Bulimia nervosa (BN) is characterized by dysregulated eating behaviour and present data suggest adipokines may regulate food intake. We investigated a possible association between BN and adipokine levels and hypothesized that plasma (P)-adiponectin would be elevated and P-leptin and P-leptin-adiponectin-ratio would be reduced in women with BN.

The study was designed as a cross-sectional study with a longitudinal arm for patients with BN. Plasma-adiponectin and leptin was measured in 148 female patients seeking psychiatric ambulatory care and 45 female controls. Fifteen patients were diagnosed with BN and the remaining with other affective and anxiety disorders. P-adiponectin and P-leptin levels were compared between patients with BN, patients without BN and controls. At follow-up 1–2 years later, adipokines were reassessed in patients with BN and the Eating Disorder Examination Questionnaire was used to assess symptom severity.

P-adiponectin was elevated in patients with BN at baseline and at follow-up when compared to patients without BN and controls (P < 0.004 and < 0.008 respectively). The difference remained significant after controlling for body mass index. P-adiponectin was correlated to symptom severity at follow-up in patients with BN without morbid obesity (ρ = 0.72, P < 0.04). P-leptin-adiponectin-ratio was significantly lower in patients with BN compared to controls (P < 0.04) and P-leptin non-significantly lower.

Findings indicate a stable elevation of P-adiponectin in women with BN. P-adiponectin at follow-up correlates to eating disorder symptom severity in patients without morbid obesity, indicating that P-adiponectin should be further investigated as a possible potential prognostic biomarker for BN.

There exist almost no data on the efficacy of treatment of posttraumatic stress disorder (PTSD) in refugees coming to Western countries, even though many studies show a very high prevalence of posttraumatic problems among refugees. The present study focuses on the efficacy of a culture sensitive treatment for PTSD primarily designed for work in refugee camps in third world countries. Using a randomized controlled design, Narrative Exposure Therapy is compared to Treatment as Usual in a sample of refugees and asylum seekers in Norway.

Adult refugees or asylum seekers diagnosed with PTSD according to DSM IV were included in the study. Treatments comprised of 10 sessions and follow-up interviews were conducted 1 and 6 months after treatment using Clinician Administered PTSD Scale, Mini International Neuropsychiatric Interview, and the Hamilton Rating Scale for Depression. The study will continue until the end of 2008.

So far, 72 patients with PTSD have been included in the trial, and among them 40 have completed treatment and post-tests. Preliminary results at 1 month follow up show a significant PTSD and depression symptom reduction in patients who had received NET and, to a much smaller extent, in those treated with usual therapy protocols. However, data present so far indicate that only in the NET group, PTSD and Depression symptom reduction remains stable over time.

Preliminary findings indicate the importance of providing also refugees and asylum seekers with focused treatment of PTSD, where Narrative Exposure Therapy seems to be a promising treatment approach.

Aggressive and disruptive behaviors often precede the onset of schizophrenia. In this register-based follow-up study with a case-control design, we wanted to investigate if serious delinquency was associated with future diagnoses of schizophrenia or schizoaffective disorder (here, broadly defined schizophrenia) among a nationwide consecutive sample of 15- to 19-year-old Finnish delinquents sent for a forensic psychiatric examination in 1989–2010.

The sample comprised 313 delinquents with no past or current psychotic disorder. For each delinquent, four age-, gender- and place of birth -matched controls were randomly selected from the Central Population Register. Five controls (0.4%) had been treated for schizophrenia before their respective index-dates and were thus excluded from further analysis, leaving us with a control population of 1247 individuals. The subjects were followed till death, emigration or the end of 2015, whichever occurred first. Diagnoses were obtained from the Care Register for Health Care.

Forty (12.8%) of the delinquents and 11 (0.9%) of the controls were diagnosed with schizophrenia later in life (HR 16.6, 95% CI 8.53–32.39, P < 0.001). Almost half of the pretrial adolescents with later schizophrenia were diagnosed within 5 years of the forensic psychiatric examination, but latency was longer among the other half of the sample, reaching up to 20.5 years.

The study supports the previous research indicating a potential link between serious delinquency and later schizophrenia. Accurate psychiatric assessments should be made in correctional services but also later in life so that any possible psychotic symptoms can be detected in individuals with a history of serious delinquency even if there were no signs of psychosis before or at the time of the crime. Future research should explore which factors influence the delinquent's risk of developing later schizophrenia.

Language disturbances are the core symptoms of schizophrenia [Crow,2000]. Considering the influence of migration on the symptoms of schizophrenia [Bhugra, Gupta,2011] and few studies on the interaction of schizophrenia and bilingualism [Bersudsky, et al.,2005], we hope to clarify the linguistic profile of disorder and emphasize the role of language in schizophrenia research.

To examine the linguistic features of schizophrenia in the first (L1) and the second (L2) languages, particularly in fluency as the ability to cope with native and nonnative pragmatics.

Among sixty Russian immigrants to Israel diagnosed with schizophrenia, ten Russian-Hebrew fluent bilinguals met criteria for inclusion in the study (age: M=33.8,s.d.=11.0; length of residence: M=14.6,s.d.=6.8; time of immigration to diagnosis:M=5.3,s.d=3.9; PANSS Total score: M = 94.9,s.d = 9.8). Interviews were analyzed using clinical, linguistic and fluency speech markers. Statistical evaluation included t-test for dependent samples, two-way ANOVA(Fisher LSD post-hoc test).

The mean length of language samples demonstrated more productivity in L1 (Table1). Clinical speech markers associated with thought disorders were similarly represented in both languages. Linguistic markers of schizophrenia occurred more often in L2. Discourse markers, as bilingual phenomenona, reflected more dysfluency in L1.

1) The higher frequency of linguistic schizophrenia markers in L2 shows more impairments in the syntax/semantic components of language, where different neural representations may underlay the two languages in a bilingual brain damaged by schizophrenia. 2) The higher frequency of fluency markers in L1 reflects attempts to maintain verbal fluency, evidenced by the use of L2 lexical items, which afford a compensatory resource for communicative discourse in schizophrenia.

To describe the frequency of drug combinations (substrate-substrate or substrate-inhibitor) with the potential to interfere with the CYP2D6 metabolic pathway in patients receiving antidepressant medication for major depressive disorder.

We carried out an observational study using outpatient medical records. We included adult subjects who initiated antidepressant medication during 2008–2010. Patients were assigned to three study groups: no combination, substrate-substrate, and substrate-inhibitor. Follow-up period was 12 months. Main measures: demographics, comorbidity and medication persistence. Statistical analysis included a logistic regression model, P < 0.05.

Five thousand six hundred and thirty patients were recruited (61.9 years, 76.9% female), 24.4% (CI: 23.8 – 26.0%) received some kind of drug combination (substrate-substrate: 15.4%, substrate-inhibitor: 9.0%). Variables significantly associated with drugs combinations that may act on the CYP2D6 metabolic pathway were: dementia (OR = 4.2), neuropathy (OR = 4.2) and stroke (OR = 1.9), P < 0.001. Medication persistence at 12 months was longer in patients with no combination (55.3%) than in patients receiving substrate-substrate (50.5%) or substrate-inhibitor (45.0%) combinations, P < 0.001.

Twenty-five percent of major depressive disorder patients received a combination of drugs with the potential to interfere with CYP2D6 metabolic pathway. These combinations increased with comorbidity and resulted in shorter medication persistence of antidepressant treatment.

Impairments in social behavior and cognition, such as the ability to identify others’ emotional state, are important features in schizophrenia. Arginine vasopressin (AVP) and oxytocin (OXT) and are nonapeptides that influence social cognition and behavior. Previous studies have shown that the administration of intranasal AVP or OXT may affect the ability to recognize facial emotions. The primary objective of this study was to investigate the effects of a single dose of AVP or OXT on social cognition in patients with schizophrenia. The secondary objective of the study was to test for sex-specific effects of intranasal AVP and OXT administration on social cognition.

In this double-blind, placebo-control, cross-over study, 34 patients diagnosed with schizophrenia or schizo-affective disorder, received a dose of AVP, OXT or placebo in three separate meetings. Forty-five minutes after administration, subjects performed facial emotion recognition tasks.

There were no significant main effects of hormone administration on the ability to recognize facial emotions between treatment conditions. However, AVP administration resulted in sex-specific differences in emotion recognition. Specifically, in men, AVP administration reduced the ability to recognize angry faces. In women, AVP administration reduced the ability to recognize sad faces and improved the ability to recognize fearful faces.

These findings indicate that intranasal AVP may affect the recognition of facial emotions differently in men and women. Thus, AVP may increase the differences between men and women on social cognition.

The authors have not supplied their declaration of competing interest.

Women during the postpartum period experience many physiological, psychological, and social changes. Quality of life (QOL) is a sense of well-being and arises from satisfaction or dissatisfaction with various aspects of life including health, employment, socioeconomic state, psychological-emotional state, and family.

The purpose of this study was to identify influence of childbirth experience and postpartum depression on QOL.

This is a descriptive cross-sectional study regarding 150 postpartum women receiving cares in the hospital of Sfax and examined during the first and the sixth week post-delivery. Data collection tools in this study were demographic questionnaire, Edinburgh Postnatal Depression Scale (EPDS), and world health organization quality of life-bref (WHOQOL-bref). Data were analyzed using SPSS.

The mean age of our sample (n = 150) was 29.61 years. During the sixth week study period, 126 of 150 were examined.

A personal psychiatric history of depression was found in 9.3% of cases.

The current pregnancy was undesired in 15.3% of cases.

The prevalence of postpartum depression in the first week was 14.7% and 19.8% in the sixth week after delivery.

The mean score of quality of life was 81.62 ± 9.09.

Scores of quality of life and all its dimensions were significantly lower in depressive women.

Because enormous changes develop in postpartum women, we suggest supportive measures for mother by her mother-in-law family, and caregivers to improve the QOL and health status of the mother and her child and to prevent postpartum depression.

The authors have not supplied their declaration of competing interest.

Bipolar disorder impacts negatively on the patient, the family as well as the society. It taxes the health care services due to a combination of the illness and associated medical as well as psychiatric comorbidities. Unfortunately, in Africa knowledge of the epidemiology and burden of bipolar disorders is based mainly on data from the United States and Europe.

To highlight the epidemiological, clinical, and economic burden of bipolar disorder in Africa.

A systematic review of publications from Africa relating to the burden of bipolar disorder was conducted, including studies on epidemiology, patient-related issues and costs.

Data from community surveys conducted in Nigeria and Ethiopia indicated a lifetime prevalence of 0.1% to 0.6% for bipolar disorder. A study from Egypt showed a misdiagnosis rate of up to 36.2%. In one study, 8.1% of the males and 5.4% of the females reported a previous suicide attempt, while another study showed that up to 60% of patients with bipolar disorder had at least one comorbidity. There were no reports on mortality and cost of illness.

Despite the heterogeneous methodologies, samples and dearth of adequate representative evidence from Africa, we have identified bipolar disorder as a major mental health issue. There still exists a dearth of evidence regarding the epidemiological, clinical, social, and economic burden of the disorder in Africa.

Sensory deficits such as blindness and deafness are very common forms of disability, affecting over 300 million people worldwide according to World Health Organization estimates. These conditions can lead to misinterpretations of the environment, which may contribute to the development of a delusional disorder in predisposed people.

The objective of this study is to establish the prevalence of blindness and hearing loss across delusional disorder.

The aim is to provide useful information regarding this frequent, often disregarded, comorbidity.

Our results proceed from the Andalusian delusional disorder case-register (DelirAnda). We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis following DSM-V criteria, we recollected data on the prevalence of blindness and hearing loss, which were defined based on clinical diagnosis.

One thousand four hundred and fifty-two patients matched DSM-5 delusional disorder criteria. Among them, 49.8% of our sample were women. The overall prevalence of sensory deficits was 7.4%, 3.5% of the patients with delusional disorder were blind, while 3.9% of them suffered from hearing loss.

Our results are consistent with previous studies, such as the Deliremp study, which found a 5.7% prevalence of sensory deficit among delusional disorder patients. These results show a higher prevalence of sensory deficit among delusional disorder patients compared with the general population. However, causality could not be established. Further study should be undertaken regarding the relationship between these two conditions.

The authors have not supplied their declaration of competing interest.