Infliximab is a tumor necrosis factor-alpha (TNF-α) inhibitor commonly used in the treatment of autoimmune disorders such as rheumatoid arthritis and ankylosing spondylitis. An increased risk of opportunistic infections, malignancy, and neurodegenerative diseases have been widely documented as adverse effects of IFX therapy. Few reports exist serving the notice of new-onset psychiatric symptoms linked to IFX treatment, such as suicidal behaviors in adults and elderly patients, as well as psychosis in an adolescent. Psychiatric side effects while under IFX treatment are reported to be rare.

Here, we present a case of a female with bipolar disorder who developed a long-standing depressive episode with suicidal thoughts after her fourth infusion of infliximab for her ankylosing spondylitis

Retrospective life chart was created, including infliximab infusion.

Montgomery Asberg Depression Scale was applied at time of hospitalisation and discharge.

The Naranjo Adverse Drug Reaction Probability Scale was applied.

A 55 year old female with ankylosing spondylitis and bipolar disorder was treated with IFX for 8 months. During this period, a total of 4 infusions were administered and AS symptoms were well responding to the treatment. Patient describes the onset of depressive symptoms such as anhedonia and insomnia after the infusion of third IFX infusion, gradually progressing to loss of function and suicidal thoughts and hospitalization in a psychiatry clinic.

The patient had a history of bipolar disorder for 10 years with recurrent manic and depressive episodes, 4 hospitalisations and 1 cure of ECT.

Patient was on sertraline, maprotiline and diazepam at the time of hospitalization. We started treatment with aripiprazole, quetiapine and valproate, followed for 4 weeks as an inpatient, consulted with rheumatology treatment options and neurology for demyelinating disorders, no pathology was discovered. Rheumatology suggested the continuation of IFX infusion under psychiatric control. Fifth dose of IFX infusion was administered and patient was discharged after euthymic mood was established and insomnia and suicidal thoughts were deteriorated. Upon follow up, depressive symptoms recurred and lamotrigine was added for augmentation.

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Although there is very scarce evidence that IFX causes psychiatric symptoms, there are few clinical trials too, showing evidence that TNF-alpha inhibitors may improve depressive symptoms. While we need more information and evidence to support the ideas of TNF alpha inhibitors effects on human neuropsychology, it is of great importance for especially patients with psychiatric history to be closely watched while administering the product, at least to minimize unintended adverse events.

None Declared

Impairments of attention and memory are evident in early psychosis, and often lead to severe, longstanding functional disability. Effective non-pharmacological interventions are needed due to the unsuccessful results of pharmacological interventions.

To determine whether yoga is effective for cognitive impairments, and the neural mechanism underlying these effects.

It was a randomized controlled study of 12-week of yoga and aerobic exercise (walking and cycling) intervention vs wait-list control for female early psychotic patients. Memory was measured with Hong Kong List Learning Test and Digit Span test, and attention was measured with Letter Cancellation test. Cognitive data analysis was based on the Intention-to-Treat method using a mixed-model analysis. Seed based functional connectivity was applied using posterior cingulate cortex (PCC) as seed with AFNI. Cortical thickness analyses were performed using FreeSurfer. Results from yoga and control groups were presented.

A total of 140 women were recruited and randomized into three groups. 95 completed the study, and 115 were included for cognitive data analysis. For imaging data, 42 participants were used for cortical thickness analyses; and 60 were included for neural connectivity analyses. Yoga group demonstrated significant improvements in working memory, verbal acquisition and attention (P=.01). Cortical thickness increased in the postcentral gyrus (P<.01); connectivity between PCC and bilateral inferior parietal gyrus increased after yoga intervention (P<.005).

Yoga has been found to be effective for memory and attention in early psychotic patients. The increases of thickness and neural connectivity indicate the possible neural mechanisms underlying the improvements of cognition.

Body dysmorphic disorder is characterized by a preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in important areas of functioning.

This study aimed to evaluate body dysmorphic disorder, self-esteem, and depression in cosmetic rhinoplasty patients

250 cosmetic rhinoplasty patients completed a demographic questionnaire, dysmorphic concern questionnaire (DCQ), Rosenberg self-esteem scale, and Beck depression index-II (BDI-II). Data were analyzed by appropriate tests.

Of 250 patients, 30 (12.0%) were male and 220 (88.0%) were female. Mean ± SD was 24.0 ± 4.7 for age. Frequency of body dysmorphic disorder (BDD) was 18.0% (45). BDD showed a significant correlation with lower self-esteem and higher depression (both P<0.001). From patients who had BDD, 5(11.1%) showed minimal depression, 14 (31.1%) mild depression, 25(55.6%) moderate depression and 1 (2.2%) severe depression. Also, BDD showed a significant association with the job (Higher in students and housewives, P= 0.04) and cigarette smoking (P<0.001).

Lower self-esteem showed in the patients with age <25 years old (P<0.001), students (P=0.003), Lower education (P<0.001) and lower income (P=0.03).

The prevalence of depression (BDI score >13) was 107 (42.2%). Severity of depression was significantly higher in married patients (P=0.003), lower education (P=0.001), lower income (P=0.04), cigarette smoking (P=0.008), having more children (P<0.001) and having a history of previous cosmetic surgery (P=0.001).

There should be special concerns about psychiatric aspects of people who seek cosmetic surgeries.

Modern situation n Ukraine is charachterized by rapid growth of socio-economic inequality.

To evaluate mental health, psychosocial problems and suicidality in adolescents aged 14-17 years with regards to socio-economic factors of the families.

To evaluate role of socio-economic enaquality as a factor impairing adolescents’ mental health.

Components of SEYLE protocol were adapted to local regulations and were used to measure wide range of psycho- social factors characterizing adolescents’ mental health. 250 children aged 14-17 representing different types of schools (from elite gymnasiums to municipal boarding-schools) were questioned.

It was found that main psychosocial problems of adolescents were in the domains of sleep disturbances, internet addiction, unhealthy life styles including smoking, alcohol and risky behaviours. Both negative and positive characteristics have a tendency to clastering. Suicidal thoughts are admitted by 30% of children with a slight prevalence in girls. One of the strong predictors of negative life styles and mental health problems is the answer to the question if a child have ever seen a parent being drunk. There was a marked association between mental health problems and socio-economic status of the family. Poorer economic status of the family was associated with higher level of depression, feeling of stress, loneliness, psychosomatic symptoms and suicidal thoughts in adolescents.

Socio-economic status of the families, parents life styles, internet abuse and fatigue play an important role in adolescents suicidality. Children are very susceptible to the stress in parents caused by socio-economic circumstances.

Anxiety and depression disorders are common in patients with chronic pain. Studies using clinical interviews in patients with chronic pain report prevalence rates ranging between 30–54% for depression and 17–29% for anxiety. This is the first study using contacts with a hospital psychiatric ward to investigate prevalence of depression and anxiety in patients with chronic pain.

Estimate the prevalence of anxiety and depression in patients with chronic pain referred for interdisciplinary treatment.

To increase the knowledge about mental disorders and chronic pain in secondary health care.

All chronic pain patients referred to and treated at an interdisciplinary pain clinic at Odense university hospital, Denmark from 1 Jan 2005–13 Nov 2015 were included as participants. The Danish National Patient Register was used to collect information on contacts with a hospital psychiatric ward 10-year prior to the first contact at the pain clinic due to depression (ICD-10: F32-F33) and/or anxiety (ICD-10: F40-F41).

In total, 7204 patients (64% women; mean age: 48.2) were included. Altogether, 17.8% (95% CI: 16.9–18.7) of patients had contact to a psychiatric ward. The prevalence of unipolar depression were: 6.1% (95% CI: 5.5–6.6) and anxiety: 2.1% (95% CI: 1.8–2.5), while 0.7% (95% CI: 0.5–0.9) had both depression and anxiety.

The prevalence rates of depression and anxiety noted in this study were lower than those reported in previous studies. A hospital-based diagnosis seems likely to be less frequent than interview-based measures, yet, might have a higher validity due to the clinician-based assessment.

The authors have not supplied their declaration of competing interest.

The SHS is a brief four-item measure of global subjective happiness rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree). SHS is suited for different age, occupational, linguistic, and cultural groups, is easy to implement and its short form possesses measurement accuracy.

To test the psychometric properties of SHS.

To validate an easy to use and valid measurement, for primary care and during treatment assessment in psychiatric patients with emotional disorder(PPED) and general population (GP) in Greece.

Translation was performed using the multiple forward and backward translation protocol. Life orientation test (GrLOT-R), Depression anxiety stress scale (DASS) and Satisfaction with life Scale (SWLS), was also administered to check construct validity of SWLS.

856 adults participated, 218 (25.5%) males, 638 (74.5%) females. The total scale of the SWLS had a coefficient alpha of .756. Item - total correlations where from .223-.735. Factor analysis has supported a unidimensional model with 1 factor explaining 59.4% of the total variance. Mean scores differed significantly between GP (M=18.4±4.4) and PPED (M=15.2±4.2) (Mean differences=4.622 p< .001). There was significant negative correlation with stress (r=-.443 p< .001) anxiety (r=-.350 p< .001) and depression (-.416 p< .001) and positive with GrLOT-R (r=.574 p< .001) and SWLS (r=.678 p< .001).

The results of the current validation study suggest that the Greek translation of the SHS is both reliable and valid, with good construct and discriminant validity and psychometric properties close to those reported in the international literature.

Assessment of suicide risk is of paramount importance for proper prevention.

To examine the association between gatekeeper training and suicide-related knowledge among a diverse set of health care workers (psychiatrists, nurses, psychologists, and educators) and students enrolled in medical and psychological schools who took part in the world suicide prevention day 2015 conference.

Among 223 participants who completed the assessment, 204 provided complete data for analyses. Participants were administered the applied suicide intervention skills training (ASIST), a 13-item survey questionnaire to assess participants’ knowledge about suicidal behavior and comfort dealing with suicidal clients. There were 62 psychiatrists; 23 nurses, 51 psychologists, 11 educators, and 57 university students.

Among participants, 57.1% of the sample had experiences of suicide a patient (students were excluded from these analyses). Those who reported a suicide among patients (compared with others) less frequently answered that suicide risk is more alarming in older adults than youths. They also less frequently disagreed with questions asking if they had the training to deal with suicidal patients. Students more frequently answered correctly on the association between depression and suicide risk, and less frequently chose the correct answer on the seriousness of suicide intent in borderline personality disorder. Students also more frequently disagreed with questions asking on their suicide assessment skill.

Our study highlights that differences exist when it comes to knowledge and skills related to suicide risk assessment both among health professionals and students. Our results also indicate that suicide awareness among these groups should be promoted.

The authors have not supplied their declaration of competing interest.

Attention deficit hyperactivity disorder (ADHD) is a developmental syndrome expressed along three domains: inattention, hyperactive-impulsive, and combined type. To compare subtypes of attention-deficit/hyperactivity disorder (ADHD) (predominantly inattentive and combined types) and a comparison group on an objective measure of activity level (actigraphy).

Actigraphs were worn by 21 children (19 boys, 2 girls) during 3 full-days clinical diagnostic assessment.10 subjects had a diagnosis of ADHD predominantly inattentive type, 11 had ADHD combined type. Children were diagnosed as having ADHD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Measurements: ADHD: ADHD Rating Scale DSM IV- Home Version to subdivide children into those with predominantly attention deficit, mainly hyperactivity, and those with both aspects equally. Mean actigraph scores were calculated for tree days.

There were no significant group differences in activity level between two groups; there were no differences between ADHD subtypes. There was poor correspondence between parent report and actigraphy.

These data no support specifications in the DSM-IV regarding hyperactivity in ADHD. Furthermore, the findings contradict specifications in the DSM-IV that suggest that children with ADHD combined type should be more hyperactive than children with ADHD predominantly inattentive type.

Social anxiety disorder (SAD) is a common anxiety disorder with a life-time prevalence around 7–10%. Perfectionism is a personality construct defined as the setting of high standards paired with overly critical self-evaluation in pursuit of those standards. Although perfectionism has generally been associated with several forms of psychopathology, research in social anxiety has received less attention.

To explore the relationship between perfectionism and SAD.

A cross-sectional survey of 571 university students was designed. We analysed the association between perfectionism components (concern over mistakes, personal standards, parental expectations, parental criticism, doubt about actions and organisation) and SAD with the Frost Multidimensional Perfectionism Scale (FMPS) and the Liebowitz Social Anxiety Scale (LSAS). SAD diagnostic was confirmed using the Structured Clinical Interview for DSM-IV-Axis-I.

Twelve percent of the sample had SAD, with no gender differences. For both sex, the prevalence of high-perfectionism (FMPS total) was higher in SAD than in control group (p < 0.001). Specifically, high-concern over mistakes and high-doubt about actions was associated to SAD in both gender whereas high-parental criticism was associated to SAD only in women. After controlling for age and personal psychiatric history, only high-concern over mistakes was associated with an increased risk of SAD (OR = 3.41;95%CI = 1.56–7.46) in women.

This study supports the association between SAD and perfectionism specifically with the high-concern over mistakes component in women.

While many people with mental illness endorse and internalize cultural stereotypes of mental illness at some point, they may have different degrees of habitual recurrence of such self-stigmatizing thoughts, which could exacerbate the experience of self-stigma and perpetuate its adverse effects on mental well-being and help-seeking. To date, studies have shown the adverse effects of the cognitive content of self-stigma (a.k.a. stereotype self-concurrence) on self-esteem and recovery among people with mental illness. However, no study has taken into account the effects of the habitual process of self-stigma (a.k.a. habitual self-stigma). The present study aims to investigate whether habitual self-stigma incrementally predicts self-esteem and recovery above and beyond stereotype self-concurrence.

Ninety seven people with mental illness completed measures of stereotype self-concurrence, habitual self-stigma, self-esteem, and recovery. The Self-Stigma Scale—Short Form (SSS-SF) was used to assess stereotype self-concurrence. The Self-stigmatizing Thinking's Automaticity and Repetition (STAR) scale was used to assess habitual self-stigma. The Rosenberg Self-Esteem Scale (RSES) was used to assess self-esteem. The Maryland Assessment of Recovery in People with Serious Mental Illness (MARS) was used to assess recovery.

Multivariate linear regressions showed that habitual self-stigma had an incremental value over and above stereotype self-concurrence in predicting self-esteem and recovery.

Future research on self-stigma should simultaneously consider both its cognitive content and habitual process so that the effects of self-stigma on people with mental illness can be more fully captured.

Workforce migration of mental health professionals seems to have a significant impact on mental health services, both in the donor and host countries. Nevertheless, information on migration in junior doctors within Europe is very limited. Therefore, the European Federation of Psychiatric Trainees (EFPT) has conducted the Brain Drain Survey.

To identify, in junior doctors training in psychiatry, the impact of international short-term mobility experiences, towards a future workforce migration across countries, exploring its patterns and reasons.

In this cross-sectional international study, data were collected from 2281 psychiatric trainees in 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on mobility and migration.

Only one-third of the trainees had a short-mobility experience in their lifetime, being education the main purpose for these experiences. Interestingly, the main predictors for future migratory tendency were not only the having a income and being dissatisfied with this income, but having a short-mobility experience. In fact, people that had short-mobility experiences were two times more likely to express a migratory tendency. Trainees that went abroad were predominantly satisfied with their experiences, reporting that these influenced their attitudes towards migration, positively.

These findings show that short-term mobility has a positive impact into future long-term migration, increasing its probability.

The authors have not supplied their declaration of competing interest.

Psychological hardiness is one of the powerful personality characteristics individuals posses that can help them improve their ability to cope with illness and external pressures. Some researchers considered psychological hardiness as a general criterion for mental health. That is, hardiness can depict a total outcome of mental health in individuals.

The present study aimed at comparing psychological hardiness with mental health among students in Paym-e-noor University in the city of Babol, Iran.

A causal-comparative (ex post facto) design was used to carry out this research. All students studying in Babol Payam-e-noor University in academic year 2012–2013 were involved in the statistical population of the research. 200 students were selected through simple random sampling. Tools of this research were both Hardiness and Mental Health Questionnaires used to analyze data with SPSS software.

Results showed a significant difference between psychological hardiness and mental health variables among male and female students. The mean score of illness criteria in male students was significantly higher than that of in female students. Also, the mean score of psychological hardiness variable in female students was higher than that of in male students.

Psychological hardiness is one of the powerful personality characteristics individuals posses that can help them improve their ability to cope with illness and external pressures. Some researchers considered psychological hardiness as a general criterion for mental health. That is, hardiness can depict a total outcome of mental health in individuals.

test for detection of Internet addiction K. Young, a method of determining the level of anxiety (Spielberg Hanina) questionnaire oneself (V.V. Stolina, SR Panteleyev), evaluation of communicative V.F. Ryahovskoho.

The sample was 158 people, of which the results methods Kimberly Young Internet-dependent turned 14 students.

Internet-addicted students have the following personal characteristics: a high level of anxiety expressed the need for communication, low self-esteem, low self-esteem, low self-understanding, lack of faith in our strength and ability, a high rate of self-incrimination, the expectation of the negative attitude of others, lack of confidence, low curiosity.

Recent developments in the field of polydrug use along with alcoholism provide growing insights into how cognitive, affective, motivational and neurobiological pathways are altered in addictive persons. Few of these insights have as yet been implemented in everyday care.

Framed within the multi-site FACE© program (Facilitating Adjustment of Cognitions and Emotions), this paper presents an integrative scientist-practitioner model that aims to translate the above insights into systematized multidisciplinary practice. The pathways from model to structured care are specified using a mixed-method design of bottom-up and top-down approach. Their practice implementation over a three month course is illustrated with case series data in the context of an open-access, first-line addiction centre in the suburban Paris region.

In as few as seven weeks, dramatic therapeutic improvements come forward. All polydrug patients referred due to long-term treatment refusal, are found to comply with the structured scientist-practitioner model approach. Multidisciplinary practitioner-observed benefits include increased or first-time therapy adherence and drug treatment compliance. Patient self-reported benefits moreover include increased addiction insight and mastery, along with enhanced cognitive-emotional regulation to gain control over addictive craving versus pleasure-seeking behaviours.

Applying an integrative model that focuses on the cognitive–emotional dynamics at hand in the addictive course with the polydrug using patient, and rigorously implementing related assessment and therapeutic methods manifestly bears immediate and middle-term benefits. Evaluation of longer term benefits is recommended, along with larger scale quantitative outcome analyses. Further research and practice implications are discussed to this respect.

The FP7-European funded project TRIMAGE is run by a European consortium of 7 research institutes and 4 SMEs. It started in December 2013 and has a duration of 4 years. It is coordinated by the Department of Physics 'E. Fermi” of the University of Pisa (Italy),

TRIMAGE aims to create a trimodal, cost-effective imaging tool consisting of PET/MR/EEG. It uses cutting edge technology with performance beyond the state of the art. The tool is intended for broad distribution to enable effective early diagnosis of schizophrenia and possibly other mental health disorders.

The goals of this project will be achieved by the scientific and technological developments in both the clinical and technological fields, as detailed by the following three strongly correlated S&T sub-objectives:

1. a) Find new biomarkers and define a suitable multimodal paradigm with already available PET, MR, EEG and PET/MR systems thus providing clinical evidence on the feasibility of early schizophrenia diagnosis.

2. b) Construct and test an optimized cost-effective trimodality imaging instrument (brain PET/MR/EEG) for diagnosis, monitoring and follow-up of schizophrenia disorders.

3. c) Validate the trimodal imaging device built by this Consortium with regard to the results and the clinical data obtained from sub-objective a).

This presentation will describe the outlines of the project and will present an update after the first year of running.