Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. The DIR/Floortime (Stanley Greenspan and Serena Wieder) is based on the Child’s Functional Development, Individual Differences and Relationships (D for development, I for individuality or individual differences and R for relationship), aiming at building the foundations for social, emotional and intellectual skills of children.

To determine the results of 18 months DIR/Floortime™ parent training for an additional benefit in encouraging children with ASD climbing the developmental “ladder”.

The participants are 15 children with ASD aged between 2 and 6 years-old. The follow-up occurs in two private DIR Floortime Model service centers in Brazil. Protocols: Functional Emotional Assessment Scale – FEAS and Functional Emotional Developmental Questionnaire – FEDQ. The participants were followed-up one on one every four months.

At the first month of assessment the children showed lack of self regulation, social interaction and engagement with their parents in a symbolic, sensory and motor play setting. At the following evaluations, they showed increase of social interaction and engagement in the same play setting. Besides the high affect of the parents during the play time promoted a two way purpose communication and behavioral organization.

Children showed a good development of functional and emotional capacities during the study period, demonstrating the effectiveness of the DIR/Floortime model in the intervention.

Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains.

Using self-reported and neurocognitive measures, we assessed different impulsive–compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls.

We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs.

Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.

The European Federation of Psychiatric Trainees (EFPT) is an independent federation of psychiatric trainees’ associations. Previous studies have shown that up to 1/3 of countries surveyed did not have separate CAP training We surveyed trainees to gain insights regarding current training within the member countries of the EFPT.

Ten item Survey of Trainee representatives from 32 countries- using surveymonkey questionnaire.

Industry standard encryption technology utilisied.

27 respondent countries. Response rate 84.4% In many countries CAP and General Adult Psychiatry training were not separate Variable availability of training posts (surplus posts 23%, no posts/ long waits 19.2%) Duration of training: 3 years (19.2%),4 years (23.1%), 5 years (26.9%). In 35% of countries CAP training was entirely separate from commencement of training. In 40%, entry to CAP training occurred after training in general adult psychiatry. Trainees in 61.5% of respondent countries indicate their intention to specialise in CAP before entering training in psychiatry; 15% of trainees can indicate this at any time.

This is a survey of trainee representatives to the EFPT of ten items related to CAP training experiences. It highlights significant differences in training experiences in 27 respondent countries. From 2010 the EFPT aims to record detailed information on CAP training yearly. CAP trainees are an integral part of EFPT, and there are specific areas of needs in CAP training.

To analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.

As part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).

Compared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.

The hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

To assess effect of pelvic tilt by birth ball, sacrum-perinea heat therapy and combination use of them on active phase of physiologic labor.

In this randomized control trial, 120 primiparous volunteer with age 18-35 years, gestational age of 38–40 weeks, in one of hospitals of Iran university of medical sciences were randomly selected and divided in four groups: Pelvic tilt by using birth ball, sacrum perinea heat therapy, combined use of two mentioned methods and control group. Tools had 3 main parts of personal characteristic, client examination form and pain visual analogue scale (VAS). All ethical points were considered.

Equality of four groups had been checked before intervention. Lowest pain score first belong to pelvic tilt by birth ball then combined group and finally in heat therapy, which all were significantly less than control group. Significant decrease of pain had been seen in birth ball group and combined group during after 30 minutes intervention, but in the heat therapy group, it was seen after 60 minutes intervention (P-value < 0.05).

All three interventions of this study had significant effect and decreased labor pain during active phase, but highest decrease was in pelvic tilt by birth ball group and its effect started after 30 minutes intervention. It is suggested that that Obstetrics and Midwives consider these safe methods for labor pain management.

The authors have not supplied their declaration of competing interest.

The association between anxiety disorders and verified coronary heart disease (CHD) remains to be clarified.

To report the prognostic association between anxiety disorder subtypes and subsequent major adverse cardiac events (MACE), report anxiety disorder prevalence in CHD, and the efficacy of randomized controlled trials (RCTs).

A comprehensive literature search was conducted for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE and RCTs. From 4,041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence), no RCTs were eligible.

Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n = 2851). There was a non-significant association between GAD and MACE risk (Risk Ratio = 1.20, 95% CI .86 – 1.68, p = .28) however the effect size was highly significant in outpatient samples with adjustment for covariates (adjusted hazard ratio = 1.94, 95% CI 1.45 – 2.60, p <.001). No other anxiety disorder subtype was associated with MACE. Prevalence data showed high comorbidity with depression (49.06%; 95% CI 34.28 – 64.01) and substantial heterogeneity between studies and anxiety disorder subtypes. Panic disorder prevalence was higher in psychiatrist/psychologist raters (9.92% vs. 4.74%) as was GAD (18.45% vs. 13.01%). Panic and GAD estimates were also significantly higher in DSM-III-R versus DSM-IV taxonomies (13.40% vs 3.43%, p <001; 11.12% vs. 6.80%, p <.001 respectively).

The paucity of extant anxiety disorder RCTs, alongside MACE risk for GAD outpatients, should stimulate further anxiety disorder intervention in the CHD population.

The Burnout Syndrome Study screened for burnout in psychiatric trainees in 22 countries, along with associated factors. This paper reports the results of the PHQ-9 depression screen that formed part of the study.

It is well documented that physicians have higher rates of mental illness compared to the general population. Post-graduate medical trainees may work long hours and be exposed to stressful or saddening situations regularly. Their environment and workload means they may not exhibit appropriate help-seeking behaviours and be at significant risk of depression.

The study used a cross sectional, multi-country online survey. Participants were asked to participate via an email invitation. The participants were asked to complete the PHQ-9 questionnaire, which is validated as a primary care self-administered screen for depression. Mixed methodology was used when recruiting trainees to obtain the most representative sample possible from each country. Statistical analysis was performed using SPSS.

Complete data was obtained from 1980 trainees with an average age of 31.9 years and with 2.8 years of training. The prevalence of depression in psychiatric trainees varied by country from 50% in Latvia to 7.1% in Belarus. The average rate of depression was 20.8%.

Prevalence of depression in the US general population is estimated at 6.7%, making the prevalence of depression in trainees of 20.8% a sign that action needs to be taken to reduce depression rates in trainees.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Diabetes and depression remain among the major problems of public health in the world. These diseases complicate each other. Several factors contribute to the occurrence of depression in diabetic. Thus, it would be necessary to determine them in order to prevent its occurrence.

To assess the prevalence of depression in a population of diabetics and to identify factors contributing to the occurrence of depression in diabetics.

A cross case-control study among 100 hospitalized diabetics in the department of endocrinology, Hedi Chaker hospital in Sfax Tunisia. We compared them to 100 witnesses. Then, we compared the two subgroups of depressed and non-depressed diabetics. We used the Hospital Anxiety and Depression Scale to screen for depression, the Beck Depression Inventory scale to determine the degree of its severity and the MINI to identify patients with a current major depressive episode (MDE) among depressed subjects.

The prevalence of depression was higher in diabetics (35% versus 14%). The prevalence of MDE was 71.43%. Depression was severe in 40% of cases. Comparing to the non-depressed diabetics, depressed diabetics were predominantly female and older. The duration of diabetes, mostly type 2, was longer. These subjects had more acute and chronic complications. Correlation factors of depression in diabetics were: advanced age, low socio economic level, low physical activity, stressful life event, lower limb arteritis, gastroparesis, android obesity, disturbance of lipid profile and anxiety.

Factors involved in the onset of depression in diabetic subjects should be taken into account to improve management of diabetes

This study aimed to investigate and compare the social skills of students addicted to computer games with normal students. The dependent variable in the present study is the social skills.

The study population included all the students in the second grade of public secondary school in the city of Isfahan at the educational year of 2009–2010. The sample size included 564 students selected using the cluster random sampling methods. Data collection was conducted using Questionnaire of Addiction to Computer Games and Social Skills Questionnaire (The Teenage Inventory of Social Skill or TISS).

There was a significant difference between the social skills of students addicted to computer games and normal students. In addition, the results indicated that normal students had a higher level of social skills in comparison with students addicted to computer games.

Addiction to computer games may affect the quality and quantity of social skills. In other words, the higher the addiction to computer games, the less the social skills. The individuals addicted to computer games have less social skills.

most obsessive-compulsive disorder (OCD) patients meet psychiatrists 5 to 10 years after onset of OCD. Its relatively high prevalence ratio and the delay in seeking help suggest that patients with OCD may seek help at nonpsychiatric clinics. the present study was undertaken to provide some epidemiological data on the prevalence and severity of OCD in dermatological patients.

The participants included 265 consecutive patients with primary dermatologic chief complaint. They were visited by a dermatologist and diagnosis of dermatological lesion was done according to ICD-10. All patients were visited by a psychiatry resident and were screened for OCD using the structured clinical interview for DSM-IV-TR (SCID-I). If the diagnosis of OCD has been made, the Yale-Brown obsessive compulsive scale(Y-BOCS) was used to evaluate the severity of OCD. To analyze the data student t-test for quantitative variables and X2 tests for categorical variables.

From the total of 265 patients, 24(9.1%) met the DSM-IV-TR criteria for OCD and 9(37.5%) with OCD had previously been diagnosed with OCD, however, only three were treated pharmacologically. The most symptoms were pathological doubt (29.1%), fear of contamination(29.1%)and washing (54.16%). Severity of OCD according to Y-BOCS was evaluated among patients with OCD. Six (25%) were found with subclinical OCD, 11(45.8%) had mild OCD, six(25%) had moderate OCD, and one (4.2%) was detected with sever OCD.

prevalence of OCD in dermatology clinic was higher compared with general population.

Though Focus of mental health care is negative emotional state, positive psychology appeals to masses. Because troubled person not only wants relief but also wants a life of meaning & purpose (National Mental health plan 2003-2004, Australian Govt.). and purposeful life without mentally healthy family is difficult. So family's transformation's imperative (Welsh Assembly Govt. 2005 a).

To strengthen Family members to transform Dysfunctional family.

1. 1) Preserve family mental health & Prevent mental illness among family-members of mentally ill patient.

2. 2) Prevent deterioration of mentally ill patient.

Discussion -for therapeutic alliance.

Therapeutic Transformation of dysfunctional family -

1. (a) Family Therapy: Why? Because family therapy focuses on well-being which is over & above the absence of depression-anxiety etc. Family therapy addresses problem and not individual unlike other therapies (NIMH, EFTA).

2. (b) Psycho-education: To build positive emotions which facilitate skills & resources needed for recovery (Fredrickson). It includes (i) Transactional-analysis (ii) Proactive behavior (iii) Social maturity (Robert Kegan).

3. (c) Positive Psychotherapy (PPT): Recovery rate was 85% (30%-single therapy) when psychotherapy was clubbed with pharmacotherapy. Positive emotions promote psychological resilience & positive emotional granularity. PPT focuses on pleasant, engaged & meaningful life (Seligman 2002).

4. (d) Spiritual Psychotherapy: Inevitable to future Psychiatry, because meditation alters levels of Melatonin, Serotonin, boosts immune response. Contents: (i) Meditation – changes brain (Dr Zedel, 2010) (ii) Spiritually-augmented CBT (SACBT), (iii) IBMT (Tang Y Y)/Yog-Nigra.

Family mental health is achieved.

Thus attained family mental health will facilitate family's transformation.