Forensic psychiatric services are costly and highly restrictive for patients. Clinical experience and the limited research available indicate some patients stay for too long in these settings. A proportion of patients may, however, require long-term (potentially life-long) secure forensic psychiatric care but their needs may not be met by existing service provision designed for faster throughput.

We conducted a national, multi-centre, cross sectional study exploring the prevalence of long-stay and characteristics of long-stayers in high and medium secure forensic psychiatric care in England.

(1) Estimate the prevalence of long-stay in secure settings in England (length of stay over 5 years in medium secure care or 10 years in high secure care); (2) describe the characteristics, needs and care pathways of long-stay patients. Develop recommendations following the exploration of international models for this patient group.

We employed a mixed-methods approach including the analysis of administrative data, case file reviews, patient interviews, consultant questionnaires, interviews with clinicians and commissioners and a Delphi survey.

Twenty-five percent (n = 401) of our sample were experiencing long-stay. This patient group has a heterogeneous set of characteristics and needs relating to their diagnosis, offending history, risk and therapeutic need and have experienced a variety of care pathways through secure care.

We found a greater number of long-stay patients than originally estimated with a set of characteristics and needs that are arguably different to that of the general forensic population, therefore calling for a specific care pathway and service provision for this patient group with a greater focus on autonomy and quality of life.

The authors have not supplied their declaration of competing interest.

Major Depressive Disorder (MDD) is prevalent, often chronic, and requires ongoing monitoring of symptoms to track response to treatment and identify early indicators of relapse. Remote Measurement Technologies (RMT) provide an exciting opportunity to transform the measurement and management of MDD, via data collected from inbuilt smartphone sensors and wearable devices alongside app-based questionnaires and tasks.

To describe the amount of data collected during a multimodal longitudinal RMT study, in an MDD population.

RADAR-MDD is a multi-centre, prospective observational cohort study. People with a history of MDD were provided with a wrist-worn wearable, and several apps designed to: a) collect data from smartphone sensors; and b) deliver questionnaires, speech tasks and cognitive assessments and followed-up for a maximum of 2 years.

A total of 623 individuals with a history of MDD were enrolled in the study with 80% completion rates for primary outcome assessments across all timepoints. 79.8% of people participated for the maximum amount of time available and 20.2% withdrew prematurely. Data availability across all RMT data types varied depending on the source of data and the participant-burden for each data type. We found no evidence of an association between the severity of depression symptoms at baseline and the availability of data. 110 participants had > 50% data available across all data types, and thus able to contribute to multiparametric analyses.

RADAR-MDD is the largest multimodal RMT study in the field of mental health. Here, we have shown that collecting RMT data from a clinical population is feasible.

No significant relationships.

Ubiquitous negative emotional states such as depression, anxiety and stress in adulthood are related to individual life scenario, particularly influenced by exposure to environmental risk factors. Here, we investigated if sub-threshold negative emotional states in general population can be predicted by experience of trauma in the childhood.

A sample of 106 healthy young adult participants from Belgrade and surroundings (43.4% male, age 29.2 ± 6.6 years, mean IQ 106.4 ± 15.9) fulfilled Childhood Trauma Questionnaire (CTQ) to identify emotional or physical abuse/neglect or sexual abuse. Present level of negative affectivity was measured by Depression Anxiety Stress Scale (DASS). Hierarchical linear regression analysis was conducted to identify subtypes of trauma as predictors of the negative affectivity.

Mean CTQ and DASS scores were 31.2 ± 6.7 and 16.4 ± 16.8, respectively. An exposure to given risk factors in the past correlated significantly with intensity of the present negative affective states (r = 0.290, P = 0.004). For the prediction of anxiety, the most important traumatism subtypes were emotional abuse, emotional neglect and physical abuse (P = 0.001; 0.028; and 0.041, respectively). Depressive symptoms were predicted only by the emotional abuse in the past (P = 0.008).

Based on clinical samples, findings from the literature yielded greater risk for mood and anxiety disorders after exposure to emotional, in comparison to the physical trauma. We confirmed the same pattern of correlations in the healthy subject's sample, who had no history mental disorders. Evaluation of the interaction effects among emotional trauma and genotype is strongly recommended in the identification of subjects at risk and for the prevention.

The authors have not supplied their declaration of competing interest.

Schizophrenia research based on traditional assessment measures for negative symptoms appears to be, to some extent, unreliable. The limitations of the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS) have been extensively acknowledged and should be taken into account. The aim of this study is to show how the PANSS and the SANS conflate negative symptoms and cognition and to offer alternatives for the limitations found.

A sample of 117 participants with schizophrenia from two independent studies was retrospectively investigated. Linear regression models were computed to explore the effect of negative symptoms and illness duration as predictors of cognitive performance.

For the PANSS, the item “abstract thinking” accounted for the association between negative symptoms and cognition. For the SANS, the “attention” subscale predicted the performance in verbal memory, but illness duration emerged as a stronger predictor than negative symptoms for outcomes of processing speed, verbal and working memory.

Utilizing alternative models to the traditional PANSS and SANS formats, and accounting for illness duration, provide more precise evidence on the relationship between negative symptoms and cognition. Since these measures are still extensively utilized, we recommend adopting more rigorous approaches to avoid misleading results.

Stress is integral part of human life todays. Stressful situations not only affect on the short-term events such as death or birth, but also it affects on events such as marriage, employment situations and particular political atmosphere that are to long-term events. However, whether these factors are short-term or long-term, individual reaction to cope with situations will be different. So the study aimed to investigate one of problems of 20th century, addiction to internet, and its relation to strss.

In sampling process 100 university students were randomly selected. All participants were requested to complete Coudron's Stress Inventory (CSI) and Addiction to internet inventory (AII).

Analyzing of the data showed that there is significant positive correlation between stress and addiction to internet. It showed people with stress are more dependent to the Internet and have more tendency to overuse of internet.

With regards to results, it is bettter to plan for increasing of skills of cope with stress and decrease addiction to internet in university students.

To present the epidemiology and psychological predictors of Internet Addiction (IA) among Greek University students.

This random sample consisted of 3545 students, drawn from 24 higher education institutions (1618/1927 M/F, mean age 20.12 ± 2.4 years). The survey was conducted in the 4 Greek cities: Athens, Preveza, Thessaloniki and Amfissa.

The prevalence rates of IA according to Young's Test in the four cities were: Athens (17.5%), Preveza (15.9%), Thessaloniki (19.3%), Amfissa (16.3%). There was a statistically significant association between location and IA (χ2 = 28.251, df = 3, p < 0.001), gender and IA for males and females (p < 0.001). We performed a t-test with the dependent variable S = sum of scores in the psychological features of loneliness, feeling abandoned, disappointed, aimless in life, and with low self-esteem; the grouping variable was IA. Results showed that the variable S was much lower for the non-addicted than for addicted students (t = 19.329, p < 0.005, df = 3085). Binary logistic regression was performed to assess the impact of psychological characteristics on the likelihood that respondents would be Internet Addicted. The model was statistically significant χ2(10, N = 3085) = 316.3, p < 0.001. The model classified correctly 85.1% of the cases. The strongest predictors of IA were the following: Loneliness (OR = 2.15, 95% CI = 1.67-2.71), feeling abandoned (OR = 1.63, 95% CI = 1.2-2.1), low self-esteem (OR = 1.72, 95% CI = 1.4-2.1) and fear of losing their job (OR = 1.36, 95% CI = 1.01-1.7).

Loneliness, helplessness, low self-esteem and fear of unemployment are the strongest predictors of IA among Greek university students.

Elevated levels of C-reactive protein (CRP) have repeatedly been observed in schizophrenia (SZ) and related disorder but without clear description of the associated clinical variables. The objectives of this study were:

– to determine the prevalence of abnormal CRP levels in an observational sample of patients with SZ or schizoaffective disorders;

– to identify the clinical variables associated with elevated CRP levels as well as the effects of treatments.

Two hundred and nineteen stable patients with schizophrenia or schizoaffective disorder (mean age = 31.6 years, 75.3% male gender) were systematically included in the network of FondaMental Expert Center for schizophrenia and assessed with a dedicated electronic medical records including the Structured Clinical Interview for DSM-IV Axis I Disorders and validated scales for depressive and psychotic symptomatology. High sensitivity CRP (hs-CRP) was measured with an assay using nephelometry (Dade Behring). Abnormal CRP level was defined by levels > 3 mg/L. Metabolic syndrome was defined according to the International Diabetes Federation.

Overall, 63 patients (28.8%) were found to have abnormal CRP levels. In univariate analysis, abnormal CRP levels were found to be significantly associated with the DSM-IV-TR schizophrenia diagnosis compared to schizoaffective disorder (32.6% vs. 10.5%, P = 0.006). This association remained significant after adjustment for BMI (P = 0.007) and antidepressants (P = 0.043). Abnormal CRP levels were also found to be significantly associated with BMI (P < 0.0001), hypertriglyceridemia (P = 0.0015), high waist circumference (P < 0.0001), metabolic syndrome (P = 0.0011) and abdominal obesity (P < 0.0001), while current tobacco status, hypertension or high fasting glucose were not (all P > 0.05). All patients were treated by antipsychotics. Patients treated by antidepressant were found to have less abnormal CRP levels than others (P = 0.01), contrary to those treated by mood stabilizing agents (P > 0.05).

CRP may be considered as a biomarker of interest to differentiate schizophrenia from schizoaffective disorder, and as a marker of inflammation induced by perivisceral fat. Treatment with antidepressant appears as a protective anti-inflammatory agent.

Due to their frequency and negative impact on quality of life, eating disorders in schizophrenia need to be considered and highlighting.

To identify the risk of eating disorders (ED) and its correlates among mental patients.

It was a descriptive and analytic study. It included 53 inpatients with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed in the department of Psychiatry at the Hedi Chaker University Hospital of Sfax in Tunisia, during the three months of August, September and October 2016. Data collections were conducted using questionnaire exploring sociodemographic and medical data. The SCOFF (sick, control, one, fat, food) Questionnaire was used to screen ED. A total score of ≥ 2 was used as a cutoff point to select persons at risk of ED.

The average age of our patients was 30.47 ± 9.5 years old. The majority of our patients was male (71.7%) and single (71%). The mean of extra Body mass was 27.9. The mean duration of disease was 9.9 ± 8.1 years and patients were mostly (54%) in atypical neuroleptics. According to the SCOFF Questionnaire, 35.8% had a risk of ED. Female gender and treatment with atypical neuroleptics were significantly associated to ED risk with respectively P = 0.02 and P = 0.038.

Eating disorders remain underestimated among patients suffering from schizophrenia. Yet, its screening prevention and management are crucial and must be multidisciplinary for optimal care.

The authors have not supplied their declaration of competing interest.

To investigate the prevalence of pathological Internet use (PIU) among adolescents in eleven European countries in relation to demographic and health-related risk factors and Internet accessibility using homogenous methodology.

Cross-sectional analysis.

The 7th Framework European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), is a Randomized Controlled Trial (RCT) evaluating preventive interventions for risk-behaviors among adolescents in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain with Sweden as the coordinating site.

11,956 adolescents (F/M: 6731/5225; mean age: 14.9 ± 0.89) recruited from randomly selected schools within the eleven study sites.

Internet users were classified by gender into three categories: adaptive, maladaptive and pathological, based on the Young Diagnostic Questionnaire for Internet Addiction (YDQ).

The overall prevalence of PIU was 4.4%. the rate was higher among males than females (5.2% vs. 3.8%). Students not living with a biological parent or relative had the highest risk for both maladaptive and pathological Internet use. Low-parental involvement and parental unemployment showed high relative risk for both maladaptive and pathological Internet use. PIU significantly correlated with the average number of hours spent online. No correlation was found between national levels of Internet accessibility and pathological Internet use.

Prevalence of PIU varied by gender. Youth in households without a biological parent and/or low level of parental involvement had the most significant health-related factors associated with PIU. National levels of Internet accessibility were not a risk factor for either maladaptive or pathological Internet use.

The aim of this study was to investigate the distribution of the regional cerebral blood flow (rCBF) in occupational related PTSD subjects and to seek for possible correlations between brain perfusion and self-rating scales (SRSs) in order to cross-check their diagnostic value and to look for their neural correlates.

Sixteen traumatized underground and long-distance train drivers developing (S) and 17 not developing (NS) PTSD after having experienced a “person-under-train” accident underwent clinical assessment and 99mTc-HMPAO-SPECT during trauma scripts. Statistical parametric mapping (SPM2) was applied to analyse rCBF changes in S as compared to NS, and to search for correlations between rCBF and SRSs scores, modeling age, months since trauma and the ratio ‘gray matter/intra-cranial volume’ as nuisance variables.

Significantly higher activity was observed during trauma script in left posterior insula, posterior cingulate, inferior parietal lobule, precuneus, and caudate in S as compared to NS. Impact of Event Scale (IES) and World Health Organisation (ten) Well-Being Index (WHO-10) scores highly correlated with tracer uptake to a great extent in the same regions in which rCBF differences between S and NS were found.

These findings support the involvement of posterior insular, cingulated, and parietal cortices (as well as the caudate) in the pathogenesis of PTSD and in the processing of related subjective well-being and distress. Our findings seem to provide a cross-validation for IES and WHO-10 scales by means of SPECT data, supporting their validity in the diagnosis of PTSD, and suggesting their use in future works.