Cerebral glutamate and gamma-aminobutyric acid (GABA) levels might predict clinical outcome in individuals at ultrahigh risk (UHR) for psychosis but have previously primarily been investigated in smaller cohorts. We aimed to study whether baseline levels of glutamate and GABA in anterior cingulate cortex (ACC) and glutamate in thalamus could predict remission status and whether baseline metabolites differed in the remission versus the nonremission group. We also investigated the relationship between baseline metabolite levels and severity of clinical symptoms, functional outcome, and cognitive deficits at follow-up.

About 124 UHR individuals were recruited at baseline. In this, 74 UHR individuals were clinically and cognitively assessed after 12 months, while remission status was available for 81 (25 remission/56 nonremission). Glutamate and GABA levels were assessed at baseline using 3 T proton magnetic resonance spectroscopy. Psychopathology, symptom severity, and remission were assessed with the Comprehensive Assessment of At-Risk Mental States and Clinical Global Impression and functional outcome with the Social and Occupational Functioning Assessment Scale. Cognitive function was estimated with the Cambridge Neuropsychological Test Automated Battery.

There were no differences between baseline glutamate and GABA levels in subjects in the nonremission group compared with the remission group, and baseline metabolites could not predict remission status. However, higher baseline levels of GABA in ACC were associated with clinical global improvement (r = −0.34, N = 51, p = 0.01) in an explorative analysis.

The variety in findings across studies suggests a probable multifactorial influence on clinical outcome in UHR individuals. Future studies should combine multimodal approaches to attempt prediction of long-term outcome.

To examine any association of birth decade, sex and exposure to alcohol and/or substance use disorders (ASUD) with age at onset (AAO) of bipolar I disorder (BD-I).

Using data from a representative clinical sample of 3896 BD-I cases recruited from 14 European countries, we examined AAO distributions in individuals born in consecutive birth decades. Cumulative probabilities with Mantel-Cox log-rank tests, pairwise comparisons and Odds Ratios (OR) with 95% confidence intervals (95% CI) were employed to analyze AAO according to birth decade, sex, and presence or absence of an ASUD.

In the total sample, median AAO of BD-I decreased from about 41 years for those born in the 1930s to about 26 years for those born in the 1960s. In a sub-sample of 1247 individuals (selected to minimize confounding), AAO significantly decreased for males and females born in each consecutive decade between 1930 and 50 (OR: 0.65; 95% CI: 0.51, 0.81), and for cases with an ASUD as compared to without (OR: 0.77, 95% CI: 0.69, 0.87). The best fitting regression model identified an independent effect for each birth decade and an interaction between ASUD status and sex, with a consistently earlier AAO in males with an ASUD (OR: 0.79: 95% CI: 0.70, 0.91).

In BD-I cases diagnosed according to internationally recognized criteria and recruited to pan-European clinical observational studies, the AAO distributions are compatible with a birth cohort effect. A potentially modifiable risk factor, namely ASUD status, was associated with the observed reduction in AAO, especially in males.

Major depression (MD) is associated with cognitive and behavioral alterations in many domains. It is not well clear what cortical structures and functional alterations characterize MD patients during resting state, a condition during which mind wandering process is prevailing.

In MD patients with severe levels of depression we expected, during resting state, an altered asymmetry of cortical activity in the EEG bands that generally mark neurological impairment, i.e. Delta and Theta EEG bands.

30 MD patients under pharmacological treatment and 32 matched controls underwent an EEG recording (38 scalp sites) during 5 min resting state with open eyes. Eye movements were corrected by ICA modeling and the 5 min recording was divided in 2 sec epochs from which Delta and Theta spectral powers were extracted.

Spectral analysis of the 5 min resting state revealed a significant difference between the two groups at the level of left temporal lobe. MD patients showed larger Delta and Theta spectral power in the left superior temporal gyrus at the level of Brodmann’s Areas 22 and 42.

Results evidenced a cortical inhibition (greater EEG Delta and Theta activity) in left temporal linguistic areas in severe depression, a result pointing to a different mind wandering process and thought architecture in MD patients during resting state.

The experience of discrimination is common in individuals with mental health problems and has been associated with a range of negative outcomes. As yet, however, there has been an absence of research on this phenomenon in adults with attention-deficit/hyperactivity disorder (ADHD). The current study examined the association between ADHD symptoms and mental health discrimination in the general adult population.

The analytic sample comprised 7274 individuals aged 18 and above residing in private households in England that were drawn from the Adult Psychiatric Morbidity Survey, 2007. Information on ADHD was obtained with the Adult ADHD Self-Report Scale (ASRS) Screener. A single-item question was used to assess mental health discrimination experienced in the previous 12 months. Logistic regression analysis was used to examine associations.

The prevalence of discrimination increased as ADHD symptoms increased but was especially elevated in those with the most severe ADHD symptoms (ASRS score 18–24). In a multivariable logistic regression analysis that was adjusted for a variety of covariates including common mental disorders, ADHD symptoms (ASRS ≥ 14) were associated with almost 3 times higher odds for experiencing mental health discrimination (odds ratio: 2.81, 95% confidence interval: 1.49–5.31).

ADHD symptoms are associated with higher odds for experiencing mental health discrimination and this association is especially elevated in those with the most severe ADHD symptoms. Interventions to inform the general public about ADHD may be important for reducing the stigma and discrimination associated with this disorder in adults.

The authors have not supplied their declaration of competing interest.

Dhat syndrome is a commonly recognized clinical entity in Indian culture. It consists of vague somatic symptoms (fatigue, weakness, anxiety, loss of appetite, guilt, etc.) and at times sexual dysfunction (impotence or premature ejaculation), which the patient attributes to the passing of semen (Dhat) in urine as a direct consequence of his excessive indulgence in masturbation or sexual intercourse.

To assess medical and psychiatric co-morbidities and prevalent knowledge and attitudes among patients of Dhat syndrome.

A cross-sectional study of 50 consecutive male patients with Dhat syndrome attending psychosexual clinic of a tertiary care hospital in Delhi was performed to ascertain co-morbid psychiatric and medical disorders and the prevalent knowledge and attitudes of subjects towards Dhat syndrome and its management.

The commonest associated psychiatric illness was neurotic depression followed by anxiety neurosis. The commonest associated medical illness was urinary tract infections (UTI) followed by sexually transmitted diseases (STDs). Majority of subjects believed Dhat to be semen; that Dhat syndrome causes both physical and mental weakness and; that health tonics are required for successful management of Dhat syndrome. More than half of the subjects believed that masturbation causes Dhat syndrome. The study reveals a change in knowledge and attitudes of patients affected with Dhat syndrome in the last decade.

Dhat syndrome exhibits significant medical and psychiatric co-morbidity. The findings of this study need to be further evaluated in the immigrant population.

Worldwide, trends in life expectancy and ageing-related diseases as Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) are increasing, having a rising impact on patients’ quality of life, on caregivers’ distress and on economic burden.

The purpose of this study was to review the use of modern technologies in medicine, usually known as Tele-Medicine, to improve quality of life of MCI and AD patients and their caregivers

–A systematic literature review was conducted of all published studies examining the relationship between Tele-Medicine and Alzheimer or MCI listed in the PubMed databases from January 1995 to December 2012. The inclusion criteria were the use of technological instruments and a Mild Cognitive Impairment or Alzheimer's diagnosis by a standardized diagnostic procedure.

A total of 69 articles met inclusion criteria. Overall, 21 suggested how to make a remote (10) or earlier (11) diagnosis; 31 described different type of patient's support during the stages of the disease; 9 described how to support patients’ caregivers and 8 showed multiple scopes.

The rising use of Tele-Medicine could actively improve conditions of AD and MCI patients and their caregivers, and could offer good instruments to make early diagnosis and screening even if patients live in remote places.

The objective of this study was to assess the levels of 10 toxic metals and essential minerals in hair samples of children with autism. Another purpose of this study was to evaluate whether the level of these elements could be correlated with the severity of autism.

The participants were 44 Autistic spectrum disorder (ASD) children according to Diagnostic and Statistical Manual of Mental Disorders 4th Edition, (DSM-IV). the age of 3 and 9 years. the severity of autistic symptomatology was measured by the Childhood Autism Rating Scale (CARS). Hair analysis was done to evaluate the long term metal exposure and minerals level. Sample preparation and testing were performed in Germany.

There was increase in some metal level such as: lead, aluminium, vandium and mercury. Also, the level of zinc, and iodine was deficient. There was a significant positive correlation between Arsenic & Fear and Nervousness (P = 0.020). Also, There was a significant negative correlation between Zinc & Fear and Nervousness (P = 0.022).

Several elements such as: lead, aluminium, vandium and mercury showed significant relationship, not only the etiology of autistic disorder but also, to the severity of the symptoms. Iodine and zinc seemed seem to have high nutritional value among autistic children.

Earlier research has shown that schizophrenic individuals process complex sound in aberrant ways (Olsson.O., Dissertation, Lund, 2000). It has also been shown that they abnormally perceive forward and backward masking (Källstrand et al., Psychiatry Res. 2002 Dec 15; 11 (1-2); 115-25). Experiments described in those studies indicate that in schizophrenia, brain-stem activity is involved, where primitive sorting of sound elements takes place. Brain Stem Response Audiometry (BSRA) shows that e.g. dissimilar spectra significantly separates schizophrenics from healthy subjects (Nielzén.S., 15th AEP Congress, March 2007, p. S86). The present study aims at demonstrating effects of loudness change of complex sound stimulation.

Eighteen paranoid schizophrenic patients were compared with 25 healthy volunteers regarding BSRA recordings from 2048 sweeps of loud noise stimuli (76 dB) and 2048 quieter ones (73 dB). Analysis of latencies in ms and amplitudes in micro-volts of the peaks and troughs was performed.

The amplitude of the highest peak of the region 1-4 ms was significantly lower with quiet noise for the schizophrenic group (P=.0002).

The schizophrenics showed significantly prolonged latencies of the highest peak during 4,5-9 ms with the quiet noise (P=.046); they had a significant longer latency from left than from right electrode (P=.049).

The results corroborate earlier cumulative BSRA results. These have been collected in a model – S-Detect – which is used as an objective decision support for the diagnosis of schizophrenia.

Dialectical behavior therapy has demonstrated effectiveness for patients suffering from co-morbid borderline personality and substance use disorder. The current study tries to replicate results of previous studies in a mixed gender sample of Egyptian outpatients.

The aim of the current study was to examine the effectiveness of DBT without drug replacement relative to treatment as usual “TAU” in improving behavioral outcomes related to SUD and BPD, and improving emotional regulation.

Forty outpatients with co-morbid BPD and SUD in Alexandria and Cairo were assigned for one year either to comprehensive DBT program (20 patients), or TAU defined as ongoing outpatient psychotherapeutic treatment from referring center (20 patients). Patients were assessed at baseline and follow up assessment at 4, 8, 12 and 16 months was done using Arabic version of Difficulties in Emotion Regulation Scale (DERS), urine multidrug screen and time line follow-back method for assessment of alcohol and substance use history.

Following one year of treatment, DBT group showed significantly lower doses of drugs used, DERS score, rates of hospital admission, ER visits, suicidal attempts and episodes of NSSI. Also, DBT patients showed markedly increased retention in treatment and longer duration of total alcohol abstinence and other drugs of abuse. Positive outcomes were maintained for four months post-treatment.

DBT demonstrated superior efficacy in comparison to TAU for treatment of Egyptian patients suffering from co-morbid borderline personality and substance use disorder across behavioral domains of SUD, BPD and reduction hospital admission, emergency room visits and DERS score.

The authors have not supplied their declaration of competing interest.