As German reunification took place in 1990 Eastern Germany as a former socialist country (GDR) became part of democratic Germany. It underwent dramatic changes influencing all parts of society.

Our objective was to analyse all suicides in the Eastern German City Magdeburg based on all relevant police files.

Little is known about the former GDR and its suicide rates since no official data existed. Our aim was to investigate differences in suicide rates by age and sex in one city of the former GDR before and after reunification.

As part of GDR-time the period 1985 - 1989 (A) and as post-reunification time the period 1999 - 2004 (B) were analysed. Basis of our investigation were all police files. Absolute suicide numbers were counted. Suicide rates were calculated per 100.000 persons, sex and year. Different age structures became comparable by using the old standard population of Europe (WHO 1976).

We identified 470 suicides in period A and 206 suicides in period B. For both sexes suicide rates were significantly higher in period A and increased with age. Women had generally lower suicide rates. Age-standardized rates show a reduction for males of about 50% and for females of two thirds in comparison of the two periods.

Suicide rates decreased in our analysed city dramatically. Women in general and particularly elder groups have lower suicide rates and thus benefited most. There are various contributing factors such as positive changes in health care and social support.

The prevalence rate of dementia in older adults with intellectual disability (ID) is comparable with that of the general population and is significantly higher in people with Down Syndrome (DS). It is recommended that diagnosis should be made following history, physical and mental state examination, cognitive assessment, blood tests and, ideally, neuroimaging. However, experience suggests that dementia may be underdiagnosed in this patient group thereby restricting access to appropriate management.

We aimed to elucidate the barriers to a timely diagnosis of dementia in the ID population attending a specialised ID memory clinic in London, UK.

We conducted a service review of the Clinic, retrospectively reviewing the records of all patients seen in 2011 to assess attendance and diagnosis rate, co-morbid physical and mental illness and the completion of neuroimaging and blood tests.

32 patients were seen at least once during 2011 in the memory clinic, of whom 11 (34%) received a diagnosis of dementia. 22 (69%) of those seen had DS and 18 (56%) were male. 12 (38%) patients have thyroid dysfunction and 8 (25%) have epilepsy. 23 patients had completed a DLD in the past year and 14 (44%) had completed more than one DLD. 12 (38%) patients had a previous brain scan and 27 (84%) patients had had blood tests in the previous year.

Comorbid physical illnesses, consistent attendance at appointments, access to psychological assessment and willingness to undergo neuroimaging and phlebotomy are significant barriers to diagnosis of dementia in patients with ID.

Negative feelings towards the body and body size misperception have long been associated with disordered eating behaviour. Over recent years the perceptual flexibility of the human body representation has been consistently demonstrated using multisensory perceptual illusions. Whether such perceptual changes can impact the emotional experience of our body, however, has yet to be explored.

The current study exploits well-established perceptual body illusions to induce illusory ownership over slimmer and wider body shapes whilst measuring changes in body satisfaction.

To identify a direct causal link between perceptual and affective body representations.

Participants were presented with video images of both a slimmer and wider mannequin body viewed through head mounted displays from a first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post illusion affective and perceptual measures captured changes in perceive body size and body satisfaction as a result of the illusion.

Illusory ownership of a slimmer body significantly increased feelings of body satisfaction as well as significantly decreasing perceived actual body width. Change in body satisfaction following illusory ownership of a wider body, however, was modulated by degree of sub clinical eating disorder pathology and did not induce a systematic change in perceived body width.

These findings suggest a link between perceived body size and body satisfaction, which may be modulated by eating disorder pathology. The results could have implications for future treatments of eating disorders.

Evaluate the efficacy of aripiprazole combination with lithium/valproate vs. placebo combination in bipolar mania using a titration regimen with a low starting dose (5 mg/day).

Eligible adult patients with bipolar mania receiving lithium/valproate and a Young Mania Rating Scale (YMRS) Total score ≥16 who might benefit from combination treatment with aripiprazole, were randomized to aripiprazole (n=181) or placebo (n=189) with lithium/valproate. Primary endpoint was mean change from baseline to Week 12 in YMRS. Secondary endpoints were Clinical Global Impressions-Bipolar Version (CGI-BP) severity of illness score, response rate (≥50% improvement in YMRS Total score), and remission rate (YMRS ≤12). Safety and tolerability were also assessed. Enrolment yielded a 77% power to detect a 2.6-point change in YMRS Total score at endpoint.

At endpoint, the mean change in YMRS Total Score (last-observation-carried-forward [LOCF]) for aripiprazole vs. placebo was not significant (treatment difference [-2.04] in favour of aripiprazole (95% CI: -4.14, 0.07; p=0.058). Mean change from baseline to endpoint in CGI-BP showed a treatment difference (-0.30) in favour of aripiprazole vs. placebo (95% CI: - 0.59, -0.01; p=0.044). Response rates were 68.8% vs. 61.3% (p=0.128) and remission rates were 69.9% vs. 64.0% (p=0.211) for aripiprazole and placebo, respectively. No unexpected adverse events (AEs) occurred. Treatment-emergent AEs (≥5% and twice the rate of placebo) were akathisia, depression, and nausea.

The target sample size of 388 patients was not achieved in this study and the primary outcome did not reach statistical significance. Now new or unexpected AEs occurred.

One of the problems of the contemporary psychiatry is, certainly, hospitalization, because the freedom of an individual, altogether with the right to life and personal safety, is a basic human right. Hospitalization of patients with schizophrenia interferes with their psychological and social integrity, which is of high importance for their lives.

Is to determine whether the socio-demographic characteristics (gender, age, education, work and marital status) influence the decision making regarding the form of hospitalization.

In purpose of the investigation, we used the closed-type questionnaires that were composed for the needs of this paper. In order to fill the questionnaires, we used the case records of hospitalized patients with schizophrenia during 2010. In order to analyze the obtained data we used the methods of descriptive statistics.

597 schizophrenic patients with diagnosis F20.0 - F20.9 hospitalized during 2010, of which 472 (79.6%) voluntarily, and 125 (20.4%) involuntarily. Among socio-demographic characteristics, the differences between the voluntarily and involuntarily admitted patients are observed by: occupation, working status, number and cause of hospitalization (first and repeated), while there are no differences regarding the level of education and marital status. By gender, there are no differences in type of hospitalization.Voluntarily admitted patients are the predominant in the group of age 41-50, and the involuntary in the group of 31-40.

According to the presented analyses of results of socio-demographic characteristics of involuntarily and voluntarily hospitalized patients with schizophrenia, we came to a conclusion that the specified characteristics influence the form of hospitalization.

Important reciprocal relationships exist between the central nervous, the endocrine and the immune systems.

The main objective was the quantitative determination of prolactin levels in acute and remitted psychotic patients receiving conventional and atypical antipsychotic treatment. Possible correlations between prolactin levels and psychotic, endocrine or immune disorders in patients' medical history or family history were checked.

58 patients (42 women and 16 men) receiving antipsychotic treatment were included in the study in order of their presentation to control visits or admission in the psychiatric hospital. They were classified into the following ICD 10 diagnostic categories: acute and transient psychotic disorders, schizophrenia, persistent delusional disorder, schizoaffective disorder and bipolar disorder. The following data were collected: prolactinemia (chemiluminescence method), ASAT, ALAT liver enzymes, glycemia, serum creatinine, thyroid hormones, sexual hormones, the intensity of psychiatric symptoms measured with BPRS, personal and family history of psychiatric, endocrine, immune disorders or treatments.

47 patients (81%) presented hyperprolactinemia (33 women and 14 men). 9 patients (16%) presented a history of autoimmune disorders, 4 (7%) having also a family history of autoimmune disorders. 9 women had amenorrhea or irregular menstrual cycle. 5 patients were on long acting antipsychotic treatment.

Regardless of the antipsychotic treatment received, the majority of the patients presented hyperprolactinemia. Women presented a higher increase in prolactin levels than men. The results were interpreted according to the thyroid and sexual hormonal status. A positive correlation between prolactin levels and BPRS scores was found (r = 0.2628 P= 0.0463, 95% CI).

To complete an up-to-date meta-analysis of studies investigating the correlation between insight and various measures of neurocognition in psychosis.

We completed a comprehensive literature search using Pubmed and ‘Web of Science’. After applying inclusion and exclusion criteria we isolated 34 papers published on this topic since 2004. This list was then added to those published prior to 2004 that had been found in an earlier meta-analysis performed by our group to give a complete collection of 69 papers. Metaanalysis of data was performed in the Comprehensive Meta-Analysis software using random effects models.

Overall our sample included 5127 patients with psychosis across 69 studies. We performed analyses for overall cognition, IQ, memory, executive function and specifically the Wisconsin Card Sorting Test (WCST). We found a small but highly significant correlation between insight and each measure of neurocognition in all patients with psychosis (mean weighted r = 0.13–0.16 across domains, p < 0.001). When restricted to those patients with diagnosis of schizophrenia (n = 1708) the strength of correlation in each domain increased slightly (mean weighted r = 0.14–0.18, p < 0.01). We found no evidence of significant publication bias.

In this comprehensive meta-analysis we found a small but robust correlation between insight and a variety of neurocognitive domains in patients with psychosis. We believe that this data supports the role of neurocognitive processes in some aspects of insight but believe that a more precise experimental approach is required to elucidate the exact mechanisms of this relationship.

The endogenous opioid system (EOS) plays a critical role in addictive processes. Molecular dysregulations in this system may be specific for different stages of addiction cycle and neurocircuitries involved, and therefore may differentially contribute to the initiation and maintenance of addiction.

We here evaluated whether the EOS is altered in brain areas involved in cognitive control of addiction including the dorsolateral prefrontal cortex (dl-PFC), orbitofrontal cortex (OFC), anterior insula (AI) and hippocampus, in human alcohol dependent subjects.

Levels of EOS mRNAs were measured by qRT-PCR, and levels of dynorphins by radioimmunoassay in postmortem human specimens.

Prodynorphin kappa-opioid receptor mRNAs and dynorphins were upregulated or demonstrated higher dispersion in alcoholics.

Dysregulation in the kappa-opioid receptor/dynorphin system in alcoholics may contribute to alcohol craving and neurocognitive dysfunctions relevant for addiction and disrupted inhibitory control.

We are grateful to the NSW Tissue Resource Centre for providing human brain samples. Supported by the Swedish VR and FAS.

Social capital is emerging as an important component of mental well-being. Our aim was to assess the relationship between social capital and common mental disorders and to explore the role of social capital in the relationship between deprivation and common mental disorders.

This study used data collected from 7023 adults in England who completed the Adult Psychiatric Morbidity Survey (2007). Common mental disorders (CMD) were measured using CIS-R. Questions on both cognitive (CSC) and structural social capital were included, as well as data on area level deprivation.

We found a strong association between higher CSC and lower levels of CMD, depression and anxiety. Structural social capital was associated with lower levels of CMD and depression but was not conclusively associated with lower levels of anxiety. While there is a relationship between low social capital and deprivation, we found that higher CSC was still associated with lower CMD in participants living in deprived areas. Results for structural social capital were less conclusive although an association with lower overall CMD was still found in the most deprived communities.

In a nationally representative sample, higher social capital is associated with lower levels of CMD. There appears to be a relationship between low social capital and deprivation and this may have implications for the mental wellbeing of individuals living in deprived communities.

Loneliness is a distressing feelings, described as an individual experience of lack of satisfying relationships. There are a number of causes of loneliness: a loss of significant persons in life, divorce; it may occurs after the birth of a child or after marriage. Loneliness is common experience, most in adolescence and older adults. Many studies shows that loneliness is a predicting factor of mental and health illnesses and as such is associated with elevated blood pressure, increased risk of cancer and stroke, impaired sleep, impaired immune function, alcoholism, depressive symptoms and suicide.

of this pilot study is to describe the relationship of loneliness in four groups of psychiatric disorders (depression, dementia, schizofrenia and anxiety disorders).

Loneliness is measured by UCLA Loneliness Scale - R (N=50 for each group).

The people with psychiatric disorders have higher level of loneliness (p< 0,01), especially with dementia and depression (p< 0,1), in comparison with the control group.

This pilot study, hand in hand with the relevant studies, demonstrates higher level of loneliness among people with specific psychiatric disorders. Therefore loneliness can be an important factor in etiology and therapy of mentall ilness.

To evaluate basic knowledge of physicians about suicide; frequency of suicide events (SE) within their professional practice and personal history; influence of specialty on physicians’ basic knowledge of SB, attitudes to it and frequency of SE.

The questionnaire “Specialist's attitudes to suicide” (developed by authors) has been proposed anonymously to the group of physicians.

425 copies of questionnaire have been filled (male, N=179, 42.1%). More than 70% of respondents considered suicide to be the consequence of mental disorder. Less than 30% agreed that not only psychiatrists are to be responsible for suicide prevention. 58% has reported the experience of patient's suicide and 67% - of parasuicide in their practice. Over 80% mentioned an emotional influence of suicidal act. Over 15% survive the suicide of their relative or intimate. About 37% of doctors had suicidal thoughts and 8% have reported an act of deliberate self-harm ever in their life. The level of knowledge regarding managing of depressed patients has turned to be unsatisfactory. Psychiatrists were more sensitive in perception of SB of their patients and have reported their own suicidal ideation more frequently than other specialists.

The educational programs in the field of depression detection and suicide risk evaluation are needed for physicians. Besides, physicians need psychotherapeutic and psychiatric assistance much more widely than is considered to be.

There are growing concerns on use of certain psychotropic medications on women's reproductive health, pregnancy and lactation. Lithium, Sodium valproate, Carbamazepine and Lamotrigine are recommended by National Institute of Clinical Excellence (NICE) in treatment of Bipolar Disorder. While treatment of Bipolar disorder is crucial, it is imperative that there is clear communication between patients, carers and health professionals to enable patients in making informed decisions about their care

NICE recommends that healthcare professionals should give relevant information at every stage of assessment and treatment. They should discuss contraception and risks of pregnancy. Furthermore, it is good practice to assess capacity of service user's to consent to treatment. This enables service user to make well-informed decision.

To find out if relevant steps were taken to aid women in making well-informed decision regarding their treatment i.e by verbal communication and providing written information.

We retrospectively analysed electronic patient record of women meeting inclusion criteria.

Out of 616 women, 119 met the inclusion criteria. Patients’ ages ranged from 20 to 55. 52% were on Lithium, followed by Sodium Valproate(22%), Lamotrigine(14%) and Carbamazepine(12%). There was evidence of verbal communication in only 35% and provision of written information in only 11%. Contraception advice was documented in only 24%. Documentation of assessment of capacity to consent to treatment was found only in 31%.

There is lack of adequate communication between clinicians and patients. There are several possible explanations for this finding with one of the main reasons being poor documentation.

High relapse rate and extreme difficulty to maintain abstinence are main characteristics of alcohol dependence. In the course of the this psychiatric disorder some patients with alcohol dependence remit while others not.

Coping styles may differ the patients with non remited alcohol dependence from remitted alcoholics and healthy controls.

We aimed to find out the coping mechanisms which maked the difference between remitted and non remitted alcoholics compared to age and sex matched healthy controls

Ninety patients with alcohol dependency were enrolled in the study. Fifty-three patients with alcohol dependence were abstinent for more than one year which formed the remission group, and thirty-seven of them were either in in-patient treatment or either not fully remmited, that is having remission less than one year. Coping styles of these two subgroups of patients with alcohol dependence were compared with forty non-psychiatric healthy, age and sex matched subjects.

Patients with alcohol dependence had higher non adaptive coping strategies compared to controls. Non-remitted patients with alcohol dependence used more non-adaptive coping strategies compared to both remited patients with alcohol dependence and healthy controls.

These results in part support higher probability of non-adaptive coping strategies in patients with alcohol dependence particularly in those with not remitted alcohol dependence compared to both abstinent alcoholics and healthy controls.

Over the years, the narcissistic destiny seems to remain a very present theme, due to our patients but also to the society we are in everyday contact - a fact proved by its persistence over different moments in history.

The main motivation that moves the narcissistic structure is apparently insuficiently explained by a simple psychiatric diagnostic; therefore we preffered for our study a phenomenological approach, which allowed us to see the complexity of the human structure beyond these limitations.

We chose to compare in our study two representative figures: a real one - Michelangelo and a fictional but based on a real case one - Dorian Gray. Most of the studies on these two themes so far convened over the presence of narcissistic traits and the obsession over beauty in both cases, still, they are not offering answers regarding the differences between destinies. Although Michelangelo and Dorian Gray are sharing the same narcissistic traits, both crossing sometimes limits of antisociality, they are not sharing the same affective and creative intensity, nor the dedication to seeking beauty.

If in Michelangelo's case the emotions work closely with his creativity, thus putting a question mark over his narcissistic traits and also his diagnostic, in Dorian's case creativity without emotions lays a tragic role.

Turning to phenomenology has given us the possibility of understanding the interior, subjective world of two important characters, their personal different dynamics, going deeper than explaining them through a personological diagnostic.

It is distinctive for Kosovo population that before the war of 1999 Kosovo has had the lowest rate of suicides in Europe. Now, after the war the data and findings tell us for a considerate increase of number of suicides.

Presentation of suicide cases in Kosovo in period from 2008–2012 analyzed from aspect of social reasons that has influenced an increasing number.

Identification of social factors and their possible direct/indirect impact in phenomena of suicides and as well the reflection in their prevention.

Data on cases were collected retroactively, by the Internal Affairs of Kosovo and Psychiatry Clinic. Analysis of data was done with Excel and SPSS 14.

In the period 2008–2012, 270 persons were found to have committed suicide. This is an increase compared to before the war. In over 80% of cases come to the expression of social factors: unemployment level (44.9%), low income per capita, the population on average 26 years old, enormous growth of drug users and alcohol (20.000), low budget for mental health, dominance in rural settlements, debt, domestic violence, inability to buy drugs, the inability of the education of the children, war trauma/PTSD, large number of people who are missing or dead after the recent war in Kosovo (8 cases).

The number of suicide cases has increased. Social factors play a major role in this.

Forensic Psychiatry and Mental Health Service as new field in our country needs strategies for management and rehabilitation programs.

To evaluate socio-demographic characteristics and prevalence of psychiatric diagnosis of inpatients hospitalized in last three year period time from January 2009 up to December 2011. Specific objectives of this study were to identify the rehabilitation programs of treatment and specific training needs of mental health professionals according to our results findings.

This retrospective study used the method of socio-demographic data collection, review and study of documented diagnosis based on ICD-10 criteria for mental disorders and Structured Clinical Interview (SCID), data records by court and other hetero-anamnesis data of all forensic inpatients who underwent psychiatric forensic evaluation and assessment according to court request. Descriptive approach for analyses was used.

Subjects were referred either directly from prison (23,2%) or from court (76,8%) for forensic psychiatric evaluation, diagnosis and treatment. The majority of offenders (85,7%) were under trial, and physical threatening being the most common charge than domestic violence and murder. Prevalence of psychiatric diagnosis was 94,6%, the most common being psychosis 69,1%. Drug abuse and personality disorders including high-risk behaviors were also common.

Rehabilitation programs of treatment and management with specific focus on psychotic disorders, sever personality disorder and drug abuse are needed. Establishment of Forensic Mental Health System in Kosovo will fulfill the implementation of legal framework including the rights and human treatment of all mentally ill offenders.

The study is aimed to assess quality of life, anxiety and depression levels and investigate the rate of psychiatric disorder in adolescent and young adults with beta Thalassemia major.

Sample includes 43 patients with β-thalassemia major. Patients were screened by Structured Interview for DSM-IV (SCID-I), Short Form-36 (SF-36) and Hospital Anxiety and Depression Scale (HAD).

Fourty two percent of the patients suffered from a psychiatric disorder. The most common psychiatric disorders were social anxiety disorder (%21) and generalized anxiety disorder (%12). Significantly lower quality of life was found on all 8 SF-36 domains for β-thalassemia major and psychiatric comorbidity patients compared to no-comorbidity patients.The correlation between HAD and SF-36 scores was statistically significant.

Psychiatric disorders are significantly related to impaired quality of life. The correlations between anxiety, depression levels and SF-36 scores indicate that high depressive and anxiety levels are associated with reduced quality of life.