The aim of our study was to investigate and compare the quality of life of parents of children with ADHD and parents of children within psychiatric troubles.

We conducted a cross sectional and comparative study, on 20 families of children with ADHD, followed in child and adolescent psychiatry department of Sfax, Tunisia, and 20 control families. We used the Short Form Health Survey (SF 36) translated and validated in Arabic to evaluate the quality of life of the parents of the two groups.

The average age of the patients of our survey was 9 years 8 months with a predominance of boys. We objectified a significant difference between the overall scores of the quality of life of parents of children with ADHD and the control sample. A highly significant difference was noted in the following areas: mental health, bodily pain and social functioning. The difference was significant in vitality score. The difference was not significant in 4 scores: general health, physical functioning, role physical, and role emotional.

Families with a child with ADHD have many challenges which impact certainly in their quality of life. As a child and adolescent's psychiatrics, we should be aware of these consequences in order to help the parents to improve their quality of life.

The authors have not supplied their declaration of competing interest.

Depression is present in 35% of adolescents who commit suicide. It is crucial that we identify which of these depressed adolescents are at greatest suicide risk. Suicide attempts are strongly associated with suicide risk, and therefore commonly used as a proxy measure. Non-suicidal self-injury (NSSI) is often seen as being less serious than suicide attempts.

To determine which clinical and psychosocial factors in depressed adolescents at baseline predict both suicide attempts and non-suicidal self-injury over 28 weeks follow-up.

Adolescents with major depressive disorder (n = 164) taking part in the Adolescent Depression Antidepressants and Psychotherapy Trial were evaluated. Clinical symptoms, family and friendship functioning, suicide attempts and non-suicidal self-injury were recorded at baseline.

Suicidal and non-suicidal self-harm were measured during 28 weeks follow-up.

High suicidality, non-suicidal self-injury and poor family function at entry were significant independent predictors of suicide attempts occurring over 28 weeks follow-up. NSSI was the strongest predictor of suicide attempts (adjusted OR = 3.2, p = 0.006). NSSI over follow-up was independently predicted by non-suicidal self-injury (adjusted OR = 20, p < 0.0005), increased hopelessness, anxiety disorder, and being younger and female at entry.

Anorexia nervosa (AN) is a severe psychiatric disorder. The epigenetic regulations are strongly suggested in AN. We and other groups have performed a whole-genome methylation study (methylome) in AN. We found that the differentially methylated CpG sites are located around genes involved in biological processes in link with embryonic morphogenesis, brain development and its plasticity, in particular adhesion and axon guidance. Here, we study an independent group of 40 AN patients. Furthermore, we have done a follow-up during more than one year, to compare the methylation profiles in subjects that evolve to the remission.

Our work is to replicate the methylome study in an independent AN cohort and to characterize profiles of methylation at two times for the same subjects to compare the AN patients that convert to remitters.

Our goal is to identify diagnostic and prognostic epigenetic signatures for AN.

Of the 40 AN patients, 18 evolved to remission. Furthermore, the blood samples of the subjects from the 2 times will be investigated, like this, each subject is its own control. Methylation of DNA is measured by using the Infinium HumanMethylation450 BeadChip technology.

Comparisons of AN to controls showed similar profiles of methylation involving the same biological processes as previously identified. We are comparing now the difference of methylation between the 18 remitters and the 18 actual AN, taking into account of the two times of samples.

We expect to characterize specific methylation signature of the prognostic of the AN remission.

The authors have not supplied their declaration of competing interest.

Despite the fact that depression has an estimated heritability around 40%, there is no definitive candidate gene contributing to its etiology. The lack of an identified genetic component for high-heritability disorders, like depression, gave rise to the concept of missing heritability. The epigenetics’ field has pushed forward new hypotheses to fill this gap since transgenerational inheritance of epigenetic patterns has been described both in animal models and, more recently, in humans. Depression is usually associated with an abnormal stress response and an altered hypothalamic-pituitary-adrenal axis, regulated by the glucocorticoid receptor (coded by NR3C1 gene). Therefore, NR3C1 has been widely investigated as a functional candidate gene involved in anxious-depressive spectrum disorders (ADSD) although a more comprehensive study of its methylation is further required (Palma-Gudiel et al., 2015).

To analyze NR3C1 promoter's methylation and to study its association with anxious-depressive spectrum disorders.

The sample consisted of 48 pairs of monozygotic twins, from the UB twin register, grouped as concordant, discordant and healthy pairs depending on whether both, one or none of the co-twins of each pair were affected by a lifetime ADSD, according to DSM-IV criteria (SCID). DNA methylation was assessed by bisulfite conversion and subsequent pyrosequencing.

Hypermethylation at specific CpG sites, not previously reported, was detected in concordant twin pairs as compared with discordant and healthy groups (P = 0.03).

The epigenetic pattern newly described in NR3C1 gene may be contributing to the familial component of depression and thus could be putatively explained by transgenerational inheritance of epigenetic phenomena.

The authors have not supplied their declaration of competing interest.

One of the WHO's innovations for improving the ICD-11 chapter Mental and Behavioral Disorders was the creation of the Global Clinical Practice Network (GCPN), an international network of more than 12,000 mental health and primary care professionals from 144 countries.

In order to evaluate perceived clinical utility of the ICD-11 guidelines, the case-controlled field studies that involved the application of the proposed diagnostic guidelines to standardized case material were implemented via the Internet in different languages.

Two hundred and seventy-eight Russian mental health care professionals, the GCPN members, have participated in case controlled Internet study for the chapter “Schizophrenia and Other Primary Psychotic Disorders”. Russian participants were represented by psychiatrists mostly (89%) and much less by psychologists (8%) which corresponds with the general situation in the Russian mental health care system.

Russian clinicians have used the proposed ICD-11 diagnostic guidelines successfully to assess delusional disorder as well as schizophrenia. But there were certain categories (schizoaffective disorder, subthreshold delusions) with which the participants seemed to struggle. The critical comments were focused on opposing so called syndrome-based assessment and nosological diagnostics. Most concerns were about elimination of Schizophrenia subtypes.

Russian mental health care professionals proved to be interested in ICD revision process and demonstrated their special diagnostics opinion based on rich clinical traditions and psychopathological approach. In order to use ICD-11 guidelines in clinical practice more efficiently supplementary appropriate training would be needed.

The authors have not supplied their declaration of competing interest.

This case shows the importance of knowledge of psychiatrists concerning the psychoactive substances of ethnobotanical plants, because of their legality and easy procuration possibility. We consider that the role of psychiatrists in mediatizing the side effects of these plants is very important.

Literature lacks of studies assessing correlates of adjustment to aging (AtA) among older populations.

The aim of this study was to build a structural model to explore the predictors of adjustment to aging (AtA) in a community-dwelling older population.

A community-dwelling sample of 1270 older adults aged between 75 and 102 years answered a questionnaire to determine socio-demographic (sex, age, professional and marital status, education, household, adult children, family's annual income, living setting and self-reported spirituality), lifestyle and health-related characteristics (perceived health, recent disease, medication and leisure). Several instruments were used to assert psychological variables, namely AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables.

Significant predictors are self-reported spirituality (β = .816; P < .001), perceived health (β = .455; P < .001), leisure (β = .322; P < .001), professional status (β = .283; P < .001), income (β = .230; P = .035), household (β = -.208; P = .007), sense of coherence (β = -.202; P = .004) and adult children (β = .164; P = .011). The variables explain 60.6% of the variability of AtA.

Self-reported spirituality is the strongest predictor of AtA. This study emphasizes the need for deepening the variables that influence older adults’ AtA, in particular perceived health and further lifestyle-related characteristics, as being relevant for promoting aging well in later life, within a salutogenic context for health care.

The authors have not supplied their declaration of competing interest.

Infants are very sensitive and special attention is needed to take care of their physical and mental health. Some studies showed that massage by parents can improve infants’ sleep quality. The aim of this study was to compare the effect of massage with sunflower oil or sesame oil on infants’ crying and sleep times.

This triple-blinded clinical trial was conducted on 120 infants who were 10-15 days old, full-term, single, exclusively breastfed and with no history of hospitalization. The infants were assigned randomly into three groups of sunflower oil massage, sesame oil massage and massage with no oils. Mothers administered 15 minutes of massage to their infants twice per day (morning and afternoon) for 28 days. Times of crying and sleep were measured by a parents’ information form at baseline, and at the end of the first, second, third, and fourth weeks of the study. Data were analyzed using the repeated measures ANOVA.

Within four weeks of following, decreasing pattern of infants crying time was not significant (P=0.18); however, the mean of crying time between the three groups was significant (P=0.007). The interaction effect of crying time and groups was not significant (P=0.18). Increasing pattern of infant sleep time was statistically significant in the fourth weeks of the following (P<0.001); however, the mean of sleep time between three groups was not significant (P<0.56). The interaction effect of sleeping time and groups was not significant (P<0.10).

Since there were not statistical significant differences between the infants’ crying and sleep times between the three groups, and despite the fact that increasing pattern of infants sleep time is a normal pattern, it is not possible to have a proper conclusion.

The stress -vulnerability model is an extremely useful model for identifying and treating relapses of mental illness. We accept that human persons carry genetic and other predisposition to mental illness. However, the question arises as to how stress impacts on a person in order to cause mental illness to develop. Furthermore there arises the issue as to what other effects such stress has on the human body beyond the human brain.

To research and integrate the current literature in order to establish how stress impacts on the brain at the cellular level, and to establish whether there are other consequences for the human body brought about by the impact of stress on the human brain.

MethodLiterature Search.

The present literature describes a complex set of interactions involving stress induces elevated levels of cortisol, immune responses, enhanced production of corticotrophin-releasing factor (CRF), glucocorticoid receptor tolerance thus impairing the negative feedback mechanism of the HPA axis, neurodegenerative changes in the hippocampus, and balance between trophic and atrophic factors within neurons, thus affecting neurogenesis and brain plasticity. The poster explores the interrelationship between all these factors, and the genetic component which in large part constitutes the ‘vulnerability’ part of the model.

We also show that the effects of heightened cortisol levels are not confined to the brain. but also cause metabolic problems including the ‘Metabolic Syndrome’.

Such problems occur in many Psychiatric illnesses, including Depression, PTSD, as well as Schizophrenia.

Suicide attempts and suicidal ideation are peculiar aspects of several cluster b disorders, including Narcissistic Personality Disorder. Similarly, difficulty in regulating negative affects can play a role in the relationship between narcissist features and suicidal ideation. To date, it is still unclear which facet of narcissism is more related to the desire to die and which other factors are involved in this relationship.

To offer preliminary empirical evidences concerning the relationship between narcissism, emotion regulation and suicide ideation.

We administered Pathological Narcissism Inventory (PNI), Difficulties in Emotion Regulation Scale (DERS) and Beck Scale for Suicidal Ideation (BSI) to a sample of individuals with Suicide ideation (n= 68) and a sample of community participants (n=140).

Controlling for age and gender, we found that BSI scores correlated significantly with the vulnerable dimension of narcissism, but not with the grandiose one, and with all DERS dimensions. Nevertheless, emotion dysregulation moderates the relationship between vulnerable narcissism and suicidal ideation.

Suicide ideation seems to be deeply connected with the vulnerable dimension of pathological narcissism and the relationship between the constructs is partially mediated by emotion dysregulation. Future directions and clinical implications are discussed.

The goal of our study was to identify brain structures in patients with panic disorder (PD) that show changes in 18FDG PET during the treatment with cognitive behavioral therapy (CBT) or antidepressants.

Twelve patients with panic disorder were studied with [18F]-2-fluoro-deoxyglucose positron emission tomography (18FDG PET) during resting state (condition of random episodic silent thinking, REST). After PET examination patients were randomly assigned to either cognitive behavioral treatment group (6 patients) or antidepressants treatment group (6 patients). After 3 month 18FDG PET examination was repeated in both groups.

Scores of psychopathology rating scales (CGI, HAMA, PDSS) decreased in both groups. Changes of 18FDG uptake in pharmacotherapy group: decreases were found in a priori hypothesized regions in right hemisphere, in superior, middle, medial and inferior frontal gyrus, superior and middle temporal gyrus, and increases were detected in a priori hypothesized regions, mainly in left hemisphere in medial and middle frontal gyrus, superior, middle and transverse temporal gyrus. Changes of 18FDG uptake in CBT group: decreases were found in a priori hypothesized regions of right hemisphere in inferior temporal gyrus, superior and inferior frontal gyrus, and increases were detected in a priori hypothesized region, mostly in left hemisphere: inferior frontal gyrus, middle temporal gyrus and insula.

Changes in brain metabolism after treatment either with CBT or with antidepressants were similar in number of brain areas, with prominent right-left difference.

Supported by the project 1M0517 MZCR.

Teaching, as a profession, is recognized as demanding and stressful.

(1) Evaluate the professional teacher stress, (2) Identify possible factors associated with it.

This is a cross-sectional study, descriptive and analytical, conducted among teachers of high school Mahmoud Magdich in Sfax. (Tunisia). Participants were asked to complete the anonymous form detailing the socio-demographic, professional characteristics and any work stressors.

The evaluation of occupational stress was evaluated by the scale of “Karasek”.

Thirty-six teachers replied to the questionnaires. The sex ratio (M/F) was 0.38. The mean age was 48.77 years. The average number of years of exercise was 23.20 years and the average number of hours worked per week was 16.25 hours. The participants stress profile according to the scale of “Karasek” was: 55.6% stressed, 27.8%, assets, 11.1% liabilities, and 5.6% relaxed. The main stress factors mentioned were respectively: the inadequate salary (58.3%), difficult working conditions (52.8%), problems with students and parents (25%) and lack of organization at work (22.2%). Factors correlated with the profile “stressed” were: female gender (P = 0.026), lack of pastime practice (P = 0.034), teaching high school degree (P = 0.04), feeling that they work “too hard” in their work (P = 0.005), they are “the end” at the end of the working day (P = 0.015) and low social support (P = 0.005).

The occupational stress among teachers was quite important. Knowing how to identify factors and taking action would be interesting for the guarantee development for teachers. Students would be the ultimate beneficiaries.

The authors have not supplied their declaration of competing interest.

Fear of giving birth may affect many pregnant women. Fear of childbirth leads to an increase in C-section demands and the ratio of C-section births. Group therapy addresses at least 8 people at the same time, which both saves time and treatment expenses.

The objective of this study was to evaluate the impact of group art therapy for the management of fear of giving birth.

Thirty women volunteers in the third trimester of pregnancy who were attending a public women's hospital and who had fear of giving birth were included in the study. They were randomly distributed to 2 groups. First group (n = 15) received 6 sessions of group art therapy. Second group (n = 15) received 6 sessions of psychoeducation regarding fear of giving birth. Each weekly psychotherapy session lasted 130 minutes.

By the end of the six weeks Beck depression scale (BDS) scores, Beck Anxiety Scale (BAS) scores and Wijma delivery expectancy/experience questionnaire version A (W-DEQ) scores decreased significantly in the group art therapy group (P < 0.001). In contrast, the psychoeducation group showed no significant changes in terms of BDS, BAS, W-DEQ scores.

Our study shows that group art therapy may be a promising cost-effective treatment method to manage fear of giving birth in pregnant women. The study needs to be replicated in women coming from different cultures and socioeconomic statuses to establish group art therapy for the treatment of fear of giving birth.

The authors have not supplied their declaration of competing interest.

Burnout is caused by high stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so this process is caused poor relationship with patient. Burnout should be considered in medical students by counseling centers of University for prevention of consequences. This study investigates burnout in senior medical students of Kashan University of Medical Sciences, Kashan,Iran(2008).

This research is a cross sectional study. In this study all of senior medical students (N=56) were answered to demographic questionnaire and Maslach burnout Inventory.

The findings showed that the majority of medical students (91.1%) had burnout and 16% of them had severe burnout. There was not significant relationship between burnout and sex, age, marital status P< 0.05.

Burnout was common problem in medical students and need to be helped. Therefore Medical Student should be encouraged to seek help and adequate facilities should be available.

Seclusion and mechanical restraint are widely used for people with serious mental disorders. In most countries one intervention is preferred while the other is considered as inhuman or not sufficiently safe, but identical arguments refer to different preferences. There is a lack of evidence from well-designed studies on compulsory measures in psychiatry.

We conducted a cohort study with optional randomisation comparing seclusion and mechanical restraint among in-patients with acute psychotic disorders. We determined an ethical aspect as main outcome variable: the restriction of human rights from the patients' point of view, measured by a scale developed for this purpose, Human DIgnity during COercive Procedures, DICOP-Score.

102 out of 233 patients exposed to coercive measures within 24 months could be included, 26 could be randomised (12 seclusion, 14 restraint). There were no significant differences between the two interventions referring to DICOP-score and duration of the intervention. The burdens most frequently reported were solitude, loss of dignity, and not having understood why the intervention was done. Watching pictures of several alternatives in the interview, including physical restraint and net bed (not available in Germany), most patients preferred seclusion.

Both from ethical and safety aspects the results do not yield evidence to prefer or forbid one of the interventions. Clinical decisions should take into account patients' preferences.