Investigators allegiance is widely discussed as a risk of bias in psychotherapy research.

To sum up the best available data concerning allegiance effect.

We systematically investigated whether meta-analyses and their included randomised controlled trials (RCTs) of psychotherapeutic treatments were reported and assessed allegiance effect.

We searched meta-analyses of RCTs of various types of psychotherapies in Medline from 1977 to 2012 and the Cochrane Database of Systematic Reviews (Last update on December 2012). We considered only meta-analyses of RCTs with at least 1 study with allegiance of the experimenter published in journals with impact factor higher than 5 and in Cochrane Database.

Of 146 meta-analyses reviewed which included 2727 RCTs, only 15 meta-analyses (10.3%) reported RCTs allegiance. Of 1198 metaanalyzed RCTs only 1 (0.1%) was controlled for allegiance and 25 of 1198 (2.8%) were reported allegiance. In all meta-analyses reviewed, 66.2% of primary included RCTs were allegiant studies. Even we found a median of 10 [interquantile range (IQR) 7–15] allegiance RCTs per metaanalysis, only 6 (4.3%) of them used a method to controlling its effects.

The majority of meta-analyses of psychological interventions published in high-impact specialty psychiatric/psychological, general medical journals as well as Cochrane Database was rarely reported and evaluated allegiance effect. The results of the present study highlight a major gap in this information in meta-analyses of psychotherapeutic interventions.

Liture describes many references to neuropsychiatric disorders in dementia. Executive functions have been widely studied in primary degenerative dementia: working memory, inhibition, mental flexibility, fluency, organization, abstraction and appropriate social behavior.

Alzheimer's disease, bvFTD and DLB are the most prevalent and studied.

Transversal descriptive-analysis of neurobehavioral disorders and social behavior in a clinical sample.

Descriptive study. Random selection of cases (patients seen in consultation Behavior Unit Memorial Hospital San Vicente del Raspeig with dementia criteria of Alzheimer's disease, bvFTD and DLB without probable vascular component) and controls (healthy, age 50 years without neurological or psychiatric pathology associated). 1 June 30, 2013. Informed consent is obtained and collected sociodemographic data, clinical (diagnosis, GDS, treatment) and psychometric (MMSE, NPI-Q, Social Norms Questionnaire). Registration Excel database and statistical analysis with SPSS.

N = 40, controls = 10, AD = 15, DFTvc = 6, DCL = 9. No significant demographic differences in dementia group. DFTvc: SNQ lower score, greater executive involvement. atypical antipsychotics, acetylcholinesterase inhibitors and memantine are the most commonly used drugs for behavioral disorders

Our clinical sample obtained similar results to those described in the literature. Prospective follow-up study in mild cognitive impairment would be needed to provide better knowledge and clinical practice.

Maternal depression is an important risk factor for child behavioral and psychological problems. Both timing and chronicity of depression may interfere with developmental tasks during infancy or the toddler years.

The aim of the present research is to assess whether maternal depression timing and depression trajectories predict child emotional and behavioral problems at 5 years, and to examine whether there are differential effects according to parental socioeconomic status.

Analysis of prospective data from 1183 children participating in the EDEN mother–child cohort study. Maternal depressive symptoms were determined in pregnancy (prenatal); 4, 8 and 12 months after birth (postpartum) and at 3 and 5 years (toddler) using the CESD and EPDS scales. Children's emotional and behavioral problems at age five were assessed using the Strengths and Difficulties Questionnaire (SDQ). Trajectories of maternal depressive symptoms were modeled with a group-based technique. A series of multiple regression models were used to examine the association between maternal depression timing and trajectories and SDQ scores.

Children exposed to maternal depression in the postpartum or toddler period presented more emotional and behavioral problems at age five. The same pattern was found for children exposed to chronic symptoms of maternal depression. Postpartum depressive symptoms were associated with more conduct problems, hyperactivity/inattention and overall problem behavior at age five in children whose mothers had a low educational level.

Maternal depression timing and chronicity may have detrimental emotional and behavioral effects on young children, especially for those from more disadvantaged backgrounds.

Previous studies have found an association between allegiance bias and methodological quality of psychological treatment comparisons.

To test the hypothesis whether poorer designed randomised controlled trials (RCTs) of psychotherapeutic interventions could be yield increased allegiance effects.

Using a systematic approach with meta-analysis we aimed to assess the relationships between allegiance effect and outcomes with respect to treatment integrity, quality of treatment and overall quality of RCTs.

We searched meta-analyses of RCTs of different types of psychotherapies in the Cochrane Database of Systematic Reviews. Eligible articles included were meta-analyses of RCTs with at least 1 study with allegiance of the experimenter. Effect sizes in allegiance trials were compared with non-allegiance by sensitivity analysis using random and fixed models and a summary relative odds ratio was calculated. Heterogeneity was quantified with the I2 metric.

A total of 30 meta-analyses including 240 RCTs were analyzed. The analysis addressing the quality of studies did not show any significant association between allegiance and non-allegiance studies, whereas significant differences were observed in cases where treatment integrity were not evaluated (sROR=1.54 [95% CI 1.01 to 2.35], P=0.047 and I2=74). Regarding the overall quality of administered psychotherapy the magnitude of the effect was stronger only in the case of low quality (sROR=1.61 [95% CI 1.00 to 2.59], P=0.049 and I2=76).

The results support the view that experimenter's allegiance acts as a systematic bias and can be explained through low quality and integrity of delivered psychotherapy.

Borderline personality disorder is a complex clinical entity, where emotional dysregulation, according to Linehan definition, plays a central role in psychopathology development. In the last years, functional neuroimaging research has investigated emotional process, by applying emotional challenging paradigms.

The aim of the study is to review the literature about emotional dysregulation and neuronal correlates in borderline personality disorder.

searches were undertaken in PubMed and other databases, from 2007 until 2012, using keywords ‘Borderline personality disorder’, ‘emotional dysregulation’, ‘neuroimaging’.

Emotional vulnerability, sensitivity and intensity for aversive emotional stimuli are greater in borderline personality disorder. Affective instability, with sudden mood shifts to negative feelings. Imaging studies reveal frontolimbic network dysfuncion, caractherized by amygdalar hiperactivity in conjunction with prefrontal and anterior cingulate cortex hipoactivity.

Neuroimaging research data support the model of emotional dysregulation with frontolimbic inhibition in borderline personality disorder. More studies focused on diferentiation between negative and positive emotional experiences processes, and on gender and comorbilities with axis I disorders will be useful.

Existing studies for both the representation and the attitude to medicines is not enough and there shortage of population surveys on this topic.

This study examined the potential and expected results of people's attitude towards the use of medication and their representation.

To investigated students' pedagogical faculties and student health schools as a qualification to their attitude to the use of medicines.

In this study participated 164 post graduate students from various higher education departments. More specifically, 61 (37.2% rate) from the Department of Early& Infant Childhood, 36 (rate 22.0%) students from medical schools, 30 (total of 18.3%) students from nursing schools, 15 (rate 9.1%) students from School Speech 12 (rate 7.3%) students from kindergarten sections and 10 (6.1%) students from pedagogical faculties.273 community individuals from different regions of Greece participated in the present study. A questionnaire concerning socio-demographic characteristics and attitudes towards medication were applied.

Univarate analysis and multi factorial applied for statistical analysis, which showed that a) the attitude of students towards drug and drug intake not statistically different between students of teaching faculties and students of the schools of health and b) the attitude of the students in the sample against specific classes of drugs are highly positive. We also found statistical significant drug intake differences between boys and girls (p=.003).

Our findings underscore the importance and value of prevention against drug intake relate to gender.

Alexithymia has been shown to be related to many psychiatric and somatic illnesses. Neurobiological underpinnings of alexithymia are important to be known.

To review the literature about advances in theory and research of alexithymia

Searches were undertaken in PubMed and other databases, from 2007 until 2012, using keywords ‘alexithymia’,’pshycopathology’ and ‘psychosomatics’.

Neurobiological model has explored the relationship between alexithymia and emotional process. Research data indicates modulation of emotional responses from the superior cortical systems, involving an integrative hemispheric function, that is, the left hemispheric verbal capacity in conjunction with the hability to evaluate e regulate emotions of the right hemisphere. Some studies point to a bidirectional inter-hemispheric deficit, wich affects affective regulation and the hability to communicate emotions and to fantasie. Affective and cognitive cllinical features of alexithymia are described. Recent epidemiology enfatizes comorbid somatic pathology, as well as other psicopathology manifestations.

Alexithymia is a multidimensional construt, wich undeniabale heuristic value. Therefore, more neurobiological research should be done, such as funcional imaging studies, to keep finding the biological factors of alexithymia's etiology, so that new perspectives can be approached.

Current data suggest that at least three psychophysiological paradigms are involved in Alcohol Dependence: attentional bias; affective modulation of the startle reflex and behavioural inhibition. These three paradigms have not been studied together in a sample of alcohol dependent subjects.

To show that the performance on these three psychophysiological processes allows discriminating alcohol dependent subjects (with different severity) from healthy controls.

59 alcohol dependent subjects were assessed with the following three psychophysiological tasks: The dot probe task (which assesses attentional bias), the startle response when viewing alcohol cues (which evaluates affective modulation of the startle reflex), and the Modified- Stop Signal-Task (which measures behavioral inhibition). The Severity of Alcohol Dependence Scale (SAD) was used for grouping patients based on their dependence severity. 52 healthy subjects were assessed as the control group.

All three paradigms correctly discriminated between patients and controls. Patients were divided into three subgroups according to their scores on the SAD (mild, moderate and severe dependence). The performance of the three groups in the three paradigms studied was also different. Patients with more severe dependence had more attentional bias for alcohol cues, exhibited lower magnitudes of startle response when viewing alcohol cues, and showed lower capacity to inhibit their behaviour when words related to alcohol were being seen.

Subjects with alcohol dependence showed different psychophysiological response patterns compared to controls in the three paradigms studied. These response patterns seem to be associated with the severity of dependence, and they could be used to determine the outcome of the treatment in patients with alcohol dependence.

Cognitive and emotional development of children is closely related to the environment, where they live. It is supposed that children in foster care or institutional care may be exposed to long-time changes in development and can show significant growth and developmental delays.

We have conducted 2 years longitudinal study of children in foster care (n = 70), in institutional care - D (n = 50) and in functional biological families (n = 50). We have evaluated the stage of cognitive and emotional development at the beginning and the end of the 2 years period.

The results of the presented study showed that emotional and cognitive development of children in institutional care is comparing to other groups statistically significantly slower than in children in foster care and functional biological families (p, 0.01). Children in foster care show similar development progress to children in biological families.

The results of the study propose that children institutional may show developmental delays due to absence of individual contact with a care giver, while foster care may be in cases of necessity acceptable substitution of biological family.

The study was supported by J&T Foundation.

Mental development is influenced by the possibility to experience long term and stable relationship with a caregiver. Children in institutional care usually may not have this possibility. There is growing evidence that long term stay in institutional care may substantially influence occurrence of psychopathology symptoms in children.

We have conducted 2 years longitudinal study of children in foster care (n = 70), in institutional care - D (n = 50) and in functional biological families (n = 50). We have assessed presence and intensity of psychopathology signs at the beginning and the end of the 2 years period.

The results of the presented study showed that psychopathology significantly persist or develops in children in institutional care, while in children in foster care and biological families tends to reduce. (p, 0.01).

The results of the study propose that children institutional may be substantially endangered by the higher occurrence of psychopathological symptoms, comparing to foster care and biological families. Foster care thus seems to be more suitable for children's development than the institutional care.

The study was supported by J&T Foundation.

Abrupt discontinuation of antidepressants, especially Selective Serotonin Reuptake Inhibitors (SSRI) and Dual-Action Antidepressants such as Venlafaxine, can lead to several psychological and somatic symptoms, which includes restlessness, psychomotor agitation, nervousness, anxiety, crying spells, irritability, depersonalization, decreased mood, memory disturbances, decreased concentration, and/or slowed thinking, nausea, dizziness and headache. Additionally, it has been demonstrated that sudden discontinuation of antiepileptic drugs in free-seizure patients, can increase the risk of suffering a seizure episode.

The aim of this study was to review the discontinuation syndrome associated with antidepressants and antiepileptic drugs, it's pharmacological management and strategies to prevent it.

We searched in MEDLINE selecting all the studies from 1990 until the present, related with the discontinuation of antidepressants and anticonvulsants. All kind of studies and reported cases are included. We also describe the case of a 47 year old patient, diagnosed with Obsessive Compulsive Disorder (OCD), who developed delirium and two seizure episodes after sudden cessation of his treatment with Venlafaxine 225 mg/ day and Pregabaline 225 mg/ day.

Withdrawal symptoms are common during discontinuation of antidepressants, especially in the case of SSRI and Venlafaxine. They are more frequently associated with their prolonged use and with agents with a short half-life. These symptoms are usually mild and transient. However, there are several cases reported in the literature describing the occurrence of delirium as a result of abrupt discontinuation of antidepressants. Additionally, it has also been reported that stopping antiepileptic drugs in seizure-free patients can increase the risk of developing a seizure episode.

Withdrawal Syndrome associated to the discontinuation of antidepressants and antiepileptic drugs is well established. Psychiatrists and General Practitioners should be aware of possible withdrawal symptoms when interrupting these treatments. Management strategies include gradual tapering of doses, clinical monitoring and patient education.

Posttraumatic stress disorder (PTSD) is characterized by a reduced expression of FKBP5, a key modulator of the glucocorticoid receptor. Smaller hippocampal volume has also been documented in PTSD. In this study we explored FKBP5 gene expression, brain structure and cognitive flexibility in patients with PTSD before and after cognitive behavioral therapy (CBT)

We measured peripheral FKBP5 RNA, volumes of the hippocampus, amygdala, and medial orbitofrontal cortex and cognitive flexibility in 39 patients with PTSD before and after CBT. The control subjects were 31 trauma-exposed individuals without PTSD who were also assessed twice.

At baseline, patients with PTSD showed lower FKBP5 gene expression and smaller hippocampal and medial orbitofrontal cortex, but not amygdala, volumes relative to control subjects. At follow-up, we found significantly increased FKBP5 expression and increased hippocampal volume in patients with PTSD. At follow-up, patients did not differ from control subjects in hippocampal volume. Improvement in PTSD symptoms was predicted by increased FKBP5 expression and increased hippocampal volume, but the primary predictor was FKBP5 expression. There was a positive correlation between the performance on a partial reversal task which tests cognitive flexibility and treatment responsiveness.

Clinical improvement in individuals with PTSD was associated with increased expression of FKBP5, increased hippocampal volume and better cognitive flexibility. The three variables were positively correlated.

Bipolar disorder is characterized by depressive and manic mood episodes. Despite an overall high heritability, environmental factors play a critical role in bipolar disorder. Stress negatively influences the clinical course bipolar disorder and may trigger mood episodes. Surprisingly, the study of stress reactivity in bipolar patients has remained relatively unexplored. Moreover, it is unknown whether altered stress reactivity may be a trait marker in unaffected siblings of bipolar disorder patients who possess an increased genetic risk for this disorder.

Male and female euthymic bipolar disorder patients (N=49), unaffected siblings (N=27) and healthy controls (N=48) were exposed to a validated social stress test. The endocrine stress response was measured using saliva cortisol levels, whereas salivary alpha-amylase (sAA) were determined as an index for the adrenergic stress response.

Exposure to stress resulted in a differential endocrine and adrenergic stress reactivity between bipolar disorder patients and their unaffected sibling. Importantly, bipolar disorder patients displayed a blunted endocrine but exaggerated adrenergic response.

Our findings illustrate the importance of measuring stress reactivity in bipolar disorder. These results provide insight into stress system functionality of euthymic bipolar disorder and enable a direct comparison with unaffected siblings who display an increased risk but have not developed bipolar disorder.

Schizophrenia and psychotic disorders represent psychiatric disease patterns characterized by great impairment due to disease severity with a great effect in patient's health related quality of life, which still remain a challenge in everyday clinical practice.

To investigate group differences in health related quality of life(HRQoL) in patients with psychosis during in hospital treatment.

174 inpatients in a psychiatric ward in Athens-Greece participated in the study. 120(69%) were males and 54(31%) females. Of them, 0(11.5%) had bipolar disorder(BD), 126(72.4%) psychosis and depression(PD) and 28(16.1%) comorbit alcohol addiction(PAA). Patients filled a battery with tests of HrQoL, psychotic symptoms, negative motions, optimism, self-esteem, happiness and life-satisfaction. Stepwise regression models were used to determine the best predictors of compliance with SPSS.

There were a statistical significant difference in compliance between BD and PAA(good compliance 100%) and PD(good compliance 66.7%)(x2=21.09p=.001). Multivariate analysis revealed that good reaction to treatment(beta=−.736), atypical antipsychotics(beta=− .312), antidepressants(beta=−.270), days of hospitalization(beta=.203), bipolar disorder(beta=.199), sleeping pills(beta=.169) and stabilizers(beta=−.188) explained 74.5% of the variance in compliance(adjusted R2=.745 p<0.001). In a second model with the inclusion of personality and emotional characteristics in the model, stress(beta=−.381) negative emotions (DASS)(beta=.290) and subjective happiness(beta=.120) explained an additional 3% in compliance with therapy(adjusted R2=.775 p<0.001).

It seems that depression comorbidity is an effective factor affecting therapy compliance in psychosis, with days staying in hospital for treatment. Also if the patient is prior to the therapy happy with his life complies better with the pharmacological approach that was used during the days of treatment.

Considering the current global economic crisis, it is an urgent need to discuss the potential effects of the crisis in family environment in Greek population.

This study examined the effect of borrowing on family orientation strategies.

This study aimed at detecting the interaction of borrowing on family acquiring social support and problem-solving behaviors.

273 community individuals from different regions of Greece participated in the present study. The measure used was the Family Crisis Oriented Personal Evaluation Scales.

Multivariate analysis was applied for the statistical analysis of data, and the results was: The loan recipients have statistically higher average than non-loans 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 by using linear regression analysis was the finding that additional 1.000 euros of family income per month increase per unit the mobilizing of family to acquire and accept Help, while lending itself was associated with 1,76 per unit increase of mobilizing family to accept help (p=.016 and p=.014 respectively).

Table 1Results of regression analysis

The present study highlights the strong association between income and ways that Greek families externally handle their problems due to economic crisis.

White matter hyperintensities (WMHs) may be associated with increased risk of suicidality in subjects with major affective disorders. Unfortunately, they may be frequently confounded by the use of previous medications and duration of illness.

Although findings from the current literature are quite conflicting, we proposed that WMHs are important markers/endophenotypes of specific subgroups of individuals with major affective disorders such as those at high suicidal risk.

A literature search has been performed aiming to examine the presence and severity of WMHs in patients with major affective disorders, and the association with suicidal behavior. The reference lists of the selected studies were also scanned for additional relevant studies.

Based on the Fazekas modified scale, the severity of WMHs may serve as a trait marker of major affective disorders. Several studies reported a significant association between WMHs, in particular periventricular WMHs, major affective disorders, and suicidal behavior. A significantly higher number of suicide attempters were found to have WMHs than nonattempters.

WMHs may represent neurobiological markers between the underlying susceptibility and clinical expression of major affective disorders. Clinicians should carefully investigate patients with major affective disorders for the presence of WMHs in order to identify specific subgroups of subjects at-risk for a poor outcome.

Schizophrenia is a mental disorder, which is characterized by positive and negative symptoms, such as disorders in the professional and social area.

Today, the dominant trend in Psychiatry is ‘social and community psychiatry’. In this paper we present the progress of the disorder, of a patient who suffers from schizophrenia -disorganized type- over the past 20 years and in which psychosocial intervention was aimed towards the prevention of hospitalization and his best possible functionality, despite the reduction of the medication received.

The material used, is from the medical records of the patient in the different structures of the Psychiatric Hospital of Corfu.

During the research we have studied the medical records of the patient, the reports of the nursing, social, psychology services, his medications since 1999 up to now, as well as his behavior particularly for the last 2 years.

The patient's, supervised, independent living, during the last 2 years, his participation in social activities, the encouragement by the medical team to make him become involved in new things (learning computer, Internet use) has resulted in the prevention of his hospitalization to the Psychiatric Hospital and the reduction of the medication received.

Despite the pessimistic outlook and the stigma of the society as far as the schizophrenic and their ‘recovery’ is concerned, it seems that these patients can improve the conditions of their life and regain their communication skills through which they can express feelings and interact with others. Although, no totally effective therapy has yet been devised, it is important to remember that many people with this illness could improve enough so as to lead independent, satisfying lives. As we learn more about the causes and treatments of schizophrenia, we should be able to help more patients achieve successful outcomes. Targeted psychosocial interventions may lead to the reduction of the severity and the number of relapses, with the minimal medication received.