To characterise patients with schizophrenia from four European countries treated with ziprasidone, and to compare these with patients treated with other second generation antipsychotics (SGAs) included in this survey.

A randomly selected, representative sample of psychiatrists (N = 744), from Germany, Greece, Italy and Spain, collected data on the five last patients with schizophrenia they had seen in consultation (N = 3996), including up to two patients treated with ziprasidone (N = 1096).

Ziprasidone was most frequently prescribed to patients requiring a switch from another antipsychotic. Compared to other surveyed SGAs, ziprasisone was more likely to be prescribed to women than to men (OR: 1.52), to patients with mild disease than to those with severe disease (OR: 1.94) and to outpatients than to inpatients (1.30). The most frequently cited reasons for prescribing ziprasidone were good tolerability and efficacy against positive and negative symptoms. Compared to other SGAs included in this survey, it was more likely to be prescribed due to the low risk of weight gain, metabolic syndrome and extrapyramidal symptoms.

Patients treated by ziprasidone more frequently belong to subgroups composed of more autonomous patients and those with mild to moderate disease severity.

Recent studies have underlined the importance of considering the form of thoughts, beyond their content, in order to achieve a better phenomenological comprehension of mental states in mood disorders. The subjective experience of thought overactivation is an important feature of mood disorders that could help in identifying, among patients with a depressive episode, those who belong to the bipolar spectrum.

Patients with a diagnosis of bipolar disorder (BD) were compared with matched healthy controls (HC) on a scale that evaluates thought overactivation.

Validate the Italian version of a scale for thought overactivation (i.e. STOQ) in a sample of bipolar patients.

Thirty euthymic BD and 30 HC completed the Subjective Thought Overactivation Questionnaire (STOQ), the Ruminative Responses Scale (RRS), the Beck Depression Inventory-II (BDI-II) and global functioning (VGF).

The 9-items version of the STOQ has been back translated and its internal consistency in this sample was satisfactory (alpha = .91). Both the brooding subscore of RRS (b-RRS) (r = .706; P < .001) and STOQ (r = .664; P < .001) correlate significantly with depressive symptoms whereas only the first correlate with VGF (r = –.801; P < .001). The two groups did not differed in the b-RRS (HC = 8.41 vs BD = 9.72; P = .21), whereas BD where significantly higher in the STOQ total score (HC = 6.62 vs. BD = 14.9; P = .007).

Our results, although limited by the small sample size, confirm the validity of the STOQ and suggest that this scale could grasp a feature characteristic of BD, independently from their tendency to ruminate. The latter seems to impact more on global functioning.

The authors have not supplied their declaration of competing interest.

Sleep disturbance is one of the most common health complaints among late adolescents and young adults. Women report more sleep-related complaints than men (Krishnan and Collop, 2006) and more anxiety or depressive symptoms (Voderholzer et al., 2003). Higher levels of repetitive negative thinking appear to be causally involved in the initiation/maintenance of emotional problems (Ehring and Watkins, 2008).

To analyze the sleep difficulties differences by gender and its associations with stress, cognitive emotion regulation, perseverative thinking and negative affect.

Five hundred and forty-nine students (80.1% females) from two Universities filled in the PSS-10 (Cohen et al., 1983; Amaral et al., 2014), CERQ (Garnefski et al., 2001; Castro et al., 2013), PTQ (Ehring et al., 2011; Chaves et al., 2013) and POMS-58 (McNair et al., 1971; Azevedo et al., 1991; Amaral et al., 2013). Three questions were used to access difficulties of initiating sleep (DIS), maintaining sleep (DMS) and early morning wakening (EMA).

Females reported more sleep difficulties (excluding DIS), stress, perseverative thinking than males. Males reported higher levels in self-blame and blaming-others dimensions. In female sample we found significant correlations between all sleep difficulties and stress, perseverative thinking, emotional regulation (rumination, self-blame, catastrophizing) and negative affect. In male sample only the difficulties of initiating sleep are correlated with stress, perseverative thinking, self-blame and negative affect.

There are no gender differences in frequency and most of correlates of DIS. DMS and EMA were higher in females and were related to perseverative thinking and emotional regulation mechanisms in this sample.

The authors have not supplied their declaration of competing interest.

Lamotrigine is widely used to prevent bipolar depression. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare, potentially life-threatening adverse effect. The long latency between drug exposure and disease onset, added to the high variability of its clinical presentation, can increase the risk of misdiagnosis lamotrigine withdrawal delay.

To highlight potential risk factors that can be related to a worse clinical onset and evolution of lamotrigine-induced DRESS syndrome.

We report the case of a 25-year-old-man, with a type I bipolar disorder, treated with lithium and lamotrigine 50 mg per day during the first 13 days of treatment, progressively increase up to 200 mg. Thirty-five days after the treatment initiation, a pruritic rash appeared in his upper arms, and scabies infestation was diagnosed. After 72 hours, the patient required urgent hospitalization due to hemodynamic instability.

On admission, facial edema and erythrodermia were involving 70 to 80% of the body surface. DRESS diagnosis due to lamotrigine was made following RegiSCAR criteria (Table 1). Psychiatric medication was stopped and DRESS treatment established. Complete recovery without recurrence was achieved after 2 months.

The lamotrigine up titration faster than recommended may have facilitated the DRESS syndrome reaction. Moreover, the latency between lamotrigine introduction and the rash onset could have increased the possibilities of misdiagnosis. In light of this, physicians need to consider at least the last 3 months treatment history when assessing a rash, as the delay of DRESS syndrome diagnosis can fastly lead to a fatal event.

Table not available.

The authors have not supplied their declaration of competing interest.

It has been estimated that around 10-20% of all pregnant women suffer from antenatal depressive or anxiety symptoms. These symptoms have been associated with multiple adverse child outcomes including obstetric problems, e.g. preterm delivery, Apgar score and low birth weight. Therefore, considerable health gains may be achieved if depression and anxiety during the perinatal period are adequately treated. Nevertheless, to date, no previous trials have published on the effects of Cognitive Behavioral Therapy (CBT) during pregnancy on child outcomes.

The ´Pregnancy Outcomes After a Maternity Intervention for Stressful Emotions´ (PROMISES) trial is a randomized controlled trial, which compares the effects of CBT vs. care as usual (CAU) during pregnancy among a group of women with (sub)clinically depressive and/or anxiety symptoms (n=226) on both maternal and child outcomes. Child outcomes comprise a range of obstetric outcomes including birth weight, Apgar score, and gestational age. Independent samples t-tests were performed to investigate differences in mean values.

No significant differences were found between the CBT- and the CAU-groups, in gestational age (39+0 vs 39+2 weeks+days, p=.99), birth weight (3447 vs 3509 grams, p=.24), or Apgar score at 1 (8.6 vs 8.6, p=.99), 5 (9.5 vs 9.6, p=.31), and 10 minutes (9.7 vs 9.8, p=.26).

Although CBT as early treatment of antenatal depression and anxiety is most likely to be effective for prevention of postpartum depression, CBT seems to have no effect on major obstetric outcomes.

Endocannabinoid system has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians. The association between endocannabinoids and its congeners and mood disorders is relatively recent. However, evidence from both clinical and preclinical studies is increasing and many researchers point out endocannabinoid system and particularly endocannabinoids and congeners as promising pharmacological targets.

The main objective of this study is to compare the plasma concentrations of endocannabinoids and congeners between a sample of patients with depression and a sample of control subjects, and the influence of variables such as age, body mass index, gender, severity of symptoms, and antidepressant medication.

Plasma concentrations of endocannabinoids and congeners will be analyzed in 69 patients with depression from primary care and 47 controls using mass spectrometry analysis.

Statistically significant differences in 2-arachidonoylglycerol and monoacylglycerols were found between both samples. Somatic symptoms of depression seems to be more related to these compounds that to cognitive-affective symptoms. In addition, differences between mildly and moderately depressed patients were found in concentrations of AEA, LEA, DGLEA and POEA. Patients with antidepressant medication showed higher levels of 2-AG, DGLEA and OEA.

The results of this study provide evidence supporting the hypothesis that in depression there is a dysregulation of the inflammatory signaling and, consequently the immune system. The results of this study could also support the realization of translational research to better understand the mechanisms of this widely distributed system.

The authors have not supplied their declaration of competing interest.

Novel psychoactive substances (NPS) use is progressively increasing year on year. A new group of phenethylamines sold as legal stimulants and hallucinogens is being reported increasingly since 2012. Within this group, 25I-NBOMe is an outstanding substance with powerful effects and high affinity with the serotonin 2a (5HT2a) receptor. Several toxicity cases have been reported so far.

To describe the presence of 25I-NBOMe and its characteristics in samples delivered to Energy Control from 2009 to 2015 in Spain.

Among the samples, 21,198 analyzed from august 2009 to august 2015 and only those samples containing 25I-NBOMe were studied (n = 56). Samples were analyzed by Energy Control, a Spanish harm-reduction NGO that offers users the possibility of analyzing the substances they intend to consume. Analysis was done by Gas Chromatography–Mass Spectrometry.

From 56 samples were 25I-NBOMe was found, 24 were bought as LSD (42.8%), 12 as 25I-NBOMe (21.4%), 4 as 25C-NBOMe (7.1%), 4 as 25I-NBOH (7.1%) and 12 as other substances (21.4%), gummy bears included. All samples were received from 2012 on, having the highest peak on 2013 (19 samples).

25I-NBOMe consumption represents an emerging issue with potential harmful effects, especially when the substance used is not the expected. Further pharmacokinetic, pharmacodynamic, clinical and epidemiological researches should be conducted to deepen knowledge about 25I-NBOMe and the management of its possible toxic effects. Physicians should be aware of NPS, their increasing use and the clinical differences between them.

The authors have not supplied their declaration of competing interest.

To conduct a three-arm partial randomised controlled trail to evaluate the effectiveness of expedited regular supportive psychotherapy and assertive case management for patients presenting with suicidal ideation or self-harm to the emergency department (ED).

we expect expedited regular supportive psychotherapy plus assertive case management will reduce the suicidality and/or suicidal behaviour in patients by at least 20% at 4 weeks compared to patients receiving only assertive case management or routine care and these differences will be sustained at 6 months.

This will be a longitudinal, prospective, three-arm controlled single-rater-blinded partial randomized clinical trial with a recruitment period of 12 months and an observation period of 6 months for each participant. Patients in the intervention group will receive regular face-to-face or over the phone brief supportive psychotherapy during weekdays following presentation to the ED with suicidal ideation or self-harm until patients are actively enrolled in regular community mental health services with active case management by the therapist. Patients in the control and the assertive outreach arms will each receive the usual follow-up services offered routinely to regular patients and assertive outreach patients respectively who present to the ED with suicidal ideation or self-harm.

Recruitment will commence in February 2016 and we expect the results of the study to be available by September 2017.

If our hypothesis is proved correct, our intervention will be a new model for caring for patients with self-harm and suicidal ideation and is expected to reduce suicide rates.

The authors have not supplied their declaration of competing interest.

Considering the effects of the level of social support and self-esteem as risk factors in the onset and continuation of depression, the purpose of the current study (in addition to studying the demographic items of depression) was to investigate the correlation between depression and level of social support and self-esteem in Iranian university students studying non medical majors.

The study was a cross-sectional descriptive-analytic research carried out on the students of Ferdowsi University of Mashhad in 2006. Self administered questionnaires on socio-demographic information (age, gender, marital status, and educational level), Eysenk self-esteem scale, Beck Depression Inventory and Cassidy social support scale were randomly given out to students who were selected by multi stage randomized sampling. The data were analyzed using SPSS version 14 using the χ2-test.

1200 students responded to the anonymous questionnaires. A total of 57.2% of the participants had depression (36.3% mild, 14.4% moderate and 6.5% severe). Depression was significantly higher in males, singles and in 25-29-year-old students. Results showed that 9.4%, 18.3% and 72.3% of the participants reported low, moderate and high levels of social support respectively. 1.8% and 6.3% of the participants reported low and moderate levels of self-esteem respectively; while 91.9% reported high levels of self-esteem.

Depression has a higher rate in non-medical university students of Iran than general population. Levels of social support and self-esteem were negatively associated with frequency of depression.

Eight themes summarised factors perceived to be related to becoming homeless: Relationship breakdown, Behavioural rebelliousness, Childhood abuse, Foster care/Frequent childhood relocation, Substance use, Eviction, Job loss, Jail; 5 themes categorised factors that participants thought contributed to continued homeless: Adverse life events, Substance use, Avoidant coping, Criminal offense, Ill-health. Chi square analysis indicated that females and young adults reported that relationship breakdown was a triggering factor for becoming homelessness. Young homeless were likely to see adverse life events as a risk factor for continued homelessness whilst mature adults more often reported alcohol/drug abuse as a triggering factor.

This study found that different subgroups experienced that different risk factors had led to their becoming and staying homeless. There may be a role for psychologically informed services to explore self-reported traumatic/trauma-like experiences to increase the ability to successfully intervene in the vicious cycle of events that prolong homelessness for many.