Lithium has been used in the treatment of bipolar disorder in pregnant women. However, information on the pharmacokinetics of lithium during perinatal period is scarce.

To study pharmacokinetics of lithium during delivery and in the neonatal period.

A prospective, observational and naturalistic study was conducted at the PERINATAL PSYCHIATRY PROGRAM CLÍNIC-BARCELONA, from 2005 to 2012. We included all consecutive cases of pregnant women with bipolar disorder I or II (n = 22), and on maintenance treatment with lithium monotherapy (n = 13) or polytherapy (n = 9) during pregnancy who elected artificial feeding. Lithium plasma concentrations in maternal blood and umbilical cord were detected. Lithium plasma concentrations in infants (n = 16) at delivery and in the neonatal period were obtained to calculate elimination half-life, which was estimated by lineal regression. Technique: AVL 9180 electrolyte analyser using a lithium-selective electrode (detection limit =0.10 mEq/L).

Women did not fulfil diabetes criteria pre-pregnancy and during pregnancy. Attending to neonatal outcomes, infants exposed to polytherapy had a higher weight at birth (percentils) than those exposed to lithium alone [53.38 (33.40) vs. 70.22 (26.25)]. No statistically significant differences were found in umbilical cord:maternal plasma concentration ratio between those treated with lithium monotherapy and women treated with polytherapy (1.05 vs. 1.08). The lithium mean elimination half-life (SD) in infants was 6.73 (9.12) days.

Lithium crosses placental barrier almost completely. Elimination half-life in neonates exposed to lithium in utero was 6.73 days. Moreover, lithium treatment during pregnancy requires therapeutics monitoring in exposed dyads.

Young women with personality disorders (PD) are common in psychiatric inpatient care. The clinical impression is that there is a considerably increased incidence the last decade.

To show changes in frequency and extent of inpatient care for PD, and the relation to suicide.

All admissions for inpatient care given a primary diagnosis of PD in compulsory or voluntary care years 1990 to 2010 were extracted from the National Patient Register. Subsequently, data from the Cause of Death Register were extracted and linked for the same time period.

There were more than 60,000 admissions for PD in Sweden 1990–2010. During the last ten years there was a doubling of the number of yearly admissions for young women in the ages 18 to 24 years, and inpatient care hospitalization for PD are currently six times more common for women than for men in this age group. The same is true for compulsory care. Every fifth woman in this age group who had committed suicide had been treated for PD within the last five year period prior to the suicide.

The incidence of inpatient care in young women with PD did show a sharp rise during the last decade. There was a corresponding increase in suicide with a diagnosis of PD. Guidelines for treatment and care exist but more knowledge and action plans directed both to health care and the society are urgently needed.

People suffering from Severe Mental Illness (SMI) have a shorter life expectancy than general population. The excess of mortality may be primarily due to premature cardiovascular diseases. Subjects with a diagnosis of SMI may have an high prevalence of Metabolic Syndrome (MetS).

To estimate the risk of MetS among subjects with SMI compared to their counterpart without SMI.

A systematic review and meta-analysis of English and non-English articles using PubMed, Embase and PsycINFO was performed. ORs with related confidence intervals were used as association measures. All pooled analyses were based on random-effects models.

The pooled analysis showed a statistically significant association for MetS in people suffering from SMI. However, we found a consistent level of heterogeneity between the included studies. Subanalyses showed that both SCZ and BD had higher risk than general population without SMI. No statistical differences were found comparing SCZ and BD subjects.

People with SMI have significantly higher risk to having MetS than general population. Despite some limitations, the results of present meta-analysis emphasize the relevance of a continuous cardio-metabolic assessment in the SMI population. Longitudinal researches are needed in order to assess the impact of a regular cardiovascular screening, prevention and treatment on the improvement of health status and life expectancy among people suffering from SMI.

The Hypothalamic-Pituitary-Adrenal Axis (HPA axis) has been implicated in the pathogenesis of many affective disorders. Peripartum depression is a condition that includes depressive episodes occurring during pregnancy and the postpartum period. During uncomplicated pregnancy, mean cortisol levels rise substantially, mostly due to high levels of corticotropin releasing hormone produced by the placenta (p-CRH). The latter also suppresses hypothalamic CRH, leading to hypo-cortisolemia after partus. Cortisol concentration is usually normalised within two weeks after delivery. Failure of the above process results in continuing hypo-cortisolemia, which might increase susceptibility to PPD.

The current study aims to investigate the relationship between evening salivary cortisol levels and depression during the peripartum period.

Three hundred and forty six pregnant women were asked to participate in the study. They completed the Edinburgh Postnatal Depression Scale (EPDS) and the Spielberger State-Trait Anxiety Inventory-State version (STAI-S) at the 36th week of pregnancy and the 6th week after delivery. At both times, study subjects were also asked to collect evening salivary samples by using a mail-delivered kit. Moreover, they were interviewed at the 36th week of pregnancy using the Mini International Neuropsychiatric Interview (MINI).

Preliminary results indicate significantly higher evening salivary cortisol levels in depressed women during late pregnancy compared to healthy controls. No difference in cortisol levels was found between women with postpartum depression and healthy controls.

Our study results support the hypothesis that depression during pregnancy resembles melancholic depression characterized by hyperactivity of the HPA-axis and hyper-cortisolemia.

Schizophrenia is a chronic illness with a worldwide lifetime prevalence of about 1% [1]. Non-adherence and partial adherence to antipsychotic medication treatment is common and long-acting injectable “depot” preparations of antipsychotic medications have been used as an alternative to oral medication therapy for patients for whom adherence is a clinically significant problem [2].

In present study,we collected the sociodemographic and clinical data of 252 patients who were diagnosed as schizophrenia according to DSM-IV-TR and who were followed up by our outpatient clinic at least two years. The data obtained from medical records and interviews; patients were grouped according to using of long acting antipsychotics.

The long acting antipsychotics were prescribed to 96 patients of 252 patients. The rates of history of suicide attempt, family history of schizophrenia and violent bahaviour were significantly more in long acting antipsychotic group (p≤ 0.05). In regression analyze, history of suicidal and violent behaviour and family history of schizophrenia were found to be significant for predicting the use of long acting antipsychotics (p≤ 0.05).

Considering the commonness of poor adherence to treatment in schizophrenia, we suggest that predicting the sociodemographical and clinical factors associated with using of long acting antipsychotics is important for treating effectively schizophrenic patients with poor treatment adherence in early stages.

Considering the current Greek economic crisis, it is reasonable to discuss the potential and expected effects of the crisis in mental health.

This study examined the effect of borrowing on mental health.

This study aimed at detecting the interaction of borrowing on the bio-psycho-social health.

273 community individuals participated in the present study. The measures used were: Family Environment Scale, the Hostility and Direction of Hostility Questionnaire, the Symtom Checklist 90-R, State - Trait Anxiety Inventory, Family Crisis Oriented Personal Evaluation Scales, Other As Shamer Scale, Experience of Shame Scale, Cardiac Anxiety Questionnaire.

The borrowers have statistically higher average than non-borrowers parents at the scales of paranoid-ideation 6,55 ± 4,03, guilt (SCL - 90) 0,93 ± 1,14, orientation of the family for achievements 6,44 ± 1,54, moral emphasis of the family environment 4,67± 2,21, and at family mobilization to accept help in the periods when the family is in crisis 11,13 ± 4,65. Particularly interesting result of this study was the finding that borrowers with heavy debt from mortgages and personal loans and credit cards have higher levels of paranoid-ideation (8,38), more stress for their heart function (1,395) and avoiding activities for heart function (1,809), higher levels of internal shame (21,38), feeling empty (4,52), higher levels of behavioral shame (20,62) and higher levels of thoughts of death (1.05).

The heavy debt has not only economic consequences but also, is associated with serious psychological distress. The factors of personality, of postponement of satisfaction, of impulsivity are correlated with the borrowing.

Four theoretical models have been postulated in formation and maintenance of delusional idea in schizophrenia:

1. 1. Cognitive biases (attentional bias, jumping-to-conclusion, need-for-clousure, attributional bias),

2. 2. Social cognition alterations (theory-of-mind, emotion facial recognition),

3. 3. Perceptive alterations of anomalous experiences and

4. 4. Emotional anomalies (anxiety, depression, self-esteem, “self” discrepancies).

To exam the joint influence of these anomalies in delusional activity in DD.

We studied the delusional activity measured by the “Maudsley Assessment of Delusion Schedule” in 68 patients with DD (n=68) diagnosed by SCID-I (DSM-IV-TR). Cognitive biases were evaluated by “Emotional Stroop”, “Experimental Beads Task”, “Need-for-Closure Scale”, “Internal, Personal and Situational Attributions Questionnaire”. Social cognition alterations were measured by Faux-pas Task and Eyes-Test; perceptive alterations by “Cardiff Anomalous Perceptions Scale”; and emotional anomalies by “Hamilton Anxiety Rating Scale”, “Beck Depression Inventory”, “Rosenberg Self-esteem Scale” and “Personal Qualities Questionnaire”. The relationship between delusional activity and these cognitive anomalies were examined using lineal regression models controlled by socio-demographic characteristics, premorbid IQ (“NART”), negative symptomatology (“PANSS”) and neuropsychological function (attention, verbal learning, working memory and executive function).

High scores in delusion activity were significantly associated with high scores in jumping-to-conclusion and depression and low scores in faux-pas and self-esteem, after being adjusted by number of studied years and negative symptomatology.

Cognitive biases (jumping-to-conclusions), social cognition deficit (faux-pas) and emotional alterations are the most implicated anomalies in formation and maintenance of delusional idea in DD.

The researches show a rapid growth of mental disorders among adolescents and young adults that often cooccurs with risk behaviours, such as suicide, which is one of the leading cause of death among young ages 15-34. Therefore it's necessary to use some tools that can promote mental health getting to young lives such as Internet and media.

SUPREME (Suicide Prevention by Internet and Media Based Mental Health Promotion) is aimed to increasing the prevention of risk behaviours and mental health promotion through the use of mass media and Internet.

The main expected outcome is to improve mental health among European adolescents.

In each European countries a sample of 300 students (average age of 15 years) will be selected. The prevention program will be a highly interactive website that which will address topics such as raising awareness about mental health and suicide, combating stigma, and stimulate peer help. The program will use different means of referral to the intervention website: “Adolescent related” and “Professional related”. A questionnaire will be administered to the pupils for require the data on lifestyles, values and attitudes, psychological well-being, familiar relationship and friendship.

Some web-sites, managed by mental health professionals, produced encouraging results about their use in prevention of risk behaviours and in increase well-being, especially in youth with low self-esteem and low life-satisfaction. With the implementation of the SUPREME project we will be able to identify best practices for promoting mental health through the Internet and the media.

Mental disorders are highly prevalent in the general population and are among the factors that most affect the quality of life, creating great social impact. The national literature that discusses mental disorders in indigenous is very scarce.

To characterize the socio-demographic profile and major psychiatric disorders that affect a sample of indigenous villagers who sought primary care mental health.

We developed a retrospective cross-sectional study of a consecutive series of cases of Karajá Indians who sought primary care. Symptoms were classified as major syndromes: affective, anxiety, psychotic and organic, and then calculated the prevalence of each syndrome and psychiatric diagnosis according to DSM-IV, as well as their association with sociodemographic variables.

63% of the sample were male. Aged 10-67 years, mean 30.7 years. Schooling to 1st elementary school was 46.2%, and 26.9% illiteracy. 54.5% are married. The affective syndrome was present in 50% of patients, depression in 28%, and 21% in Bipolar Disorder. The anxiety disorder accounted for 8%, the psychotic 15%, and 12% organic. Considering the whole sample, 20% are composed of married patients with affective syndrome. Of the patients diagnosed with affective syndrome, 30% had problems with alcohol and drugs, 38% had suicidal ideation, and suicide attempt 6%. Regarding treatment used, 35% and 33% of patients were on antidepressants and mood stabilizers, respectively.

There is a high prevalence of Depression and Bipolar Disorder among the causes of mental disorder among Indians who seek primary care.

Parkinson's disease (PD) is classified primarily as a movement disorder. Psychiatric complications, however, are common during the progression of the disease. Psychosis is rare in untreated patients with PD, but the prevalence rises to 40% during dopaminergic treatment.

We report the clinical course of a ropinirole induced psychosis in a 57-year-old female with PD.

The patient was treated with different antiparkinsonians (rasagiline, ropinirole and levodopa), and after a dosage increase of ropinirole, psychotic symptoms appeared (auditory hallucinations and paranoid delusion). Antipsychotic treatment started with quetiapine and a gradual dose reduction of antiparkisonians. Nevertheless, psychotic symptoms required a hospital admission.

Rasagiline was suspended at admission, the dose of ropinirole was decreased until withdrawal, and the dose of levodopa was reduced. The dose of quetiapine was increased to control psychotic symptoms.

The pathogenesis of psychosis in PD is poorly understood. It has been related with the presence of dementia and concomitant treatment with dopaminergic agonists (DA). According to the literature, pergolide is associated with a significantly increased risk for the development of psychosis, followed by ropinirole, pramipexole and cabergoline, whereas levodopa has the lowest associated risk. Treatment includes, in the first place, suspending anticholinergics and selegiline, and then, amantadine, DA, and entacapone. Finally, levodopa may also be reduced. These patients frequently require antipsychotic treatment that may worsen extrapyramidal symptoms.

Psychosis should be considered in PD, especially in patients treated with DA. Treatment begins with reducing antiparkinsonians and then adding antipsychotics. Clozapine and quetiapine are a good choice.

While evidence-based psychiatric practices (EBPs) are assumed to be more efficient, savings and sustainability are elusive during times of economic instability. This presentation uses two-years of penetration and cost-related data from46 community mental health providers to document EBP penetration and sustainability during a period of serious funding contraction.

This study sought to identify specific elements that contribute to EBP-related savings and sustainability in urban, rural and blended environments.

This study identifies critical organizational practices that sustain EBPs during difficult economic times.

Using existing claims data on the State of Michigan website, researchers used a stratified regression analysis to identify critical variables contributing to increased use of EBPs and decreased use of high-cost services. Follow-up qualitative data were collected from administrators of high and low penetration organizations to provide insight into within-agency strategies that contribute to EBP implementation and sustainability.

Findings identify direct and indirect contributors to sustainability and efficiency when implementing evidence-based practices. Direct contributors include unit-cost funding and the number of EBPs implemented. Indirect contributors include organizational promotion activities that create an atmosphere of excellence. Findings vary across urban, rural and blended environments.

Evidence-based practices require a strong organizational commitment to remain viable during difficult financial times.

Worldwide, thalassemia poses a serious public health problem due to the high prevalence. Mothers usually take active roles in the care of their ill children. Several studies have found that parents of children with chronic diseases or disabilities have higher depression scores than control parents. The main aim of the present study was to investigate if mothers of children with thalassemia higher scores of depression compared with a group of control mothers.

In this study, 30 mothers were assessed using the Beck Depression Inventory (BDI), Symptom check list-90-revised (SCL-90-R), COPE and SF-36, also 30 mothers were enroled as control group who have healty children.

Mothers who have children with the diagnosis of thalasemia had higher scores of depression from the BDI and lower quality of life scores (p< 0.05).

It seems that depressive people experience specific events before depression. Several studies have indicated that presence of a patient or disabled child in the family can cause stress and depression in parents.The results of this study can contribute to the development of a screening program for decreasing depression burden and promoting quality of life for mothers of children with thalassemia. It is an ongoing study.

Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.

SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.

We investigated the differences on psychological problems between students with poor and good peer relationships.

1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).

Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.

Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.

Considering the current Greek economic crisis, it is reasonable to discuss the potential and expected effects of the crisis in mental health.

This study examined the effect of unemployment on mental health.

This study aimed at detecting the interaction of unemployment on the bio-psycho-social health.

273 community individuals participated in the present study (122 men - 151 women, mean age 49,2± 6,9). The measures used were: a) Family Environment Scale (FES), b) the Hostility and Direction of Hostility Questionnaire (HDHQ), c) the Symtom Checklist 90-R (SCL-90), and d) State - Trait Anxiety Inventory (STAI), e) Short Form Health Survey (SF-36), f) Other As Shamer Scale (OAS), g) Experience of Shame Scale (ESS).

Multivariate analysis was applied for the statistical analysis of data, and the results was: a) the unemployed have the highest level (6.82) of feelings of inferiority, the total price (47.30) of internal shame, State Anxiety (47,58), Obsessive- Compulsive (11,42), interpersonal sensitivity (8,30), depression (13,64), phobic anxiety (3,79), and intropunitiveness hostility (7,45). Still have the lowest levels of the scales of Intellectual - Cultural Orientation (4,97), family orientation for active recreational activity (3,61), mental health (58,00), physical role (62,12) and summary scale of physical health (266,64).

It was found that the unemployed suffer more than all social groups at periods of economic crisis and this has impacts on psychosomatic health, on state stress, as much as on the feelings of inferiority and shame which they feel.

Some authors have found an association between affective temperaments and mood fluctuations, and a common comorbidity between somatization disorders and mood disorders. In addition, It’s known a significant association between abnormal affective temperaments and somatoform disorders.

The present study investigated associations between affective temperaments and somatization in a 55 healthy subjects sample.

The aim of the study was to describe associations between affective temperament and somatization scores in a sample of healthy subjects.

In this observational study we adopted the following rating scales: Mini International Neuropsychiatric Interview (MINI), 17-item Self Rating Depression Scale (SDS), Hypomania check list 32(HCL-32), Self Rating Anxiety Scale (SAS), DCPR diagnostic criteria for psychosomatic research, Brief TEMPS-A, Modified Somatic Perception Questionnaire (MSPQ), Somatosensory Amplification Scale- SSAS.

Logistic regression analysis showed that cyclothymic temperament scores at Brief TEMPS-A are associated with MSPQ scores for somatic perception (somatosensory amplification) and SASS scores (hypochondriacal aspects). Moreover, depressive temperaments scores at Brief TEMPS-A are significantly associated to MSPQ tools.

Our data suggest an association between an affective temperamental dysregulation and somatization aspects in a 55 healthy subjects sample.

EEG-neurofeedback is used as a component of therapy in patients diagnosed with ADHD. The efficacy of NF on inattentive symptoms has been previously suggested.

The aim of the study was to assess the efficacy of 20 sessions training of eeg-neurofeedback (NF) in patients suffered from ADHD.

The studied group consisted of 44 patients (34 boys and 7 girls).To determine the efficacy of EEG-B on symptoms intensity, The Symptoms of ADHD Questionnaire was used: before the treatment and after 20 sessions of NF. NF trainings took place once or twice a week. The trainings were conduct based on two protocols: theta/beta and theta/SMR for left hemisphere and for right hemisphere, respectively. The changes in theta/beta and theta/SMR ratios were estimated to assess the influence of NF on eeg parameters.

The significant reduction in symptoms intensity was found after 20 sessions of NF. Theta/beta and theta/SMR ratios median values have been significantly decreased.

The results of the study indicate the 20 sessions NF training being efficacious in reduction of the intensity of ADHD symptoms. The improvement of eeg parameters responsible for attention functions was also observed.