In the last ten years it has sought a connection between the psychoanalysis and the neuroscience. The meeting point between these two branches is the neuropsychoanalysis [1].

A literature search was conducted on March 2014. PubMed and Scopus databases were used to find studies for inclusion in the systematic review. The keywords used for the literature search were: ‘psychoanalysis”, ‘psychoanalytic psychotherapy”, ‘psychodynamic”, ‘psychodynamic psychotherapy”, ‘fmri”, ‘functional neuroimaging” and ‘functional magnetic resonance”. keywords were used together with the logical operator ‘and”. Only studies wich compared functional magnetic resonance imaging results before and after psychoanalytic psychotherapy in adult subjects were taken into account. Two (n=2) potentially relevant studies were obtained for the systematic review.

As shown in the table, Buchheim et al. study results demostrate that the therapy hours modulated the attivaction of brain areas. After treatment, Fischmann et al. found a marked reduction in activation pattern.

The common results of the studies investigated in this systematic review is represented by a reduction, a modulation or a normalization of the activation areas before and after the psychoanalytic psychotherapy.

Finding the prediction factors for the risks of post-stroke depression (PSD) is important to stroke survivors. However, most existing studies focused only on general clinical data, which limited the predictive ability. To improve the predictive ability, this study proposed a comprehensive PSD risk prediction model with social psychological factors, neurological, cognitive functional factors and general clinical factors.

The study recruited 188 stroke patients. Patients were diagnosed by DSM-IV criteria. Predictors were collected within a week after stroke. Boosted regression trees (BRT) was used to classify these predictors, and then a predictive model was constructed based on the selected predictors. The receiver operating characteristic (ROC) curve was used to determine the performance of the predictive model .

The risk prediction model was constructed with 6 factors: Body Mass Index (BMI), cerebral infraction history (CI), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Neuroticism (EPQ-N), factor 1 of the 20 items Toronto Alexithymia Scale (TAS-F1) and Snaith-Hamilton-Pleasure Scale (SHARPS). In the contribution of risk prediction factors, social psychological factors was more than 0.60. ROC curve of prediction model was 0.826 (p<0.001; 95% CI) and the accuracy of prediction was 0.81 (p<0.001). Transforming the prediction model to a tree diagram, it was convenient to clinic operation.

A PSD risk prediction model with good prediction performance was constructed to achieve diagnose concisely and clearly. The social psychological factors play an important role for diagnosing PSD in the early period.

The current study aims to overcome past methodological limitations and capture adolescents in need of psychiatric care with psychopathological symptoms in a cohort with unrestricted access to mental health professionals.

The study source population consisted of a random sample of adolescents aged 16-17 years (N=1,369) assessed by the Israeli Draft Board. An adapted version of the Brief Symptom Inventory was used to identify clinically relevant psychopathological symptoms with scores categorized as severe if they were in the top 10th percentile of symptoms, otherwise not severe. An independent interview with a subsequent referral to a mental health professional was used to categorize adolescents in need of psychiatric care. To examine the association between severe psychopathological symptoms and the need for psychiatric care, logistic regression models were fitted unadjusted and adjusted for age, sex, and intellectual assessment scores. Adjusted classification measures were estimated to examine the utility of severe psychopathological symptoms for clinical prediction of need for psychiatric care.

Information on 1,283 adolescents was available in the final analytic sample. Logistic regression modeling showed a statistically significant (p<0.001) association between self-reported severe psychopathological symptoms and the need for psychiatric care (OR adjusted: 4.38; 95% CI: 3.55–5.40). Severe psychopathological symptoms had a classification accuracy of 83% (CI: 81%–85%).

Severe psychopathological symptoms, although accounting for a fair proportion of treatment seeking, would perhaps be better useful for classification purposes alongside other variables rather than in isolation.

Risk-taking (RT) and self-harm (SH) occur across the lifespan, but many types of RT and SH typically appear for the first time in adolescence. According to Vrouva, Fonagy, and Fearon (2010), it is important to measure RT and SH simultaneously because they are clinically, empirically, and conceptually linked.

1. (1) analyse the prevalence of risk-taking and self-harm behaviours in community adolescents, controlling the effect of genderand age;

2. (2) examine the link between RT and SH behaviours;

3. (3) investigate the relationship between attachment style and RT and SH behaviours.

346 adolescents (girls: n = 194, 56%) aged between 12 and 18 years (M = 15.10, SD = 1.77) completed a sociodemographic questionnaire, the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA) and the Attachment Questionnaire for Children (AQ-C).

RT behaviours more prevalent are taking chances while doing one’s hobbies, smoking tobacco and cheating. SH behaviours more frequent are self-demeaning thoughts and behaviours intentionally. Boys showed higher RT behaviours than girls. There is a positive association between age and both behaviours (RT and SH). Insecurely attached teenagers reported higher SH behaviours than did securely attached adolescents.

This study shows the prevalence of RT and SH behaviours in a community sample of adolescents, showing how gender and age can influence the expression of both behaviors. It seems that secure attachment may be protective to the engagement in SH behaviors, strengthening the important role of quality of relationships on psychological adjustment in adolescents

The discovery of mirror neurons, considered to be responsible for empathy, intrigued researchers all over the world. Many studies have been developed associating mirror neurons to the incidence of Autism Spectrum Disorder (ASD).

Identifying a possible influence of mirror neuron in autism.

Reviewing the recent trajectory of neuroscience in relation to the connection of impaired mirror neurons in autism.

Bibliographical review of studies in English, published in SciELO and LILACS databases, between 2008 and 2013. The keywords used were: autism, brain, cortex and mirror neuron.

Different subjects explored the influence of mirror neurons in autism as shown below (Fig. 1). Among 17 studies, 12 were bibliographical reviews and 5 involved experiments. Seventy-six percent of the studies were favorable to the influence of these neurons, while 24% were not.

There was a balance in the distribution of themes explored in the articles and few studies exploring the role of mirror neurons in autism. Even though the current research may not be conclusive, it can be said that currently neuroscientists tend to agree that mirror neurons significantly influence ASD. Recent studies suggest that, if properly stimulated, ASD individuals can develop their social skill and, consequently, be socially inserted. According to most author studied, technological development is needed in order to enable scientific advances involving mirror-neurons and ASD.

The authors have not supplied their declaration of competing interest.

To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.

A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.

A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.

Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

Valproic acid (VPA) is a valuable treatment for bipolar disorder, schizoaffective disorder, and agitation1. However, potential side-effects include sedation, headaches, tremors, ataxia, gastrointestinal issues, neural tube defect, 3 and mild hyperammonemia even in normal liver function test 1 and VPA level.

To illustrate clinical presentation of VIHE and provide literature review on post-VIHE treatment options.

A 59-year-old male with PMH of Diabetes Mellitus, Hypertension, Hyperlipidemia, LVH, COPD, s/p CVA, and PPH of schizoaffective disorder, bipolar type. Patient stable on VPA 1250mg daily and Olanzapine 5mg daily for >2years until recent manic decompensation resulting to up-titration of VPA to 1500mg H.S. Thereafter, he presented with altered mental status, with VPA level (111.4 ug/ml), hyponatremia (119 mmol/L) and hyperammonemia (84 umol/L). Subsequently, admitted as a case of VIHE and hyponatremia.

VPA has shown to cause hyperammonemia alone or when combined with antipsychotics6. VIHE reported in up to 47.7% of patients on VPA1, but symptomatic in approximately 10% of patients on VPA with blood ammonia level about 2-fold the normal range8. VIHE presents with confusion, ataxia, blurred vision, delirium, and seizures3. Treatment options include VPA discontinuation, switch to other mood stabilizers (lithium carbonate, lamotrigine), utilization of medications to lower blood ammonia levels (Lactulose, Rifaximin/Neomycin) ,3 antipsychotic monotherapy, and supplements (Levocarnitine or Carglumic acid) in the prevention, maintenance, and treatment of VIHE. These supplements can be added to VPA if the benefits of re-initiating or continuing VPA outweighs the risk3.

Further research is needed.

No significant relationships.

No significant relationships.

According to studies done in recent years regarding the treatment of patients with recurrent depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. According to the literature, complete remission occurs in only 40–50% of patients, in other cases there is residual symptoms.

Evaluating the effectiveness of art therapy in treatment in patients with recurrent depressive disorder on the quality of remission.

The study involved 135 patients: 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy. We used clinical, psychopathological, psychodiagnostic and statistical methods.

The results of the effectiveness of art therapy in complex treatment in patients with recurrent depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment, as well as in reducing of the severity of anhedonia and improving the quality of life in remission period.

These results support the use of art therapy in treatment in patients with recurrent depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.

The authors have not supplied their declaration of competing interest.

Sexual dysfunction is a common condition in patients taking antipsychotic medication, with a reported prevalence of 45-80% in males, and 30-80% in females (1). Ziprasidone induced spontaneous orgasm (2) and priapism (3) were reported in the literature. Here, we report a case of increased sexual arousal after ziprasidone treatment.

A twenty-three-year old, single, female patient was admitted to our clinic with reference and persecutory delusions, auditory and visual hallucinations. Her complaints had been persisting for about one month. Her mental status examination revealed the following: attention and concentration were diminished, speech was slow, delusions of reference and other Schneiderian first-rank symptoms, and hallucinations were present, reality testing was impaired, judgment and abstract thinking skills partially preserved. The patient was not able to tolerate her treatment due to side effects. Therefore, it was changed to ziprasidone 40 mg/day and the dosage was increased gradually. After increasing the ziprasidone dose to 60 mg/day, she complained about increased sexual arousal. No other symptoms suggestive of a manic episode were present, and no other medical causes were detected. The patient also said that she never had a similar period in her life previously. Ziprasidone was tapered slowly, and quetiapine 300 mg/day was started. She indicated that increased sexual arousal disappeared after the cessation of ziprasidone.

Ziprasidone has been reported to cause sexual dysfunction at a much lower rate than other antipsychotics. To the best of our knowledge, this is the first case report of increased sexual arousal with ziprasidone.

Quality of life reflects comprehensive personal satisfaction with life. It represents subjective experience of individuals, which undoubtedly depends on objective circumstances of life. There are several studies dealing with quality of life within student population. Such studies provide important information considering the fact that students reprsnt the healthy part of the population.

The goal of this study was to register and compare parameters of subjective perception of QOL in medical students and students of humanities.

Study involved 200 students of Sarajevo University, 100 medical and 100 students of humanities. MANSA questionnaire was used to assess QOL.

Statistically significant differences between the groups was found in repeated years of study, quality of teaching and professor-student relationship, sex life, finances and psychological wellbeing. No significant difference was found in satisfaction with life in general, number and quality of friendships, leisure time, accommodation, family relationships, health, and tobacco and PAS use. There was no difference in general assessment of QOL between the groups. Also both groups of students were satisfied with their current QOL.

Although no significant differences were found between groups, results reflect less satisfaction with quality of teaching and repeated study years in medical students. Clearly, study of medicine is a long and difficult process, and it should be a common goal for all involved in educating future physicians to contribute, in order to create professional and competent doctors, able to take care of quality of their own lives and the lives of their patients

Emotional neglect means that the child’s emotional and developmental needs are not fulfilled by the parents or other caregivers. Adverse childhood events (ACEs) are a risk factor for mental health problems and impaired parenting skills. The objective here was to examine whether parents’ ACEs increase the child’s risk of experiencing emotional neglect.

The participants in the present study were members of the Northern Finland Birth Cohort 1986 (NFBC1986). Emotional neglect experiences were measured in 190 members of this cohort by means of the Trauma and Distress Scale (TADS), and ACEs in both parents were measured with a specific questionnaire. A linear regression model was used to examine the association between parents’ ACEs and the children’s emotional neglect scores.

The children’s mean emotional neglect score was 8.11 on a scale from 5 to 25. There was no significant difference between males (mean 8.01) and females (mean 8.19). Only father’s ACEs were associated with child’s emotional neglect score. In the linear regression model, the children’s emotional neglect scores increased by 0.3 points for father’s ACE.

Our findings suggest that father’s ACEs may increase the child’s risk of experiencing emotional neglect. It seems that childhood adversities are transferred from parents to children, but larger samples would be needed to confirm these findings.

The 40 item Social Communication Questionnaire (SCQ) screens for autism spectrum disorder (ASD) and is quicker to administer than the (two hour) Autism Diagnostic Interview-Revised (ADI-R). A recent study, however, found that two questions on the SCQ were answered “autism positive” in 40% of a normal population children's sample. A modified SCQ (MSCQ) without these questions may be more specific than the SCQ.

To compare the performance of the MSCQ with that of the ADI-R.

42 children were recruited to the study, 22 from Mater CAMHS and 20 from St Paul's Hospital and Special School. 20 were diagnosed with autism, 10 with ASD, and 12 with other clinical diagnoses. The MSCQ was sent out as a postal questionnaire to be completed before attending for ADI-R interview. To assess the diagnostic validity of the MSCQ correlations between the MSCQ and ADI-R were calculated. Receiver operating characteristic (ROC) curves were then applied to assess its discriminate ability.

A strong correlation of 0.84 was found between ADI-RTotal and MSCQTotal scores. Using ROC Curves, a cut-off of 14.5 on the MSCQ had a sensitivity of 0.90 and a specificity of 0.82 for identifying ASD from other clinical disorders. A cut-off of 21.5 on the MSCQ had a sensitivity of 0.75 and a specificity of 0.77 for identifying autism from other diagnoses.

These preliminary findings suggest that the MSCQ is a clinically useful and accurate method of assessing for ASD.

The association between previous trauma and the development of alcohol and substance misuse is well established, however, much of the research is focused on the association of PTSD with alcohol and substance misuse. This research will be focussing on trauma in general and its influence on the development of alcohol and substance misuse in women.

The main objective of this study was to investigate the relationship between previous traumatic events and the development of alcohol and substance misuse in women.

This was a retrospective case note study of 146 female patients from a UK based detoxification and rehabilitation centre. Trauma history from patient files were audited, with the trauma experienced being assigned a category.

Out of 146 women with alcohol and/or substance misuse, 132 (90%) had experienced a previous trauma. The types of trauma experienced include; domestic (53%), traumatic grief (36%), sexual abuse (35%), physical (15%), bullying (4%) and neglect (4%). These results show that women who suffer from alcohol/substance misuse are highly likely to have suffered a previous trauma.

The results from this study suggest that women who have suffered previous trauma are high risk for alcohol and substance misuse problems, therefore early intervention and a robust psychological support system should be provided to women who have a history of trauma. Furthermore in addition to addiction treatment and behaviour focused therapy already in place trauma focussed therapy may prove beneficial.

The authors have not supplied their declaration of competing interest.

Attention deficit hyperactivity disorder (ADHD) is one of the sensory modulation disorders among others like autism, Asperger syndrome and Fragile X syndrome. Little is known about patients with ADHD and their sensory processing issues in Sri Lanka.

To investigate differences in sensory processing among children between (3–10) yrs with attention deficit hyperactivity disorder and those who are typically developing in Sri Lanka.

A descriptive cross sectional study of 75 children aged (3–10) yrs attending child guidance clinic at Lady Ridgeway Hospital (LRH) were compared with 75 age matched peers who were typically developing, using the Short Sensory Profile (SSP).

Out of the sample population of 150, there was a significant difference in sensory processing total score (P-0.001) (df-29) of children with ADHD when compared to the typically developing group. The greatest differences were reported on the tactile (P-0.013), taste (P-0.000), under responsiveness (P-0.002), auditory filtering (P-0.002) & low energy (P-0.017). Out of the raw items commonest sensory processing problems were difficulty standing in line, distractability if there is a lot of noise around, being unable to work with background noise & difficulty paying attention due to auditory deficits.

Majority of children in this sample were reported to have difficulties with processing and responding to sensory input on the SSP. Further studies are needed to assess sensory issues in children with ADHD, to carry out effective interventions.

The authors have not supplied their declaration of competing interest.

Although 85% of inpatients with Borderline Personality Disorder (BPD) receive psychotropic drug treatment, no drug is approved for this indication so far. A dysregulation of the endogenous opioid system (EOS) has been posed to underly the neurobiology of BPD. Accordingly, the opioid antagonist naltrexone might be helpful to treat symptoms of BPD. Two small studies showed limited differences of naltrexone vs. placebo on dissociation, which were not significant, perhaps due to the low power of the studies:

Naltrexone was administered in treatment-refractory patients with BPD in a university department of psychiatry. This study aimed to assess the relative contribution of naltrexone and other psychopharmacological drugs to the improvement of overall symptomatology in patients with BPD.

A retrospective analysis of the charts of inpatients (n=161) with BPD was performed. Patients were classified as either treatment responders or non-responders. As all patients received multiple psychopharmacological treatments, stepwise logistic regression analysis was performed to detect, which drug contributed most to improvement of symptomatology.

None of the drugs applied contributed significantly to improvement, with the exception of naltrexone (odds ratio, p=2,9) Patients treated with naltrexone (n=55, 34,16%) recovered significantly more often and faster and, in particular, showed highly significant reduction of self-harm and suicidal thoughts. Higher doses of naltrexone treatment were more effective than low-dose treatment; however, the latter was still better than any other treatment.

Large-scale double-blind studies are warranted to examine the efficacy of opioid antagonists (naltrexone, nalmefene) in BPD.

The study focused on the level of expressed emotion of family members of schizophrenia patients prior to and during their long-term hospitalization and how that affected the course of treatment.

The retrospective study included 112 patients diagnosed with schizophrenia and their family members. The patients had been court-ordered to undergo psychiatric treatment for a crime they committed. The following scales were used to assess the level of expressed emotion: Five minute Speech Sample (FMSS), Level of Expressed Emotional Scale (LEE), Family Attitude Scale (FAS) and Perceived Criticism (PC). Socio-demographic parameters were also used in the research.

The results show that expressed emotion of family members was high before and during long-term hospitalization of 71.4% of patients who experienced clinical worsening. This is particularly true for parents (62.5%), and more frequently for mothers. Course of the illness was better in the group of patients whose family members had low expressed emotion.

Successful treatment and favourable outcome of schizophrenia depend on the quality of relationship between the patient and his family members. High level of expressed emotion is one of the risk factors for relapse in schizophrenia.

Atypical antipsychotics (AAPs) are known to increase the risk of metabolic syndrome (MetS), a predictor for cardiovascular disease and diabetes. This risk differs according to the AAPs.

The objective of this analysis was to examine the incidence of MetS in schizophrenia patients treated with asenapine or olanzapine.

The aim was to estimate the incidence of MetS among schizophrenia patients (DSM-IV criteria) after 52 weeks of exposure to asenapine or olanzapine.

Pooled data from patients completing 52-week extension of randomized trials (041512, 041513, 25544 and A7501014) were included. Patients were treated with asenapine or olanzapine.

The National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP III) definition of MetS was used, defined as 3 or more of the 5 following risk determinants: waist circumference > 102 cm for male and > 88 cm for female, triglycerides = 150 mg/dL, HDL cholesterol < 40 mg/dL for male and < 50 mg/dL for female, sitting blood pressure ≥ 130/85 mm Hg, or fasting glucose ≥ 110 mg/dL.

Incidence (i.e. new metabolic cases in patients without MetS at baseline) was calculated at week 52.

741 patients were included in this analysis of 52-week studies (asenapine 397, olanzapine 344). After 52 weeks of treatment exposure, the incidence of MetS was significantly higher in olanzapine-treated patients than in asenapine-treated patients (19.44% versus 11.46%, p = 0.01).

These post-hoc analyses confirmed a higher risk of developing a MetS with olanzapine. The incidence of MetS after 52 weeks of treatment with asenapine was found to be significantly lower.