Studies have shown that people with Intellectual Disabilities (ID) develop mental illness at rates similar to or higher than general population1.

There is no previous study on mental health of adults with ID in Turkey.

The purpose of this study was to investigate the prevalence and associated factors of mental disorders in adults with ID in Turkey.

151 participants with ID aged 18 and over were recruited from care homes, rehabilitation centers and from people attending to psychiatry outpatients for the first time. Every participant underwent face to face assessment by a psychiatrist supported by an informant and previous notes. A structured purpose designed socio-demographic form was used. Diagnoses were drawn according to DSM-5. Point prevalence of disorders was calculated and associated factors were investigated.

63.5% of the participants met criteria for one psychiatric disorder, 21% had more than one disorder. The most common disorders were: challenging behavior (34%), autism spectrum disorders (%13.9), and anxiety disorders (13.9%) and attention deficit hyperactivity disorder (10.6%). Living in a care home and being young were associated with mental ill health (P < 0.05) [1].

This study demonstrates high psychiatric comorbidity in adults with ID. Young age and care homes were the associated factors in this sample. These results are important to raise awareness of professionals and service providers about mental health of adults with ID.

This project was funded by the Scientific and Technological Research Council of Turkey (TUBITAK) with a project number of BİDEB 115C015. The funding body did not have any involvement with data collection, analysis or writing up.

This study examined the relation between schizotypy and the encoding style in a sub-clinical sample. We evaluated, first, the level of schizotypy with the Schizotypal Personality Questionnaire (SPQB) (Raine and al, 1995). Three factors are evaluated

1. a) cognitive-perceptual factor,

2. b) b) interpersonal factor and disorganisation.

A total of 184 students (113 women and 71 men) participated at this study. The mean age of the sample was 22,58 years (SD = 1,96). They were test using a French version of the ESQ, the brief SPQB, State-Trait Anxiety Inventory (STAI), The Center for Epidemiologic Studies Depression (CES-D) Scale.

The results demonstrated that we have a positive correlation between internal encoding style, schizotypy, depression and anxiety. Secondly, a high level of internal encoding style means a high level of congnitivo-perceptual and for interpersonal factors with an impact of depression and anxiety.

An internal encoding style is link with a high score in schizotypy.

The 5-HT2A agonist classic psychedelic, psilocybin (O-phosphoryl-4-hydroxy-N,N-dimethyltryptamine) is a tryptophan, indole-based alkaloid present in up to 2% of certain hallucinogenic “magic” mushroom species; typically Psilocybe azurescens, semilanceata, and cyanescens,. In addition, mushrooms may contain psilocin (4-hydroxy-N,N-dimethyltryptamine). Both are indolylalkylamines (tryptamines); other naturally occurring tryptamine compounds include norbaeocystin, baeocystin, norpsilocin, and aeruginascin. A putative synergistic contribution of these compounds has been referred to as the “entourage” effect. Aeruginascin (N,N,N-trimethyl-4-phosphoryloxytryptamine) is found naturally in Inocybe aeruginascens and Pholiotina cyanopus mushroom species and ingestion reportedly invokes elevation in mood without accompanying hallucinogenic effects:

To review the pharmacology of aeruginascin and putative entourage effect.

The extant literature on aeruginascin was reviewed and discussed.

Methylation of aeruginascin results in an active metabolite, 4-hydroxy-N,N,N-trimethyltryptamine (4-HO-TMT) which has been shown to bind at 5-HT1A, 5-HT2A, and 5-HT2B receptors with Inhibition Constants (Ki) of 4400, 670, and 120 nM respectively; compared with psilocybin’s binding of 567.4, 107.2 and 4.6 nM respectively. Further, 4-HO-TMT does not bind at the 5-HT3 receptor, and as a quaternary trimethylammonium compound it is less likely to be able to cross the blood-brain-barrier (BBB).

There are very limited data with respect to the pharmacology of aeruginascin. Its activity at serotonin receptors is less by several orders of magnitude than psilocybin and it has potentially less brain penetrance. Given that it is found in different mushrooms species the data would suggest that its direct contribution to any entourage effect is limited. Further research in needed into other naturally occurring tryptamine compounds.

PC is a member of the Scientific Advisory Board of Zylorion. AA, EB, JC, CE have no disclosures to report.

The authors have not supplied their declaration of competing interest.

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.

Evaluate the efficacy of art therapy during acute psychotic episodes.

Thirty-six inpatients with ICD-diagnoses of schizophrenia (F20.0–F20.9) age between 20–60 were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Art therapy was administered in 12 sessions of 90 minutes for 6 weeks. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. Scales used: 17 – Item Hamilton Rating Scale for Depression (HRSD) for depression and Scale for the assessment of negative symptoms (SANS).

The approach was non-directive – patients could choose to create whatever they wanted and use any available material. Interventions by the art therapist aimed at supporting the art process and helping to understand the image. The last 30 minutes of a session were reserved for a shared viewing and reflecting on the images.

With post-treatment and follow-up scores of SANS and HRSD patients who had received AT had a significantly greater mean reduction of positive and negative and also depressive symptoms at 12-week follow-up than patients treated as usual. Social functioning was significantly higher in the AT group. There were no significant interactions between intervention group and gender.

Evidence on the efficacy and effectiveness of AT in patients with schizophrenia is far from being conclusive and benefits might be limited to a subgroup of patients. Results of this study suggest AT can be implemented in routine hospital settings for patients experiencing acute psychotic states.

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

Previous studies showed associations of stress and episodes of active disease [1,2]. We reported survey data on psychosocial problems of IBD patients [3]. This study investigates associations of stress with health impairments and analyses a scale of perceived stress as an indicator for psychosocial impairments (construct/criterion validity) [4].

In a multiregional German survey in 2005, 1083 patients with Crohn's disease (CD) and ulcerative colitis were recruited (gastroenterological practices, university outpatient clinics, patient organization). The questionnaire incorporated WHO's ICF [5] and established items and scales (i.a. HADS [6]). Scale construction followed item response theory analysing psychometric properties.

Of the survey responders (58% CD, 65% female, mean age 42yrs), ⅓ reported severe fatigue. Clinically relevant anxiety was observed in 24%, depression in 29% of men and 21% of women. With three items we constructed a scale with good psychometric properties. Three groups (low, moderate, high perceived stress) were identified, differing substantially in reported anxiety/depression and the GIBDI disease activity score.

IBD patients report multiple psychosocial impairments. The scale of perceived stress may identify IBD patients with high demand for psychosocial attendance, if confirmed in independent samples. For enhanced secondary prevention [7] we propose integration of this psychosocial indicator into the diagnostic process.

Low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets are strongly recommended to improve irritable bowel syndrome (IBS) symptoms. They are also hypothesized to improve the psychopathological status that often accompanies the syndrome. A study (Ledochowski et al., 2000) suggested that the ingestion of FODMAPs affected negatively the mood and that the elimination of dietary FODMAPs improved depressive symptoms.

We aimed to assess the levels of psychopathology pre- and post-diet in IBS patients free of any severe psychiatric disease (e.g., bipolar disorder, major depressive disorder, schizophrenia) or alcohol/substance abuse.

We consecutively recruited 75 IBS outpatients (68% females; age range = 21–68 years) at the Gastrointestinal Outpatient Center of our University Hospital. They filled out the Symptom Checklist-90-Revised (SCL-90-R), a visual analogue scale (VAS) to rate the intensity of abdominal bloating/pain, and a 2-week diary card registering the frequency of bloating/pain. Then, they were blindly assigned to a low-FODMAP diet, a low-FODMAP gluten-free diet and a control diet for 4 weeks. During the last 2 weeks they filled out a 2nd diary card and rerated the intensity of bloating/pain. Patients were reassessed after a 16-month follow-up. Independent t-test, χ2 test, and one-way ANOVA with Tukey post-hoc test were used.

Baseline characteristics did not differ between the three groups. Post-diet and at follow-up, the two low-FODMAP diets, vs. the test diet, improved not only the intensity and frequency of bloating/pain, but also the SCL-90-R GSI, anxiety, and phobic anxiety scores (P-values < 0.05).

The low-FODMAP diet may improve psychopathology in IBS patients.

The authors have not supplied their declaration of competing interest.

To evaluate the safety and efficacy of pregabalin in relieving the symptoms of GAD in patients ≥65 years of age.

This was a multicenter, randomized, flexible-dose, placebo-controlled, double-blind, parallel-group trial of pregabalin in the treatment of GAD. Randomization was 2:1, pregabalin:placebo. Patients underwent an 8-week double-blind, flexible-dosage (150-600 mg/d) treatment phase, including a 1-week dose-escalation period (50 mg/d to 150 mg/d). The primary efficacy assessment was change from baseline to endpoint-LOCF in HAM-A total score. Additionally, change from baseline to week 8 (observed cases) in HAM-A psychic and somatic factors was evaluated.

Mean age at GAD onset was 56 years; 77% of patients were women; mean age at enrollment was 72 years; mean duration of GAD was 17 years. Mean change from baseline in HAM-A total score was –12.84 (n=177) for the pregabalin group and –10.7 (n=96) for the placebo group (P=.0437). At week 8, patients treated with pregabalin had significant improvement in both the HAM-A psychic (–7.8 vs –6.3, P=.0111) and somatic (–6.6 vs –5.4, P=.0248) factors. The most common adverse events (AEs) among pregabalin-treated patients were dizziness (20.3%), somnolence (13.0%), headache (10.2%), and nausea (9.0%). Most AEs were mild-to-moderate and self-limiting. Discontinuation rates due to AEs were 10.7% and 9.4% in the pregabalin and placebo groups, respectively.

Pregabalin was effective in reducing the symptoms of GAD in patients aged 65 years and older, and it was safe and well tolerated in this population.

There are seldom mental health studies in Portugal about immigrant populations, particularly in groups belonging to non-Portuguese speaking minorities. The recent phenomenon of emergence of new migratory flows coming from Eastern Europe countries, which traditionally had no cultural or linguistic contact with the host country and the implications of this migratory process in the mental health status of this population, is the centre of this investigation.

This study aims to perform a socio-demographic characterization, identify the main health problems and health surveillance patterns of the immigrant population from Eastern Europe countries in Portugal. It also aims to assess the stress vulnerability and ths mental health status of this population.

The study was conducted in immigrant local centres from January 31st 2005 to March 31st 2006 and focused on 566 Eastern Europe immigrants residing in several regions of Portugal, 296 males and 270 females. We used the 23 QVS (Vaz Serra, 2000); GHQ-28 (Goldberg & Hillier, 1979); SSQ6 (Saranson, Saranson & Pierce, 1987) and a Socio-demographic questionnaire.

From the 566 individuals in sample one; we conclude that this population is predominantly male, in active young age, with high academic qualifications.

Regarding mental health status, 10,4% of the inquired immigrants presented psychiatric pathology assessed by the cutting point of GHQ-28 and 54.9% presented stress vulnerability determined by the cutting point of 23QVS. We verified a statistically relevant correlation between stress vulnerability and the levels of mental health of the surveyed population.

Short term benefits of Specialized Early Intervention (SEI) services for treatment of first episode of psychosis (FEP) are not sustained after transfer to regular care. Optimum length of SEI services remains to be determined.

To carry out a randomized controlled trial (RCT) of extending SEI service for an additional three years compared to “regular” care after both groups have received two years of SEI treatment.

The experimental group (extended SEI) will have better clinical (remission length and proportion) and functional outcomes and be cost effective compared to the control group (regular care).

Remission (length and proportion in remission) are the primary outcomes. We aim to randomize a total of 212 patients following two years of SEI service for their FEP. Outcome evaluations to assess symptoms, functioning and service utilization are carried out at entry and every three months. In this presentation we will report only the method and preliminary results (success of urn randomization, drop out and relapse rates) on the sample recruited thus far.

Of the 58 patients approached 50 (86%) agreed to be randomized. Patients were young (mean age 25), mostly male (with a diagnosis of Schizophrenia Spectrum Psychosis (71%). The average length of follow up to date is 13.2 months (s.d. = 5.4). Treatment discontinuation in the experimental and control conditions were 0 and 4 (15%), respectively.

The pilot results show the feasibility for carrying out such a study. The methodological challenges of conducting this long term RCT will be discussed.

The mechanism of weight gain due to treatment with olanzapine, a serotonin receptor antagonist, has not been fully understood. Weight gain and food intake are under the control of neuropeptides/hormones, POMC (proopiomelanocortin), CART (cocaine and amphetamine regulated transcript), AgRP (Agouti-related peptide) and NPY (neuropeptide Y) that are synthesized and secreted from the arcuate nucleus (ARC) of hypothalamus.

In this study, the altereration of the ARC neuropeptide/hormone levels in rats were determined as one of the weight gain mechanism. To examine olanzapine's weight gain effects, olanzapine was orally administrated to 10 healthy male Wistar rats to analyze both the hypotalamic gene expression and peripheral levels of those candidate neuropeptides.

Food consumption was found to be increased and hypotalamic mRNA levels of NPY, AgRP and POMC were decreased while CART levels did not show any alteration. Consistent with the expression data, circulating levels of NPY, AgRP and α-MSH decreased significantly but CART levels were also reduced unexpectedly. in conclusion, it may be presumed that the antagonistic effect of olanzapine on the ARC neurons might be the basis for a disregulation of the neurohormones secretion which may cause weight gain due to olanzapine therapy.

Exhaustive literature is available in the portrayal of mental illness in the English language films. However no major studies are available around the portrayal of mental health in Bollywood movies which in fact is consumed by nearly 25-30% of the world population.

in the era of unprecedented growth in visual medium, we wish to study the portrayal of mental illness in Bollywood cinema and how effective this medium is to create awareness around mental health and stigma.

Literature search with a specific purpose to identify any available literature on mental illness in South Asian cinema was undertaken. to create a synthesis of portrayal of mental illness, its impact on cultural consumption with its advantages and deficiencies. This was followed by a listing a cluster reviews of Bollywood films that have characters with mental health problems to identify how these illustrate both the condition and reactions to them.

These findings were compared with the literature surrounding mental health and the Indian culture to show if the perceptions correlate. The information was collated to see any patterns and 6 such patterns were identified.

Results

Recognising these motifs are crucial for public and clinician alike in contact with the population open to the influence of these films to not only understand the phenomenology of mental illness in this populace but also some of unique cultural factors, medication, stigma and charting out appropriate management plan. (On-going)

The details of the synthetic factors will be presented in the results and discussion.

These findings demonstrate a lower autonomic power in panic disorder patients and tendency to increase it during the treatment.

Supported by: Project IGA MZ ČR NS10301-3/2009

To evaluate the efficacy and tolerability of once-daily quetiapine XR adjunctive to antidepressant therapy versus antidepressant alone in patients with MDD showing an inadequate response to antidepressant treatment (mainly SSRIs/SNRIs).

6-week, multicentre, double-blind, parallel-group study (D1448C00007). Patients were randomised to receive quetiapine XR 150mg/day (n=167), 300mg/day (n=163) or placebo (n=163) as add-on to maintained antidepressant treatment. Primary endpoint: baseline to Week 6 change in MADRS total score. Secondary variables included: baseline to Week 1 change in MADRS total score; baseline to Week 6 change in HAM-A total and psychic anxiety subscale scores. Safety assessments included AE reporting.

Mean change in MADRS total score (overall baseline mean, 28.4) from baseline to Week 6 was significant (p<0.01) for quetiapine XR 150mg/day (-15.26) and 300mg/day (-14.94) versus placebo (-12.21). Separation from placebo in MADRS total score was apparent from Week 1 for both quetiapine doses (p<0.001).

At Week 6, mean change from baseline in HAM-A total score (overall baseline mean, 20.8) was significant for quetiapine XR 150mg/day (-10.27, p<0.01) and 300mg/day (-9.70, p<0.05) versus placebo (-7.92). Mean change from baseline in HAM-A psychic anxiety subscale score (overall baseline mean, 12.83) was significant with quetiapine XR 150mg/day (-6.82, p<0.001) and 300mg/day (-6.47, p<0.01) versus placebo (-5.11).

Most common AEs (>10%) were dry mouth, somnolence, fatigue, sedation, constipation and dizziness with quetiapine XR.

In patients with MDD with an inadequate response to antidepressant treatment, adjunctive quetiapine XR 150mg/day and 300mg/day was well tolerated and effective at reducing depressive and anxiety symptoms.