New psychopharmacology provides a better tolerability profile and drug adherence, which should be accompanied by lower relapse rate, incomings and improvement in psychosocial functioning of patients.

1. To describe sociodemographic, clinical and psychometric properties of a sample of psychotic patients admitted to the Acute Unit. 2. Assessing the functionality of psychotic patients requiring hospitalization.

Sample:patients admitted to the Psychiatric Hospital Unit of the Hospital San Juan de Alicante (August 1 to 31, 2013), with admission diagnosis of psychotic decompensation (F20). Register of sociodemographic and clinical dates, PANSS, CGI and PSP. Statistical analysis using SPSS.

N=19. 94%=male, 84.2%=single, 68.4%=family support.37%=schizophrenia, 52.7%=brief reactive psychosis, 10.5%=schizophreniform disorder. 9.7% first psychotic episodes. 52.6%=toxic consumption. Mean scores:PSP = 50.89, CGI= 4.42, PANSS=89.89. Significant relationship between the support and PSP(35=not, 53=yes, p<0.015). Direct relationship between PANSS and CGI (p< 0.0001, 0.89R).

Although toxics, poor adherence or the long course of the disease are associated with unfavorable scores on scales of function and psychopathology, our results donnot meet it. We attribute the negative results to low sample size and heterogeneity of the group of patients included in the study. Maybe factors such as family support, employment and intellectual level have a greater role. We consider it appropriate to continue the study in the future, standardizing clinical groups and expanding the sample size in order to obtain results with greater statistical significance.

Highlighting of clinical features of depressive disorder in women hospitalized in the Clinic of Psychiatry of Craiova and identification of risk factors for unfavorable outcome in short term hospital treatment.

Evolution of depression in women is unfavorable with a high rate of recurrence, associated with presence of somatic comorbidities.

Retrospective study on hospitalized female patients with depression in Psychiatric Clinic of Craiova (1 January 2005 – 31 December 2009) on the following categories: social-demographic, clinical, indicators of treatment, therapeutic response and evolution of depressive disorder.

From a total of 2463 patients hospitalized with depression, 60% were women. Socio-demographic analysis highlighted the highest frequency of depression in 40-49 years age-group (53.0%), medium educational level (66.9%), unemployed (28%), and married (66.5%), with a low (55.0%) economic level. Clinical analysis showed presence of psycho-trauma in childhood (92.2%), positive family history for depression (75.8%) and female specific psychiatric history. The antidepressants often used were the SNRIs (47.8%), followed by SSRIs (27.4%). Complete remission (?? ?-17<7) was present in 16.4%, while the decrease of GAFS (social functioning) and MMSE (cognitive impairment) scores is a significant indicator for prediction of unfavorable evolution (p<0.001).

Significantly associated factors with unfavorable short-term evolution were: positive family history for psychiatric disorders, incomplete remission, ages between 40 and 49 years (p<0.001), presence of psychotrauma in childhood (p<0.001), psychiatric history specific to women (p<0.001), SNRIs therapy (p<0.001), SSRIs and SNRIs associations (p<0.001).

Studies have shown higher rate of various psychiatric disorders among individuals with substance abuse / dependence. There is little data in developing countries, such as Pakistan, on prevalence of psychiatric co-morbidity in this population and impact on treatment.

To assess the psychiatric co-morbidity among individuals with substance dependence and to determine its demographic associations in patients with substance dependence in Pakistan.

This was a descriptive study conducted at a tertiary care hospital in Pakistan. Participants were 588 individuals with substance dependence admitted to a tertiary care hospital in Pakistan, mainly in male inpatient substance dependence unit. The patients were assessed for psychiatric co-morbidity using DSM IV criteria. Informed consent was obtained. The study was approved by the Institutional Research Committee. The results were obtained by using chi square test on SPSS 17.

Out of 588, 200 patients (34%) were found co-morbid with other psychiatric disorders along with substance dependence. Reason of first substance use and history of previous substance dependence were observed to be significantly associated with co-morbid psychiatric disorders, x2 (48, n = 549) = 112.396, p < 0.01 and x2 (18, n = 588) = 29.66, p = 0.041 respectively.

1. 1. There was high rate of psychiatric co-morbidity among individuals with substance dependence in this sample.

2. 2. Depression, personality disorders and anxiety disorders were the major co-morbid diagnosis among this population.

Childhood obesity has reached epidemic proportions: Some 4.7 million youths between 6 and 17 years of age are overweight or obese. The number of over-weight youths (11%) has more than doubled over the past 30 years. Obesity has links with disease such as diabetes, heart disease, sleep disorders and some forms of cancers. Developing and maintaining a healthy lifestyle are essential for the prevention of obesity.

In a cross sectional study we aimed to investigate and compare the attitudes towards healthy eating and obesity in adolescent students in Pakistan and the UK. The sample size for this study consisted of 618 students in total. A self administered anonymised questionnaire was given to the students and they were to answer questions regarding eating and exercise.

A Total of 151 students were recruited from the UK, while 467 students were recruited from schools in Pakistan. 5.4% of the students in the UK and 2.6% students in Pakistan were obese. The reasons for students' different eating habits varied between both countries; in the UK an increase in eating was linked to stress while in Pakistan it was linked to cravings. In both the UK and in Pakistan, a high percentage of students took part in physical activity, 80% and 81.8% respectively. There were some similarities in eating habits, with similar numbers of students refraining from eating unhealthy foods in both the countries.

We found significant differences in BMI and reasons for overeating when comparing students in Pakistan and the UK. These findings have implications for designing interventions

To develop and validate a prognostic model for predicting recurrence of major depression using data from a population-based, nationally representative cohort.

Wave 1 and wave 2 longitudinal data from the US National Epidemiological Survey on Alcohol and Related Condition. Participants with a major depressive disorder at baseline and who had visited health professionals for depression were included in this analysis. Mental disorders were assessed based on the DSM-IV criteria. For this study, we included the wave 1 (baseline) participants who reported current or lifetime major depressive episode. We included eligible participants from South and West region in the training data (n = 1,518). Eligible participants from Northeast and Mid-West region were kept in validation data (n = 1,195).

With the training data, a prediction model with 19 unique factors had a C statistics of 0.7504 and excellent calibration. The model had a C statistics of 0.7195 in external validation data (n = 1195) and 0.7365 in combined data. The algorithm calibrated very well in validation data. In the combined data, the 3-year observed and predicted risk of recurrence was 25.40% and 25.34%, respectively.

The developed prediction model for recurrence of major depression has acceptable discrimination and excellent calibration and is feasible to be used by physicians. The prognostic model may assist physicians and patients in quantifying the probability of recurrence so that physicians can develop specific treatment plans for those who are at high risk of recurrence, leading to personalized treatment and better use of resources.

The high number of suicides drew attention to medical professionals. In Europe suicide is one of the leading cause of death caused by intentional and unintentional injuries. Alcohol abuse is linked to poor impulse control, aggression and suicide behaviour.

We tried to evaluate the level and the impact of alcohol usage in individuals which committed suicide.

There were collected all the date provided by the archives of forensic services of Brasov county between 2002 and 2012 regarding age, sex, marital status, methods of suicide and blood alcohol concentration.

The statistics included 589 men (83%) and 121 women (17%), sex ratio B:F=4.87. The mean age of the study group was 48.15 years. The individuals which had used alcohol before committing suicide were significantly younger than those who didn't used alcohol (45.87 vs. 50.19, p<0.005). There were a significant difference between individuals with violent methods of suicide compared with others in terms of age and blood alcohol concentration.

The abuse of alcohol is strongly linked with suicide, especially when individuals exhibit high levels of blood alcohol concentration. This behaviour is linked with younger age of suicide.

In this study, women with primary infertility compared with fertile women in terms of their attachment style and psychopathology. Furthermore, the relationship between psychopathology and attachment style is also investigated in women with primary infertility.

Forty-eight primary infertile women admitted to the infertility clinic for in vitro fertilization (IVF) or Intrauterine Insemination (IUI) treatment were consecutively enrolled. Diagnosis of primary infertility in women was determined by Gynecologists and it is defined as undetermined cause of infertility in men and women despite necessary laboratory investigations. The control group consisted of 48 women with at least one living child, who had become pregnant through natural methods and having no previous psychiatric admission. Control group is matched with primary infertile women in terms of their age and level of education. Socio-demographic characteristics and clinical features of the study group and the control group were determined. Symptom Checklist 90R (SCL-90-R), Beck Depression Inventory (BDI), Adult Attachment Style Questionnaire (AAS) were given to the both groups. These scales' scores were compared between infertile and fertile groups.

No significant difference was found between primary infertile and fertile women in terms of secure, avoidant, anxious-ambivalent attachment scores. Secure attachment scores in both groups were higher than other forms of attachment. Insecure attachment scores were associated with the increasing level of psychopathology in primary infertile women.

We suggest that management of insecure attachment should positively affect the chances of pregnancy in primary infertile women.

The aim of the study was to investigate the development of the psychiatric emergency situation in the city of Ulm, Germany, over a decade ranging from 2004- 2013.

All reports regarding medical emergencies in the city of Ulm (110,000 inhabitants) from 2004 to 2013 were examined. Psychiatric emergencies were identified and worked off retrospectively with respect of demographic variables, diagnosis, pharmacotherapy, general medical treatment and time trends.

Data were available of 933 psychiatric emergency care episodes. 40% of episodes concerned male patients (60% female). Average age was 45.3 years. Diagnoses were made on a syndromal level on the basis of a classification by Hippius (Hippius H: Psychiatrie. Springer, Berlin, 1979). The most frequent syndromal diagnoses were 'state of psychomotor excitement', 'suicidal syndrome', 'syndrome of addictive behaviour' and 'acute intoxication'. These syndromal diagnoses occurred with increasing frequency later in the day. Medication interventions comprised mostly midazolame followed by haloperidol, diazepam and lorazepam.

The results of our study are roughly in line with those described in the literature based on studies dating back to the 1980s and 1990s. Emergency medicine is an multidisciplinary subject, in which psychiatric disorders account for a substantial proportion of episodes of care.

Eating Disorders (ED), including obesity, with and without Metabolic Syndrome (MetS), are associated with anxiety and depression. Increased levels of cytokines and their consequences on the pathway of kynurenine (KYN), the main metabolite of tryptophan, have been proposed to account for these associations.

To review the evidences suggesting biochemical connections between the Depression and Anxiety Spectrum (DAS), MetS and ED, respectively, focusing on the role of the KYN pathway.

Three PubMed searches of the literature conducted in October 2013 (key words:‘kynurenine’ ‘eating disorders’; ‘kynurenine’ ‘waist circumference’; ‘kynurenine’‘obesity’‘metabolic syndrome’) provided 2, 3 and 7 references, respectively.

The metabolism of L-tryptophan through the KYN pathway depends on the following three factors: 1) NUTRITION; in underweight ED LKYN metabolites (quinolinic acid, kynurenic acid, 5-hydroxyindoleacetic acid) are significantly reduced until the restoration of normal body weight. In overweight and obesity with and without MetS, increased KYN levels and KYN/tryptophan ratio are found, with abdominal fat content as strongest factor for an increase of the KYN/TRP ratio. 2) AGE; KYN/TRP ratios are markedly increased vs. decreased in overweight and obese adults vs. juveniles, respectively. 3) INFLAMMATION; IFN-gamma induces the indoleamine 2,3- dioxygenase (IDO)-catalyzed synthesis of KYN, whose derivatives increase in diabetes (xanturenic acid), psychosis (kynurenic acid), and depression (quinolinic acid).

The KYN pathway may link DAS, MetS and ED explaining the frequent association of DAS to so many different disorders. Further studies are needed in order to understand these complex connections.

Corticosteroids have either somatic and psychiatric side effects. Somatic adverse effects are well described while neuropsychiatric have received less attention. Psychiatric symptoms such as depression, psychosis and especially mania are common side effects of corticotherapy.

Describe a case of a 53-year-old female patient, with no psychiatric history, who developed psychiatric symptoms during the treatment of an acute exacerbation of multiple sclerosis with large parenteral doses of corticosteroids. Three days after the onset of corticotherapy she developed increased energy, elevated mood, increased motor activity, racing thoughts, and diminished need for sleep. She subsequently developed grandiose and persecutory ideation and then feared her grandson was going to die. This lead to her admission to psychiatric unit of our hospital to address these behavioral problems. Her husband noticed that she had become’hyper’ in the past when she received pulse corticosteroid therapy, but the most recent episode was by far the worst.

Revision of the scientific literature through Pubmed, Embase and Psychinfo using search terms including corticosteroids, mania, depression, psychosis and mood.

Prednisone was suspended and Risperidone 2mg was begun for presumed steroid-induced mood disorder, and the patient became calmer and much less guarded over the next 2-3 days. After a week she recovered complete euthymic mood and reverted to normal functioning.

These data suggest that Risperidone is well tolerated and appears to be useful for mood disturbances associated with corticosteroid therapy. Controlled trials seem warranted to confirm these observations.