.

• To assess the effectiveness of collaborative care approaches in comparison to standard care for people with SMI who are living in the community.

A Cochrane Review: The Cochrane Schizophrenia Group Specialised register was searched in April 2011. Fifty one experts in the field of SMI and collaborative care were also contacted.

We included one RCT (306 participants; US veterans with bipolar disorder I or II) in this review. The trial provides data for one comparison: collaborative care versus standard care The reanalysis of data from the one included study indicated that collaborative care significantly reduced psychiatric admissions at year 2 in comparison to standard care (N= 306, 1 RCT, RR 0.75, 95% CI 0.57 to 0.99). Direct intervention (all-treatment) costs of collaborative care at the three year follow up did not differ significantly from standard care,mean difference -$2981.00 (N= 306, 1 RCT95% CI $16934.93 to $10972.93).

One trial at moderate risk of bias suggests that collaborative care may significantly reduce psychiatric admissions. More large, well designed, conducted and reported trials may be required to determine the effects of collaborative care and help inform healthcare professionals and policy makers about the value of collaborative care for people with SMI

Panic disorder is common disease characterized by spontaneous attacks of massive anxiety and fear. Anxiety is generally considered to be a condition in which the organism is increasingly aroused and EEG may therefore play an important role in the study of the biological basis of anxiety disorders. Standardized low-resolution electromagnetic tomography (sLORETA) is a new quantitative EEG method for determining distribution of neuronal electrical activity in the form of three- dimensional images of current density of the cerebral cortex.

EEG may be usefull method in searching for predictors to the pharmaco and cognitive-behavioral therapy (CBT).

The study aimed at finding electrotomographic differences between patients with panic disorder who respond to combined CBT and pharmacotherapy.

The study comprised 24 patients diagnosed with panic disorder with or without agoraphobia. The severity of symptoms was measured with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Sheehan Anxiety Scale, subjective and objective Clinical Global Impression (CGI) and Dissociative Experiences Scale (DES). Based on final BAI score decreases by 25%, the patients were classified into two groups - responders and non-responders. 21-channel EEGs were recorded at baseline and after completion of therapy.

In non-responders, there were no statistically significant changes in sLORETA findings following therapy. Responders showed a significant decrease of alpha-2 sources (p< 0.05) in the occipital lobes and cuneus and a statistical trend for increased beta-3 sources (p< 0.10) in the posterior cingulate.

Only treatment response was associated with significant changes of electric neuronal activity.

In Brazil, children and adolescents are considered holders of Special Rights, as depicted in Article 227 of the 1988 Brazilian Constitution. Special Rights refers to a condition in which their rights should be respected, but also protected from physical, moral and psychological harm. Moreover, the Brazilian Child and Adolescent Statute (Law n. 8.069) specifically guarantees full protection of children and adolescents.

This case-report sought to discuss the intersection of Psychiatry and the Brazilian Law in a case of suspicious recurrent child abuse. AIM. To demonstrate the importance of protecting children from maltreatment by reporting the case of a suspicious recurrent child abuse.

Case-report: A 7-year-old child and her mother were evaluated by two psychiatrists, as requested by the Public Attorney Office of the State of Rio de Janeiro. Denouncements of possible recurrent negligent treatment by the parents had been referred to the Public Attorney Office since the child was one year old. Other family members were also interviewed, to better understand the family dynamics. RESULTS. The mother had no symptoms of mental disorder. The child had symptoms of possible child abuse, such as physical and school failure, emotional and social withdrawal.

Clinicians must pay attention to emotional signs and symptoms that can be indicators of child abuse, which must be reported to law enforcement. We also highlight the importance of evaluating and giving support to the whole family.

Suicide is a major public health problem. Although suicide statistics have always been difficult to determine, there is no doubt that deaths caused by this psychiatric challenge are similar to the ones caused by homicide or road traffic injuries. The presence of a personality disorder has often been related to suicide.

In the present work we analyze the presence of personality disorders (PD) in suicide victims and controls, in order to determinate such axis II disorders were more common in the suicide group.

We compared the results of two samples (271 suicides and 142 sudden-death controls), which were studied using a psychological autopsy. Personality disorders were diagnosed using the SCID-II. Data were analyzed using the SPSS software 19.0 version.

Although age differences were found between both groups, they were almost not statistically significant (p=0’049). There were no differences in gender results (p=0’289). The prevalence of PD was statistically significant (p=0’00) among the suicide group. When we studied the suicide group, we found that the existence of previous suicide attempts and PD was statistically significant also.

Although PD were more frequent among suicide victims, we found that PD also had more previous suicide attempts. Therefore, the presence of more PD among suicide victims may be due to the higher rates of suicide attempts

To describe a case of Ekbom Syndrome with Folie à Deux, between mother and daughter, that has the mother as the “primary patient” even with borderline intelligence and the daughter as the induced patient, but without any cognitive deficits.

To highlight that some cases of Folie à Deux can occur in a strictly affective dominance fashion relationship.

Case report.

MRC, 46 years old, illiterate, was referred to the outpatient psychiatric clinic of the University Hospital of the Federal University of Alagoas-Brazil, by a dermatologist of the same hospital because of hyperchromic scaly pruritic skin lesions in legs and back with no findings at skin biopsy that the patient attributed to “bugs” under her skin and that her daughter also believed that existed even when her mother showed her desquamative skin as being the bug.

The dominance between the primary patient and the induced one can be of affective nature only but not cognitive nature in Folie ... Deux with Ekbom Syndrome.

Alterations of the Hypothalamic-Pituitary-Adrenal Axis (HPAA) may be related to the development of psychiatric disorders, especially in the context of childhood adversity. The “attenuation hypothesis” postulates that chronic childhood adversity leads to initial hyperactivation of the HPAA, which subsequently may turn into hypoactivation during adolescence, and support the development of emotional and behavioural problems. However, studies investigating this hypothesis during the course of adolescence are rare.

The sample comprised 49 adolescents (f/m 19/30), subsampled from a larger longitudinal study on adolescent development. Assessments were performed at three points in time (T1-T3). Pituitary Gland Volume (PGV) as an estimate of chronic HPAA activity was measured by MRI at T1 (mean age 12.5) and T3 (mean age 16.5). HPAA functioning was assessed via multiple salivary cortisol measures at T2 (mean age 15.5). The Cortisol Awakening Response (CAR) was calculated as a measure of HPAA activity. Additionally, childhood adversity was assessed at T2 using the Childhood Trauma Questionnaire (CTQ).

There was a significant sex-specific association of PGV at T1 and HPAA activity at T2. While PGV was positively predicting HPAA activity in boys, girls showed a reverse pattern (attenuation of the HPAA). A blunted CAR in girls was significantly related to their report of childhood adversity.

The results show that girls may have a higher tendency of attenuation of the HPAA in the context of childhood adversity and initial hyperactivation of the HPAA. This may contribute to their higher risk for diverse psychiatric disorders during adolescence.

Physical domestic violence (DV) against women is associated with adverse health effects and great burden on victims, families and communities. The phenomenon, though prevalent in EMR countries, is not well defined regarding the determining factors.

This systematic review is to sum up evidences from the EMR countries, on factors associated with physical DV.

Methods:

Pubmed, EMBASE, ISI, PsycInfo, IMEMR, Ovid, Global health, Cochrane Library, IranMedex, SID, IranDoc, Science direct, Elsevier, Proquest and Magiran were searched with no language limits up to December 30, 2011. The hand searching included papers’ lists of references and evidence list of “The National agenda for preventing domestic violence”.

Quantitative studies on ever partnered, not-pregnant women in the EMR countries, which referred to either predisposing or protective factors of physical DV, in each of victims, perpetrators and community domains, were selected. A criterion based critical appraisal was performed by two reviewers.

The Odds Ratios of all reported factors - regardless of statistical significance- were either directly extracted from the papers or indirectly calculated from provided contingency tables, and used to make summary tables.

According to 16 finally selected articles, either partners’ lower levels of education, their witnessing /exposure to DV in childhood, personal/ family unfavorable socioeconomic status, rural residency and husbands’ alcohol / drug abuse were predisposing; while consanguinity, women’s age and employment were protective factors.

Findings are consistent with most international evidences. A meta-analysis will provide a more comprehensive understanding and evidence.

In the last decades, the early intervention on individuals at risk of developing mental disorders became one of the most important and emerging issue not only in psychiatry but also in the overall evidence-based medicine. Subjects who reported severe psychotic-like experiences may be considered five times more likely to manifest psychosis in the following four years when compared to the general population. We aimed to conduct a general screening with the scope to detect subjects at risk for psychotic-like experiences, depression and suicide. Also, we aimed to evaluate the possible correlation between the screening evaluations, gender and early traumatic experiences.

A total of 120 patients was screened using the TeenScreen Program, Community Assessment of Psychic Experiences, Beck Depression Inventory, Beck Hopelessness Scale, Childhood Trauma Questionnaire.

At the bivariate analyses, male subjects had significant lower total scores in several measures (p=0.001) than female. When multivariate analyses were performed to evaluate the association with gender and early traumatic experiences, we found that female subjects were 1.7 times more likely to be older (p< 0.01) and 1.52 times more likely to report depressive symptoms compared to male. Also, subjects with higher total scores at the CTQ were several times more likely to be older than those with lower total scores.

Although the small sample size did not allow to generalize the present findings, the detection of some subgroups of subjects at higher clinical risk may play a critical role in terms of prevention and early interventions.

Although religion is one the protective factors classically related to suicidal behavior, as far as we know, no studied based on psychological autopsy has been published. Holy Week in Seville (Spain) may be the most important traditional event of the city. Besides socio-cultural and economic aspects, it is the celebration of the Passion and Death of Christ through the brotherhood processions to the Cathedral, and its religious feeling is present in a large majority of the population.

In the present work we tried to study if, as well as other religious aspects, belonging to a brotherhood and participating actively in it are protective factors for suicide.

We compared the results of two samples (271 suicides and 142 sudden-death controls), which were studied using a psychological autopsy. We developed a questionnaire to study religious thoughts/feelings, specially those related with the Holy Week brotherhoods.

In our sample, religious people committed less suicides than the atheist (80 %-68’1% between the males, 100%-92’4% between the females), being the differences statistically significant for the males (chi square test =0’002). Belonging to a brotherhood was also a protective factor (only 22’5% of the suicide victims belonged, compared with the 37’8% of the controls), and if the participated actively they had even less risk (RR=0’562).