Data related to brain function may have the potential to improve the reliability and validity of assessments for the aetiologically and clinically heterogeneous syndrome of attention-deficit/hyperactivity disorder (ADHD). This study investigated associations between questionnaire assessments of behavioural features of adults with ADHD and an aspect of neurocognitive performance which has been reported to be impaired in adults with ADHD.

Fifty-nine adult patients with a DSM-IV diagnosis of ADHD, and their informants, completed questionnaires related to aspects of severity of ADHD. Associations were examined between questionnaire ratings and performance on a computer-administered task of spatial working memory (SWM).

Correlations between ratings of ADHD and SWM indicated moderate but significant correlations for patients' ratings, but not for informants' ratings. Also, patients who reported a past history of ‘self-harm’ (N = 33) had a significantly worse mean performance on both measures of SWM (p = 0.004, 0.003).

The results indicate that aspects of impulsivity, i.e. self-ratings of ‘emotive’ behaviour (involving rapid response to stimuli and marked reactivity of mood) and of past ‘self-harm’, show relatively strong associations with SWM performance in adults selected on the basis of an ADHD diagnosis. A profile of neurocognitive performances may have a role in the assessment of ADHD.

Koro syndrome is a culturally related disorder characterized by intense anxiety that the penis (vulva or nipples in females) is shrinking or retracting and will recede into the body. Usually it occurs in epidemics in Southeastern Asia, being extremely rare in western countries. The condition is more common in males and is classified within Obsessive Compulsive and Related Disorders.

A 27-year-old single man was referred to the psychiatric department. By the age of 23, he began worrying that his penis was shrinking and retracting into the abdomen. He described these thoughts as intrusive, ridiculous and repetitive. During the first months the thoughts were not very disturbing but he progressively developed an urge to verify the length of his penis several times a day. To diminish the anxiety provoked by the obsessive doubts on penis length, he started to have repetitive thoughts and mental images about sexual acts, to consume pornography compulsively and to increase his masturbatory behaviors (from some times a week to several times a day). He described those thoughts and behaviors as unpleasant and uniquely driven to reduce anxiety provoked by obsessions.

He was prescribed fluvoxamine 200 mg/day and initiated cognitive behavioral therapy with good response. Y-BOCS score decreased from 30 at initial evaluation to 18 after 3 months of treatment.

Koro syndrome is a very rare condition in psychiatry in western countries, usually presenting secondarily to other psychiatric disorders. Awareness of this diagnosis and knowledge on its management are critical to provide optimal care to patients.

The authors have not supplied their declaration of competing interest.

Despite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients.

We retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1 Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine.

Responders (n = 29) displayed lower retardation baseline scores (13.6 ± 2.9) than non-responders (15.6 ± 2.9; n = 25; P = 0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n = 8) were responders to rTMS (P = 0.005).

Low MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.

Misophonia refers to a condition in which there is a strong aversion to certain sounds, in response to it the person reports unpleasant emotional experiences and autonomic arousal.

To present the case of misophonia carrier and discuss diagnostic features.

Case report and literature review.

Female, 32 years old, married, two children. In anamnesis reported obsessional symptoms (Check doors and windows, concerned with order and symmetry of objects; read all that lies ahead, pull the hand two or three times on mobile) since adolescence. Also reported triggering situations of anger: intolerance to some noises and sounds, like chewing third, mobile keyboard, click the “mouse” computer, printer and rub hands. In the presence of these noises, she tries to move away, and already tried to attack physically relatives and insulting co-workers. She was treated with escitalopram and re-evaluation after thirty days, reported partial relief misophonia and reduction of obsessional symptoms.

The condition was first described in the early 2000s by two audiologists, and has become the focus of interest in the field of psychiatry. Some reports suggest that misophonic symptoms may be part of other conditions such as Tourette's syndrome, obsessive compulsive disorder and generalized anxiety disorder. Specifically, the characteristics shared between misophonia and OCD, as the relief of discomfort associated with avoidance behaviour suggest that the condition is part of the obsessive-compulsive spectrum, which seems to happen with the case described above.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

The term “Hikikomori” refer to the modern phenomenon–severe (acute, prolonged) social withdrawal (SSW). Recently, there have been increasing reports of Hikikomori around the globe, Ukraine is not an exception.

To describe epidemiological and psychopathological features of Hikikomori from Ukraine.

Hikikomori was defined as a six-month or longer period of spending almost all time at home, avoiding social situations, social relationships, associated with significant distress/impairment. Lifetime history of psychiatric diagnosis was determined by the M.I.N.I. 7.0. Additional measures was Alexithymia Scale (TAS-20), Life experience questionnaire (LEQ), Buss-Durkee Hostility Inventory (BDHI), Chaban quality of life scale (CQLS).

In total, 65.4% of Hikikomori group (HG, n = 26) had at least one psychiatric diagnosis, 34.6% had not. Personality disorders (15.4%), PTSD (11%), MDD (7.7%), SAD (7.7%), OCD (7.7%), bulimia nervosa (3.8%) were the most common. Onset of SSW in 41.7% started before 18 y.o. Healthy individuals formed the control group (CG, n = 25). Individuals with Hikikomori had high level of alexithymia (TAS-20 M = 71, SD = 11.6 vs. M = 60.8 SD = 13.8, P = 0.006). Childhood trauma was reported by 31.8% of CG vs. 52% of HG. Hikikomori had higher trauma index (LEQ M = 3.03, SD = 0.98 vs. 2.31, SD = 1.1, P = 0.019), larger number of lifespan traumatic events (LEQ 95%CI 4.57–7.35 vs. 2.8–5.28, P = 0.039); higher levels of irritability, resentment, suspiciousness, higher aggressiveness (BDHI M = 23, SD = 6.4 vs. M = 16.6, SD = 6, P = 0.001), low quality of life (CQLS M = 12.4, SD = 3.3, Р ≤ 0.001).

Hikikomori exist in Ukraine, SSW quantitatively and qualitatively related to childhood trauma, manifests in adolescence, can be characterized by defined psychopathological features and affects quality of life.

The author has not supplied his/her declaration of competing interest.

The mental health of Adolescents in America is a major concern for the field of psychiatry. In particular, Lesbian, Gay, Bisexual and Transgender (LGBT) adolescents are at higher risk of adverse mental health outcomes. This is largely attributed to “minority stress” and from outright bullying and discrimination. In this presentation, this link between bullying and depression will be explored.

By the end of this presentation, the audience will be able to better understand the link between anti-LGBT bullying and mental illness and identify the ways to help their patients.

This presentation is informed by a literature search from PubMed In addition, it is informed by a symposium previously done at the American Psychiatric Association (APA) annual meeting in 2014.

There is clear evidence in the literature that bullying of LGBT adolescents is pervasive. In addition, LGBT people are more likely to be depressed than their heterosexual counterparts. This combination has led to 4-5 times higher rates of attempted suicide by LGBT adolescents. Having Gay-Straight Alliances in schools, supportive teachers and school administrators, and broader anti-discrimination legislation has a protective effect on this.

LGBT adolescents are exposed to more stress by being a minority in society and by being explicitly bullied and discriminated against. This can lead to depression in some of these adolescents, and can also lead to suicide in the most vulnerable among them. There are proven ways to reduce these risks, and psychiatrists have a role to play in advocating for these reforms.

The author has not supplied his declaration of competing interest.

To evaluate the efficacy of short-term lurasidone in antipsychotic treatment-naïve (TN) adolescents with schizophrenia versus those treated previously (TP) with antipsychotics.

Patients aged 13–17 with schizophrenia, and a Positive and Negative Symptom Scale (PANSS) score ≥ 70 and < 120, were randomized to 6 weeks of double-blind treatment with lurasidone (40 or 80 mg/day) or placebo. In a post-hoc, pooled-dose analysis, efficacy was evaluated for TN (criteria: never received antipsychotic treatment) versus TP at the time of the study. Treatment response criteria: ≥20% reduction in PANSS total score.

Altogether, 57 TN and 269 TP patients enrolled in the 6-week DB study. Mean endpoint change in PANSS total score was significantly greater for lurasidone versus placebo in both the TN group (−25.0 vs. -14.4; p < 0.02; effect size = 0.75), and in the TP group (−17.3 vs. -10.0; p < 0.001; effect size = 0.45); and responder rates were higher for lurasidone versus placebo in both the TN group 84.6% versus 38.9%; number needed to treat [NNT] = 3 and in the TP group (60% vs. 42%; NNT = 6). Rates of treatment-emergent adverse events, and mean changes in body weight and metabolic parameters were similar for the TN and TP groups.

In a 6-week, placebo-controlled trial, lurasidone demonstrated significant efficacy in adolescents with schizophrenia regardless of previous antipsychotic therapy status; however, the effect size was notably larger in the TN patient group. In both the TN and TP groups, minimal effects were noted on weight, metabolic parameters, or prolactin.

La littérature internationale indique des prévalences de troubles psychotiques comprises entre 0,5 et 2 % en population générale. En l’absence de données précises en France, deux indicateurs nationaux sont présentés ici : la prévalence annuelle d’habitants pris en charge pour schizophrénie et autres troubles psychotiques par les établissements de santé ayant une activité psychiatrique (EP) et la prévalence de personnes en affection de longue durée (ALD) pour ces mêmes troubles.

Pour le 1er indicateur : l’analyse porte sur les données issues du RIM-P : prises en charge à temps complet ou partiel et activité ambulatoire. Le 2e indicateur réunit les données d’ALD23 des principaux régimes d’assurance maladie (CnamTS, RSI et MSA). Les codes CIM : F20 à F29 de schizophrénie et autres troubles psychotiques ont été sélectionnés pour ces deux indicateurs (diagnostics principaux et associés en EP).

En 2012 en France métropolitaine, 235 000 patients, soit 3,7 pour 1000 habitants, ont été pris en charge pour troubles psychotiques en EP, dont 62 % pour schizophrénie et 294 000 personnes (4,6 pour 1000) étaient en ALD pour troubles psychotiques, parmi lesquelles 45 % pour schizophrénie. Les prévalences sont globalement plus élevées chez les hommes que chez les femmes : 1,5 fois pour tous TP et 2 fois plus pour la schizophrénie. Ces prévalences étaient maximales entre 30 et 45 ans chez les hommes (taux de suivi en EP : 8,8 pour 1000 ; ALD : 10 pour 1000), et entre 40 et 60 ans chez les femmes (taux de suivi en EP : 5,1 pour 1000 ; ALD : 6,6 pour 1000). Les taux diminuent ensuite lentement avec l’âge chez les femmes, et de façon plus marquée chez les hommes, après 60 ans, les taux féminins sont supérieurs aux taux masculins.

Ces deux sources de données permettent de préciser la prévalence annuelle en France de personnes suivies pour schizophrénie et autres troubles psychotiques dans le système de soins. Elles ne couvrent néanmoins pas les patients suivis en libéral, qui ne seraient pas déclarés en ALD au titre de leur psychose, ni les malades en rupture totale de soins.

There is a growing number of studies showing interactions between genetic polymorphisms associated with dopaminergic neurotransmission and traumatic life events (TLEs) on a risk of psychotic-like experiences (PLEs). Anomalous self-experiences (ASEs) have been associated both with TLEs as well as with PLEs. However, it remains unknown what is the role of ASEs in the complexity of gene–environment interactions on the emergence of PLEs.

We included 445 young adults—university students from three big cities in Poland. We used the Traumatic Events Checklist to assess TLEs, the Inventory of Psychotic-Like anomalous self-experiences in order to measure ASEs, and the Prodromal Questionnaire (PQ16) to record the level of PLEs. The following gene polymorphisms, related to dopaminergic neurotransmission, were determined: the catechol-O-methyltransferase (COMT) rs4680 polymorphism, the dopamine D2 receptor (DRD2) rs6277 polymorphism, and the dopamine transporter 1 (DAT1) rs28363170 polymorphism.

There was a significant effect of the interaction between the DAT1 polymorphism, a severity of ASEs, and a history of TLEs on the level of PLEs. Among the DAT1 10R/10R homozygotes with low level of ASEs, a severity of PLEs was significantly higher in individuals with a history of any TLEs. Higher scores of the PQ16 were associated with a greater severity of ASEs both in the DAT1 9R allele carriers and the DAT1 10R/10R homozygotes.

Our findings imply that genetic liability related to aberrant dopamine transport might impact the association between TLEs and PLEs in subjects with high levels of ASEs.

The presence of subthreshold psychotic symptoms in adolescents with eating disorders is poorly described. This study provides a detailed characterization of adolescents affected by eating disorders in the absence or presence of subthreshold psychotic symptoms, taking into account a wide set of sociodemographic, psychological, and clinical variables.

Ninety-four adolescents diagnosed with eating disorders were interviewed, focusing on clinical anamnesis and sociodemographic data collection. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to assess the presence (HR+) or absence (HR−) of subthreshold psychosis. The clinicians completed a questionnaire on eating disorders severity, whereas patients provided self-report measures of global social functioning and psychological symptoms associated with eating disorders.

Attenuated psychotic symptoms were highly frequent (84% of subjects). HR+ patients experienced more frequently purging behaviors and dysmorphophobia and received a greater amount of antipsychotic drugs. Compared to HR− counterparts, HR+ patients reported higher eating disorders severity and psychological symptoms (i.e., ineffectiveness, interpersonal and affective problems) associated with eating disorders. Finally, a significant correlation between global social functioning and eating disorders severity emerged only for HR− subjects.

These descriptive data are warranted to identify a potential psychotic core in eating disorders, mainly concerning body image and weight as well as specific psychological features. The availability of reliable and valid markers of risk can further increase our capacity to detect the early emergence of psychosis in adolescents with eating disorders, whose outcome might be worsened by the presence of psychotic symptoms.

This study used longitudinal data to examine the influence of the religiosity of pre-adolescents with psychiatric problems on the course of mental health during adolescence.

In the TRAILS clinical cohort of 543 pre-adolescents (10–12 years), mental health problems were assessed using self-report at baseline, T2 (12–14 years), T3 (14–17 years), and T4 (17–21 years). The Youth Self Report (YSR) was used at baseline, T2, and T3, and the Adult Self Report (ASR) was used at T4. Religiosity was assessed at baseline using self-report and information from mothers and fathers, resulting in three categorical religiosity variables and six SOCON (Social Cultural Developments Questionnaire) religiosity scales that assess religiosity in greater detail. Repeated measure ANOVA analyses were performed for each independent religiosity variable with internalizing and externalizing problem behavior as dependent variables, gender as a factor and time (T1, T2, T3 and T4) as within factor. Results were adjusted for marital status of parents and socioeconomic status and corrected for multiple testing.

There were main effects of the self-report SOCON scale “Humanistic beliefs” and gender and gender “by Humanistic beliefs” interaction effect on internalizing problems. Follow-up tests revealed that among females “high” scores on “Humanistic beliefs” were associated with increased internalizing problems.

There were hardly any associations between religiosity and mental health in a clinical cohort of pre-adolescents up to adolescence. The exception being that among females strong humanistic beliefs were associated with internalizing problems. Implications of these findings are discussed.