The authors have not supplied their declaration of competing interest.

We randomized 40 patients into two groups: usual care (UC) or a nine-session, manualized, antipsychotic adherence intervention (AAI). the AAI attempted to improve adherence by combining three psychosocial techniques:

1. a. education,

2. b. skills training, and

3. c. alliance building.

Sessions employed a semi-structured format to facilitate open communication. the primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention.

Compared to the UC group, a greater proportion of the AAI group was adherent post-intervention based on medication possession ratio, a commonly used measure of medication adherence (85% vs. 66.6%; OR=2.64), a difference that was statistically not significant. the entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention.

The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data shows that patients prefer brief adherence interventions and accept telephone strategies.

Apathy, defined as a lack of motivation, is common in neurodegenerative diseases. Specific scales are available for the evaluation of apathy but it lacks objective evaluation methods.

To evaluate the changes in reaction time task according to the presence or absence of reward stimulation and to assess the relation between these performances and apathy scales.

13 patients with Mild Cognitive Impairment, 15 patients with Alzheimer's disease and 91 elderly healthy subjects were enrolled. A computerized test using the experiment software E-prime® was designed to assess reaction times in different experimental conditions after a training trial (neutral, stimulation, stress, stimulation after stress, extinction) and relation between the performances to the test and the Apathy Inventory (AI) scores were observed.

Patients reaction times were significantly higher than control. Reactions times were lower in stimulation conditions and maximum during the stress condition. In the patients population, apathetic subjects (AI total score >2) had significantly higher reaction times than non apathetic subjects (p<0,05). We found significant positive correlation between AI dimensions lack of initiative and lack of interest, and reaction times in the following conditions: lack of interest and neutral condition (p<0,01), stimulation condition (p<0,05), lack of initiative and stress condition (p<0,05). Furthermore, AI total score was correlated with both stimulation and extinction conditions (p<0,05). There was no significant correlation with the emotional blunting.

the reaction time task may be a promising tool for an objective evaluation of the initiative and interest dimensions of apathy in neurodegenerative diseases.

Police and ambulance personnel are widely believed to have a high prevalence of excessive alcohol consumption. However, the empirical basis for this assumption is scant or non-existent. We assessed the association of alcohol use with burnout and job stress, with ‘drinking to cope’ and neuroticism as two possibly moderating factors in two occupations, the police- and ambulance services.

A comprehensive nationwide questionnaire survey of police (n = 2665) and ambulance personnel (n = 1180) in operational duty. The questionnaire encompassed the Alcohol Use Disorders Identification Test (AUDIT), the Maslach Burnout Inventory, the Job Stress Survey, and the Basic Character Inventory (BCI). A series of multiple linear regression analyses were conducted to examine relationships among the variables.

With a modified AUDIT score of 6 or more, the prevalence for men was 17.7% (police) vs. 16.6% (ambulance personnel). The prevalence for women was 9.1% vs. 7.4%, respectively. Personnel who were male, younger, and with higher levels of neuroticism reported higher levels of alcohol problems. ‘Drinking to cope’ was most strongly associated with higher levels of alcohol problems (standardized beta = 0.29, p < 0.001), and was found to moderate the effect of depersonalization and gender.

The prevalence of hazardous drinking was moderate in both groups. However, among those personnel who drank to reduce stress, males and those experiencing higher levels of depersonalization may be at increased risk of developing alcohol-related problems.

To evaluate safety, tolerability and overall effectiveness of a titrated- versus fixed-dose switching strategy from risperidone to aripiprazole in a general practice setting.

This 12-week, multicentre, open-label study included patients with schizophrenia (DSM-IV-TR) experiencing insufficient efficacy and/or safety/tolerability issues while receiving risperidone for ≥6 weeks. Patients were randomized to titrated- or fixed-dose switching regimens.

Discontinuations due to AEs were similar between titrated- and fixed-dose strategies (3.5% vs. 5.0%; p=0.448). Titrated- and fixed-dose groups showed improvements (Week 12) in mean PANSS Total scores (–14.8 vs. –17.2; LOCF), mean CGI-I scores (2.9 vs. 2.8; p=0.425; LOCF), ASEX scores (–1.5 vs. –1.9 from baseline; OC), serum prolactin levels (−48.7 vs. −48.5 from baseline; OC) and SWN scores (+8.6 vs. +10.3 from baseline; p=0.223; OC). POM scores indicated a preference for aripiprazole compared with risperidone using either regimen. Both strategies showed improvements (titrated-dose vs. fixed-dose; Week 12; LOCF) in social cognition as indicated by decreased GEOPTE patient (–5.3 vs. –6.1), caregiver (–5.4 vs. –9.9) and index scores (–5.1 vs. –9.8).

Switching to aripiprazole from risperidone can be effectively and safely achieved in a general practice setting through a slow down-titration of risperidone and either a titrated- or fixed-dose switching strategy for aripiprazole.

Individuals with co-occurring disorders have higher levels of psychological distress and poorer psychosocial functioning, as compared with individuals with substance dependence only. Studies identified substance abuse as a risk factor, which increases the likelihood that an individual with mental disorders may become violent.

To examine the gender differences in drug-related problems and predictors of recidivism among a sample of 1,444 offenders with co-morbid drug abuse and mental disorders participating in California's Proposition 36.

Characteristics and problem severity in multiple key life areas were assessed at intake using Addiction Severity Index, and drug treatment participation, mental health diagnoses and arrests were based on official records.

Women demonstrated greater problem severity than men in family relationships, health, psychological health, and sexual and physical abuse history. Men on the other hand had greater criminal history, high rates of attention disorder, and psychotic disorder. Logistic regression analyses showing that for the combined sample, male, young age, cocaine use (relative to methamphetamine), drug abuse severity, methadone treatment, arrest history and fewer prior treatment history were associated with higher recidivism at 12-month follow-up; lower education, cocaine use, and arrest history were related to women's recidivism, while young age, outpatient treatment, and arrest history were predictors of men's recidivism.

Although the specific type of mental disorder did not seem to be predictive of recidivism, the high rates of mental health disorder and arrest of this population is problematic. Intervention strategies taking into consideration gender-specific problems and needs can improve outcomes for both.

Worry is a repetitive cognitive process in which a person anticipates and elaborates on possible undesirable future events and their consequences. On the other hand, mindfulness is nonelaborative, nonjudgmental, present-centered awareness in which experiences that arise in the attentional field are acknowledged and accepted. In previous research, worry and mindfulness have been proposed, respectively, as risk and protective factors for psychopathology, including depression and anxiety. However, so far, the roles of worry and mindfulness were studied separately.

To estimate both specific and common contribution of worry and mindfulness to severity of anxiety and depressive symptoms in a sample of adults from the general population.

One-hundred fifty-six adults recruited from the community took part in the study. They completed self-report questionnaires measuring anxiety symptoms (State-Trait Anxiety Inventory), depressive symptoms (Beck Depression Inventory), worry (Penn State Worry Questionnaire) and mindfulness (Cognitive and Affective Mindfulness Scale Revised). A series of hierarchical stepwise regression analyses were performed on the collected data.

Mindfulness and worry were found to be related to severity of both depressive and anxiety symptoms, with worry being a risk factor and mindfulness being a protective factor. However, the relative contribution of worry and mindfulness was different for the two types of symptoms: worry was a stronger predictor of variance in anxiety symptoms than mindfulness, mindfulness was on the other hand a better predictor of variance in depressive symptoms.

Worry and mindfulness introduce both unique and common contribution to severity of anxiety and depressive symptoms.

Recently the need for modern psychiatrists to have strong psychopathological bases has been repeatedly affirmed.

To provide a general overview on the current status of training and practice in psychopathology across Europe.

1. 1) to describe the current status of training on psychopathology;2)to identify the unmet needs of European residents in psychiatry;3)to suggest future perspectives of training in psychopathology.

An online survey, promoted by the EPA Section on Philosophy and Psychiatry, was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member.

Thirty-two associations returned the questionnaire out of the 41 contacted (response rate: 78%). All respondents recognize psychopathology as a core component of training in psychiatry. The primary aims of psychopathology are to assess psychiatric symptoms, to understand patients' abnormal experiences, and to make nosographical diagnoses. A formal training course in psychopathology is available in almost all surveyed countries. In most countries:1)there is not a defined number of hours dedicated to psychopathology;2)teaching is mainly theoretical;3)a structured training on psychopathological rating scales is missing. At the end of the training, about half of respondents is not satisfied with received training in psychopathology.

European early career psychiatrists clearly recognize the need to rediscover psychopathology, which represents the heritage of European Psychiatry. Initiatives to improve training and practice of psychopathology should be addressed by national and international psychiatric organizations.

Negative symptoms represent a separate dimension of schizophrenia psychopathology, distinct from positive symptoms, disorganization and cognitive impairment. It is increasingly acknowledged that negative symptoms are associated with poor functional outcome and represent an unmet need in schizophrenia treatment. Improvement in definition of their phenomenology, assessment instruments and experimental models are needed in order to improve schizophrenia prognosis.

The presentation will review key aspects of the evolution of negative symptom constructs. In particular, findings concerning phenomenology, clinical assessment, association with functional outcome and brain imaging correlates will be presented.

We searched PubMed for English full-text publications with the keywords

Schizophrenia AND “negative symptoms”/“primary negative symptoms”/“deficit schizophrenia”/“persistent negative symptoms”/“affective flattening”/alogia/“expressive deficit”/apathy/asociality/“social withdrawal”/anhedonia/“anticipatory anhedonia”/avolition/neuroimaging.

The distinction between secondary negative symptoms (i.e., those due to identifiable factors, such as drug effects, psychotic symptoms or depression), and primary or persistent negative symptoms (i.e., those etiologically related to the core pathophysiology of schizophrenia) is grounded on solid research evidence and might have major implications for both treatment development and clinical care. The evidence that negative symptoms cluster in motivation- and expressive-related domains is founded on large consensus and empirical evidence and will foster pathophysiological modeling. The motivation-related domain is a stronger predictor of functional outcome than the expressive one.

An improved definition and assessment of negative symptoms needs to translate in large-scale studies to advance knowledge. In the short-term, the improved identification of treatable causes of secondary negative symptoms can translate into better care for people with schizophrenia.

AM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.

SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.