Truancy is a serious public health problem that affects adolescents from all countries around the world; however, little is known about the short- and long-term outcomes of potential underlying psychological and mental ill-health for those adolescents who truant. Working in Europe to Stop Truancy Among Youth (WE-STAY) project is developed, as a randomized controlled trial (RCT), in order to examine truancy, and its subsequent association with psychological distress and mental illhealth. The WE-STAY Consortium comprises 10 European countries: Estonia, France, Germany, Hungary, Israel, Italy, Romania, Slovenia, Spain and Sweden serving as the coordinating centre.

The main objectives of WE-STAY are to gather epidemiological information on truancy on European adolescents; and to perform interventional school-based programs for adolescents, aimed at reducing truancy rates and improve mental health of students.

The WE-STAY project is implementing and evaluating outcomes of three different kinds of preventive interventions on truancy, which is compared with a minimal intervention serving as the control arm. Validated psychometric instruments incorporated into a self-report questionnaire is administered at baseline, 1- and 12-month follow-up assessments.

The WE-STAY project is expected to generate valuable information about the behaviour of European adolescents regarding attendance to school. The existing research on truancy is very scarce and affected by methodological shortcomings that make evaluating the effectiveness of their programs difficult. The main philosophy underlying the WE-STAY project is to consider truancy as a warning-sign for psychological and social distress in adolescents.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia in hospitalized patients. The syndrome is an osmoregulatory disorder, consisting of hyponatremia, decreased serum osmolality, inappropriately elevated urine osmolality, excessive urine sodium in a patient who is euvolemic.

The selective serotonin reuptake inhibitors (SSRIs), a frequently prescribed class of antidepressant, have been well reported to cause SIADH. This often poses a clinical challenge to psychiatrists in the consultation liaison and psychogeriatrics setting, where patients are at a higher risk of developing hyponatremia. Other classes of antidepressants should be considered if clinically indicated.

To report an elderly psychiatric patient who was diagnosed with SIADH induced by duloxetine, which belongs to a class of antidepressant known as the serotonin-norepinephrine-reuptake inhibitors (SNRIs).

Patients developing antidepressants induced SIADH present a clinical dilemma to clinicians. Future studies evaluating the incidence of SIADH attributed to the different classes of antidepressants would be helpful to clinicians. Close monitoring of sodium level should be considered when antidepressant therapy is started for patients who are at high risk of developing SIADH.

Cardiac surgery with cardiopulmonary bypass represents a severe source of stress and has been reported to be associated to the development of Posttraumatic Stress Disorder (PTSD). This disorder leads to a significant disability that might greatly decrease the benefits of surgery. Research rarely focused on the role of attachment styles in the development of PTSD, and no studies addressed this issue in patients undergoing cardiac surgery.

To assess the influence of attachment styles on the development of PTSD.

The identification of specific personological traits predictive of the development of PTSD.

Participants were recruited among patients scheduled for elective cardiac surgery with cardiopulmonary bypass and evaluated through

1. a) Experiences in Close Relationships (ECR)

2. b) Post-traumatic 10 Stress Symptom Inventory - Modified (PTSS-10)

3. c) Perceived Stress Scale (PSS).

Six months after surgery, participants were mailed the PTSS-10 and the PSS. Multiple logistic regression analysis was performed with PTSD as dependent variable, and attachment-related avoidance and anxiety, sex, age and perceived stress as independent variables.

One hundred twenty-one patients (94% of candidates for elective cardiac surgery who met study inclusion criteria) underwent surgery; 61(59%) were assessed after 6 months. Fourteen subjects (19.7%) scored ≥35 on the PTSS-10 at followup and were considered as having a probable diagnosis of PTSD. Attachment related avoidance at baseline predicted the development of PTSD at follow-up (p< 0.017), after controlling for age, sex and perceived stress.

Subjects endorsing the avoidant attachment style are more likely to develop PTSD after cardiac surgery.

Prescription and sale of Methylphenidate (MPD) has increased sharply in Iceland in recent years as it has done worldwide. MPD is known to have abuse potential but significant i.v. use of prescription stimulants has not been reported in the literature. Clinical experience however has indicated that such i.v. use has now become very prevalent in Iceland.

To investigate the prevalence, pattern and symptoms of i.v. MPD abuse in Iceland.

The study is cross-sectional in design. The study tool is a semi-structured interview designed especially for the purpose of this study. All substance abusers admitted to drug treatment in Iceland who have used substances i.v. in the past 30 days, are offered to participate in the study. The aim is to include 150 individuals.

The study is in its preliminary stage. First results show that MPD is now the most commonly abused i.v. drug in Iceland, 85% of the sample admitted to using MPD i.v. in the past 30 days. Methylphenidate is preferred by i.v. substance abusers over illegal stimulants.

Our preliminary data shows that MPD abuse is a very prevalent problem in Iceland. It is the most commonly abused i.v. drug in Iceland at present. It is important to objectively verify and characterize the pattern of MPD abuse as to evaluate the complications associated with i.v. use of MPD. Increased knowledge of this problem is necessary both for Iceland as well as other countries.

The quality of a woman's relationship with her partner is associated with an increased risk of developing anxiety and depression in the postpartum.

To assess the prevalence of post-partum depression (PPD) and correlation between anxiety and depression in postpartum and the marital relationship in a sample of couples recruited at the Gynaecology Ward, “Maggiore della Carità” Hospital, Novara.

Evaluation of marital relationship functioning with regards to PDD onset.

This longitudinal study involved 44 couples recruited from February 2012 to March 2012. Single women, women suffering from severe chronic illnesses, drug addiction or alcoholism and with a previous diagnosis of psychiatric disorders were excluded. Mothers-to-be were assessed for depression and anxiety, during pregnancy and after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory-II (BDI-II). Both parents were assessed with the Relationship Satisfaction Scale (RSS); Relationship Assessment Scale (RAS); Marital Adjustment Test (MAT).

The prevalence of PDD was 18% according to the EPDS and 10.5% according to the BDI-II. No gender differences emerged as far as the partner relationship is concerned. The Chi-square analysis revealed a statistically significant inverse correlation between the development of PDD assessed with EPDS after delivery and RSS score (p = 0.039) and RAS (p = 0.05). A statistically significant inverse correlation emerged between BDI-II and RAS (p = 0.005), and BDD and MAT (p = 0.006).

The prevalence of PDD was consistent with the literature. Satisfaction with the marital relationship and the functioning of parental relationship correlates with PDD onset. Clinical implications are discussed.

Treatment of atypical depression (AD) modern antidepressants poorly understood, whereas the study of AD in the context of chronobiological disorders necessitates selection pathogenetically substantiated therapy.

To determine the effectiveness of agomelatine in the treatment of AD.

To compare the efficacy of agomelatine in patients with AD and melancholic depression (MD), the impact of the drug on the separate atypical symptoms, and the effect on AD in the first depressive episode (FDE), bipolar disorder (BD) and recurrent depressive disorder (RDD).

6 week monotherapy agomelatine patients with AD (n=60, main group) and MD (n=30, control group) at a dose of 25 mg/day with the possibility of increasing to 50 mg/day. Used rating scales ADDS, BDI, HDRS-17, LSEQ, GAF.

Response rate of onset in the treatment of AD was higher (third week) than in the MD (fifth week). Reduction on a scale HDRS-17 was significant at the first week of treatment in both groups (p< 0,001). of atypical symptoms better than others were reduced hypersomnia and hyperphagia. Treatment of patients with AD at FDE, BD and RDD showed a higher percentage of responders at BD (82%) than in the RDD (64.2%) and especially (p < 0,01) for FDE (40%).

Agomelatine has shown high efficacy in the treatment of AD (88.3%) and MD (83.3%), despite the opposite nature of the symptoms (insomnia and hypersomnia, decreased and increased appetite), as well as comparable efficacy in the treatment of AD in the structure as RDD and BD.

Comparative study of the blood lipid spectrum changes in first-episode schizophrenia patients treated with risperidone and haloperidol.

68 patients with first-episode schizophrenia (average age 24,9 years) and 20 age-matched normal controls were investigated. All patients had PANSS total score not less than 80 points. The patients were divided in two groups of 34 persons in each group: treated with haloperidol and risperidone. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)) levels were determined in serum before treatment and after 8 weeks of therapy.

Before the treatment TC, LDL, non-HDL, apoB, Lp(a) levels were authentically higher, but HDL level was lower. After treatment with risperidone and haloperidol HDL and apoA1 levels were increased. In patient group treated with risperidone TC, LDL, non-HDL, apoB, Lp(a) levels did not authentically change after 8 weeks. After treatment with haloperidol TC, LDL, non- HDL, apoB, Lp(a) levels were decreased.

Changes of blood lipid spectrum in first-episode schizophrenia patients were discovered. It was established changes of lipid spectrum in patients treated with risperidone and haloperidol. Haloperidol was noticed to positively influence on blood lipid spectrum in first-episode schizophrenia patients.

Deficits in social cognition, especially in Theory of Mind (ToM) and empathy, may contribute in poor social functioning of patients with bipolar disorder (BD).

Previous studies have found impaired empathy in euthymic patients with bipolar disorder using self-report measures of empathy. However, evidence on the neuropsychological processes that underlie empathic abilities in BD is scarce.

The aim of the study was to assess empathy and ToM abilities in euthymic BD using both self-report and neuropsychological measures.

Fifty-seven euthymic BD patients and 53 healthy control subjects completed the Empathy Quotient, a self-report measure of empathy. A multi-level battery of ToM tasks was applied in all study participants, including First order false beliefs stories, Hinting task and Faux Pas Recognition Test (FP). Besides the ability to recognize Faux Pas, three specific components of ToM were assessed with FP: the affective ToM, the cognitive ToM, and the emotional perspective taking. The two groups were matched for gender, age and education.

Patients with BD reported significantly lower levels of empathy than healthy controls. There was no significant difference between the two groups in the First order false beliefs and Hinting task scores. Patients had significantly lower score than healthy controls in FP recognition and cognitive ToM. However, there was no significant difference between the two groups in affective ToM and emotional perspective taking.

Deficits in higher order ToM were found in the euthymic BD. These deficits might have important contribution to empathy impairments found, using self-report scales.

The child pornography collecting process and the way the pornographer considers his collection need to be better understood. It is these psychopathological issues and the risk of the person acting out his fantasies that need to be analyzed.

We want to understand the phenomenon of child pornography, because it is sometimes a matter of deviance without leading to actual abuse.

The aim of our study is thus to identify the characteristics of people who download child pornography.

We collected datas from forensic psychiatric assessments. The criterion for inclusion was the possession of pornographic images of minors. We studied pathological characteristics of this sample.

Subjects were almost exclusively male with an average age of forty years. They have generally a good academic level. A significant difference is observed between the childhood aspects of child pornographers, sex online and offline offenders. A sense of loneliness is expressed in 32.8%.

Child generally fulfills a fantasy of a pedophile nature. Different profiles of child pornographers have been proposed which are not always related to pedophilia. Our study has permitted to have informations about the sexuality of child pornographers. The feel to not be well integrated could explain the use of virtual mean of telecommunication. Clinical differences can be made between child pornographers and sex online offenders.

Patients with severe psychotic disorders exhibit a severely reduced quality of life (QoL) at all stages of the disease. Integrated care often led to an improvement in QoL. However, the specific mediators of QoL change are not yet well understood.

The ACCESS II study is a prospective, long-term study investigating the effectiveness of an integrated care program for people with severe psychotic disorders (IC-TACT) that includes Therapeutic Assertive Community Treatment within a care network of in- and outpatient services at the University Medical Center Hamburg-Eppendorf, Germany. We examined longitudinal associations between QoL and the hypothesized mediators of change (i.e., negative symptoms, depression, and anxiety), using cross-lagged panel models.

The sample includes 418 severely ill patients treated in IC-TACT for at least 1 year. QoL increased, whereas symptom severity decreased significantly from baseline to 6-month follow-up (p-values ≤ 0.001), and remained stable until 12-month follow-up. QoL and symptom severity demonstrated significant auto-correlated effects and significant cross-lagged effects from QoL at baseline to negative symptoms (6 months, β = −0.20, p < 0.001) to QoL (12 months, β = −0.19, p < 0.01) resulting in a significant indirect, mediated effect. Additionally, negative symptoms after 6 months had a significant effect on the severity of depression after 12 months (β = 0.13, p < 0.05).

Negative symptoms appear to represent an important mechanism of change in IC-TACT indicating that improvement of QoL could potentially be achieved through optimized intervention on negative symptoms. Moreover, this may lead to a reduction in the severity of depression after 12 months.

Depressed patients tend to under-estimate their everyday memory function. Whether this under-estimation is related to the depressive state, or whether it represents underlying personality traits present also between or after depressive episodes, is not clear.

Comparisons of subjective memory evaluation as measured by the Everyday Memory Questionnaire (EMQ) were made between sub-groups with Current Depression (N=14), Previous Depression (N=19), and Healthy Controls (N=10). Analyses were adjusted for effects of sociodemographic variables, use of medication, and premorbid intellectual abilities (Similarities sub-test (WASI)). To assess the relationship between affective state and subjective memory function irrespective of actual memory performance, adjustment for objective memory performance as represented by the Total recall sub-task from CVLT and Long-delayed free recall from RCFT was included in a final step in the ANCOVA model.

The overall crude relationship between group and EMQ total score was significant (F(2,40)=4.11, p=0.011, eta sq.= .17). In posthoc follow-up tests, the Currently Depressed reported significantly lower on EMQ than both Previously Depressed and Controls (Dunnett's C test, p= .018 and p= .034, respectively). However, after adjustment for relevant confounders and mediators, both the Previously and Currently Depressed performed significantly worse on EMQ compared to Controls (overall ANCOVA F(2,33)=9.22, p= .001, eta sq.= .36; pairwise follow-ups p= .001 and p= .011, respectively).

Depressed patients’ under-estimation of their memory function is independent of mood state and it may represent a vulnerability or personality structure involving negative cognitive patterns that may be successfully targeted by cognitive therapy.

The aim of our study is the evaluation of co-administration of N-acetyl-cysteine (NAC) in cognitive functions in a sample of patients affected by schizophrenia diagnosed according to DSM IV-TR criteria, and treated with stable atypical antipsychotic therapy.

We administered NAC (1800 mg/die) to 12 male patients, tested each patient at baseline and re-tested after 90 days using a battery of neurocognitive tests (Wisconsin Card Sorting Test, Verbal Fluency Test, Stroop Test) and PANSS scale for severity symptomatology evaluation. The results obtained in each test at baseline were compared with those at the end of the study.

A significant improvement for WCST error numbers (sig. 0.049), VFT fonemic (sig. 0.049), PANSS positive (sig. 0.028), negative (sig. 0.002) and total (sig. 0.024) was observed.

Our results show that co-administration of N-acetyl-cysteine added to atypical antipsychotic therapy improves the cognitive-executive functions. The effectiveness on reducing positive and negative symptoms was confirmed.

[1]. Grabe et al. (2006). Alexithymia in Obsessive Compulsive Disorder - Results from a Family Study. Psychother Psychosom 75:312-8

[2]. Grabe et al. (2007). Alexithymia and Outcome in Psychotherapy. Psychother Psychosom (in press)

Less than half of depressed patients achieve remission. Identification of biological markers may help clinicians to predict remission and improve patient's treatment.

To identify brain regions whose activity during self-referential processing at baseline could predict long-term remission among patients with Major Depressive Disorder (MDD) and to investigate the brain effects of Agomelatine.

Nineteen acutely depressed patients and fourteen healthy controls performed self-referential judgments on emotional pictures during two fMRI sessions: before treatment and after 6 to 7 weeks of Agomelatine in patients or one week of placebo in controls. Patients were treated during 6 months and remission was assessed (HAM-D≤7).

Activation in dorsomedial prefrontal cortex (dmPFC) and precuneus, during self-referential processing at baseline, was lower in future remitters than in non-remitters and remained stable after 6/7 weeks of treatment in both groups of patients. Pre-treatment activation of dmPFC and precuneus predicted clinical remission at 6 months with a sensitivity of 100% and a specificity of 71.6%. After 6–7 weeks of Agomelatine, the brain activation of MDD patients during self-referential processing was normalized i.e. decrease in the excessive activation of the dorsolateral prefrontal cortex and increase in the ventral anterior cingulate cortex activation.

Pre-treatment activation of precuneus and dmPFC during self-referential processing appears to be a valid predictor of clinical remission. Such results are consistent with the idea that cortical midline structures activity may play a major role in treatment outcome of MDD and may help developing biomarkers-based treatment of MDD.

Food craving (FC) has been linked todepressive mood before. However, no study exists evaluating FC in a sample of bipolar disorder (BD).

This study aimed to determine the prevalence of FC in individuals with BD during euthymia.

Fifty individuals with a BD diagnosis according to the DSM-IV guidelines were drawn from the dedicated outpatient center of the University Clinic of Psychiatry Graz. Data were compared with data from a healthy control sample (HC, n=50). All probands took part in the BIPFAT study exploring shared pathophysiological pathways of obesity and brain function in BD. Participants completed a comprehensive diagnostic battery (including the Food Craving Questionnaire by White et al. 2002) measuring anamnestic, anthropometric, and clinical data. We performed a MANCOVA controlling for key covariates including gender, age, body mass index, smoking, mood stabilizing medication, and lipid levels.

BD patients exhibited significantly more total food craving (F=6.10, p=.016) and more sweets craving than controls (F=6.38, p=.014). Additionally, levels of fat craving were higher by trend in the male patient group than in the male control group (F=3.15, p=.087).

A higher prevalence of FC in BD patients than in controls suggests that FC may be of clinical importance in BD. Potentially, FC plays a role in the development of obesity, a well-known risk factor for unfavorable course of illness in BD. Furthermore, the impact of dysfunctions in the serotonergic system and/or an altered activation of the hypothalamic-pituitary-adrenal axis in relationship to increased FC are critically discussed.