Posttraumatic stress disorder (PTSD) is characterized by a reduced expression of FKBP5, a key modulator of the glucocorticoid receptor. Smaller hippocampal volume has also been documented in PTSD. In this study we explored FKBP5 gene expression, brain structure and cognitive flexibility in patients with PTSD before and after cognitive behavioral therapy (CBT)

We measured peripheral FKBP5 RNA, volumes of the hippocampus, amygdala, and medial orbitofrontal cortex and cognitive flexibility in 39 patients with PTSD before and after CBT. The control subjects were 31 trauma-exposed individuals without PTSD who were also assessed twice.

At baseline, patients with PTSD showed lower FKBP5 gene expression and smaller hippocampal and medial orbitofrontal cortex, but not amygdala, volumes relative to control subjects. At follow-up, we found significantly increased FKBP5 expression and increased hippocampal volume in patients with PTSD. At follow-up, patients did not differ from control subjects in hippocampal volume. Improvement in PTSD symptoms was predicted by increased FKBP5 expression and increased hippocampal volume, but the primary predictor was FKBP5 expression. There was a positive correlation between the performance on a partial reversal task which tests cognitive flexibility and treatment responsiveness.

Clinical improvement in individuals with PTSD was associated with increased expression of FKBP5, increased hippocampal volume and better cognitive flexibility. The three variables were positively correlated.

The prevalention of depression in in-patients is 33% and in patients with coronary disease /heart attack/ is 45%. The occuring of comorbid depression and heart attack is 16-22% but not recognized and not treated often.

To compare differences between male and female with heart attack and comorbid depression.

102 patients with diagnosis of heart attack were assessed for depression during the second week following heart attack, after week 12, 24, 52 and 76. 76% patient were diagnosed as having depression according DSM-IV.For assessment of depression HAMD and MADRS were used and CGI, Zung Rating Scale for Depression, Beck Anxiety Inventory, laboratory and internal parameters, number of rehospitalizations and morbidity.

In 76% patients with heart attack depressive symptoms were present (52% male). 37% male with comorbid depression /mostly not treated/ and acute heart attack died but only 13% male without depression. From 68% male without depression after heart attack nobody died.

We averaged more often occuring comorbid depression and heart attack in male /52 vs 46%/ and mortality in depressive male /mostly not treated/ is higher as in female. Number of rehospitalizations is higher in male /1.9x/ like in female /8x/ too in compare with controls.

The high cognitive abilities named executive functions (EF) are responsible for emotional regulation and for goal-oriented behavior. EF are frequently disrupted in anxiety disorders and negatively affect daily function and quality of life (QoL). Nevertheless, EF evaluation is usually performed in the laboratory using neuro-psychological assessments that refer to specific components (such as working memory, inhibition), but lacks a comprehensive profile of EF and the expressions in real life context.

To elaborate the knowledge about EF in daily life of children/youth with psychiatric disorders, by comparing their EF to those of healthy controls, using an ecological measure that imitates daily life scenarios; To examine the relationship between EF and QoL in the study group.

Participants were 49 children and youth aged 8-18 years: 25 subjects with psychiatric (mainly anxiety) disorders and 24 healthy controls. The children’s parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL) to profile emotional difficulties; The Behavior Rating Inventory of Executive Functions (BRIEF) which examines EF components related to meta-cognition and behavioral regulation; and the Pediatric Quality of Life Inventory (Peds-QoL).

The study group had more EF difficulties [reduced behavioral regulation (F=31.81; p<.001) and metacognition (F=26.25; p<.001)], and lower QoL. In the study group, EF difficulties correlated with reduced physical, emotional, social, and school-related QoL.

EF should be evaluated in children/youth with psychiatric disorders, by ecological evaluation that reflect the difficulties in daily life. This may focus intervention on child’s specific needs and improve the outcomes in terms of better function, development and QoL.

The primary goal of this study is to examine the effectiveness of a community-based multimodal intervention program for suicide prevention in regions where the suicide rate was relatively high compared to control regions. The secondary goal was to explore the effectiveness of a community-based multimodal intervention program for suicide prevention in highly populated regions.

NOCOMIT-J is a community-based large-scale non-randomized controlled trial, involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program consists of

1. 1) Establishing social support networks in the public health system for suicide prevention and mental health promotion;

2. 2) A primary prevention measures of awareness campaign for the public and key personnel;

3. 3) Secondary prevention measures for screening, counseling and outreach services for high-risk individuals;

4. 4) After-care for individuals bereaved by suicide;

5. 5) Suicide prevention measures especially for individuals with mental illness and work-related problems.

This study protocol was reviewed and approved by the Central Ethics Committee of the J-MISP. Additionally, the regional leaders obtained written authorization from the local governors.

The intervention started in July 2006, and continued for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions, a total of population of 2,120,000 individuals.

Because treatment and prevention of suicide are complex and encompass many factors, success will need multi-sector collaboration. We hope that the results of NOCOMIT-J will help to develop effective strategies to reduce future suicide rate. (ClinicalTrials.gov: NCT00737165)

The outcome questionnaire (OQ-45) has been one of the most frequently used instrument to measure clinical outcomes in psychotherapy. Probably due to its subscale structure, its applicability for a variety of disorders and life struggles, its sensitivity to change by repeated measurements and its predictive ability. Given its popularity, OQ-45 has been translated into several languages.

As the Spanish version has not been published, through this poster it is going to show the reliability and the dimensional structure of the OQ-45.

One hundred and thirty-nine patients in clinical settings have completed the Spanish version. Three different confirmatory factor analysis have been calculated to analyze the construct validity.

The Cronbach Alpha of the instrument was adequate .92, but also, in the three dimensions: symptoms distress (.90), interpersonal relations (.78) and social role (.66). Through the CFA was proved that the Four-factor bi-level model structure [χ2(900) = 3930.47, P < .001, AGF = .86, CFI = .91, RMSEA = .061(.049 to .073)]suited appropriately, in fact, more properly than the three-factor correlated or the three-factor with a second order factor models.

The three-factor bi-level model structure of the OQ-45 is confirmed indicating an empirically and clinically relevant measure of client functioning. In this model each item loaded on one of the three subscales originally created. Besides, each item also captures common variance represented by the general factor of overall maladjustment, where this factor may indicate the degree to which respondents are functionally impaired. Thus, OQ-45 is an instrument that could be used for monitoring treatment efficacy and for making informed decisions about clinically significant changes.

The authors have not supplied their declaration of competing interest.

The corpus callosum (CC) is the largest interhemispheric white matter commissure connecting the cerebral hemispheres and plays a crucial role in interhemispheric communication and cognitive processes. The subdivisions of the CC were attempted to define corresponding areas of the cortex from which the fibers originate. Previous neuroanatomic studies of the CC provide impetus for investigating its role in obsessive-compulsive disorder (OCD).

In this study diffusion tensor imaging (DTI) was employed to microstructural abnormalities of white matter of the CC in OCD patients. Nine patients with OCD and matched control subjects underwent DTI. Fractional anisotropy (FA), an index of the integrity of white matter tracts, was determined in the seven subdivisions of the CC.

Significant reduction in FA was found in the rostrum of the CC of patients with OCD compared with one of controls. FA of the other subdivisions except the rostrum in OCD patients did not differ compared with control subjects. Higher FA in the rostrum correlated with lower Y-BOCS scores (r = -0.852, p = 0.004).

The rostrum contains fibers from inferior premotor as well as medial and caudate/orbital prefrontal regions. These results supported the theory of dysfunction of prefrontal cortex and striatal circuits in OCD and suggested the implication of the orbitofrontal circuit for symptom severity in the OCD patients.

Prior research on body-image-related issues has mainly focused on the relationship between overall body satisfaction and health-related outcomes, particularly among Western women. However, there is still a paucity of information on whether body satisfaction with specific body parts is differentially associated with body-image-related mental distress, especially across gay, bisexual, and heterosexual men in Taiwan.

To Identify the differences by sexual orientation regarding the relationship between satisfaction with specific body parts and body-image-related mental distress among Taiwanese men.

To develop effective interventions to reduce mental distress related to body dissatisfaction in men.

A total of 665 male participants were recruited via a popular electronic bulletin board system frequented by Taiwanese youth.

Increased levels of satisfaction with weight were significantly associated with lower odds of body-image-related mental distress across gay, bisexual, and heterosexual men (AOR=0.38, 0.31, and 0.56, respectively). Gay men who were more satisfied with their height (AOR=0.57) and body fat (AOR=0.28), as well as heterosexual men who were more satisfied with their facial features (AOR=0.51), muscle (AOR=0.53), and body fat (AOR=0.55), were significantly less likely to have body-image-related mental distress than their counterparts.

Higher levels of satisfaction with various specific body parts were associated with reduced risk of body-image-related mental distress. Further, these associations varied differentially across gay, bisexual, and heterosexual men. Future research may explore the possible mechanisms through which satisfaction with specific body parts influences men's body-image-related mental distress. Accordingly, interventions could be tailored for men of different sexual orientations.

The financial crisis that began in 2008 affecting many European countries and mainly Greece has an ongoing impact on public mental health and quality of life. The aim of this study was to investigate the potential impact of the financial crisis on criminality verifying differences in crime rates between the years 2008 and 2011 in Greece.

Data on crime in Greece for 2008 and 2011 were provided by the Crime Analysis Section of the Public Security Department of the Hellenic Police Headquarters. In order to create a comprehensive global index of criminality we calculated an overall crime rate including the following crimes committed: homicides, financial crimes (fraud, extortion), drug-related crimes, illegal weapon possession, sex-related crimes (rape, sexual exploitation), thefts/ burglaries and robberies. The overall and the aforementioned specific crude crime rates were calculated per 100,000 residents. Paired samples t-test was used to examine the differences in the rates between 2008 and 2011.

A significant increase in the overall crime rate between 2008 and 2011 (t=5.01, p=0.001) was found. Moreover, between 2008 and 2011 there was significant increase in the crude rates of homicide (t=2.41, p=0.03), fraud (t=7.35, p=0.001), extortion (t=3.22, p=0.009), illegal weapon possession (t=5.27, p=0.001), theft/burglary (t=4.62, p=0.001) and robbery (t=3.23, p=0.007). There were not statistical differences in the crude rates of sex-related and drug-related crime.

According to the results of this study criminality in Greece shows significant increase during the current financial crisis as reflected in many crime indicators.

Previous studies concerning early experiences in childhood show that these play a crucial role in the individuals’ development and may lead to a decrease in the vulnerability to show psychological problems. Mindfulness skills and feelings of hope seem to function as mechanisms that promote adjustment and psychological well-being.

The aim of this study was to explore the relationship between early positive emotional memories, hope, and mindfulness skills, as well as their role in the psychological well-being.

A sample of 402 adolescents with ages ranging from 12 to 18 years old completed four self-report instruments: the Early Memories of Warmth and Safeness Scale, the Children and Adolescent Mindfulness Measure, the Children Hope Scale and the Positive and Negative Affect Schedule.

Girls exhibited more negative affect when compared to boys. Age and years of education were not correlated with any of the study variables. Students with no school disapprovals showed more positive emotional memories and more hope. Mindfulness skills, hope, warmth and safety memories, and positive and negative affect were significantly correlated in an expected way. The set of variables that better predicted positive affect was: hope, early warmth and safety memories, and mindfulness skills. For negative affect, mindfulness was the best predictor followed by hope and lastly by positive emotional memories.

The current study heightened the role of positive emotional memories, mindfulness, and hope in affective states, suggesting that they may be addressed in intervention programs for the adjustment or the psychological well-being of the adolescents.

Mounting evidence has implicated oxidative stress in severe psychiatric disorders, including major depressive disorder (MDD). Glutathione (GSH) is the major intracellular antioxidant that protects cells against oxidative stress.

To test the hypothesis that oxidative stress is implicated MDD by measuring cortical GSH in MDD patients and in matched healthy controls in vivo, using magnetic resonance spectroscopy (MRS).

Fifteen psychotropic medication-free patients with MDD diagnosed according DSM-IV-TR criteria and 13 healthy volunteers (HV) participated in the study. A history of other axis I diagnoses or substance/alcohol abuse was exclusionary for all subjects. In vivo brain GSH levels, expressed in institutional units, were obtained from a single 3 × 3 × 2-cm3 occipital lobe voxel at 3.0 Tesla using MRS spectral editing.

Statistical comparisons revealed a 20.6% mean cortical GSH decrease (p< .003) in MDD (2.3 ± 0.4) compared to HV (2.9 ± 0.6), which remained significant after adjusting for age, sex, bmi, and smoking status. In addition, we found GSH levels to correlate negatively with depressive symptoms and with indices of emotional and functional disability across all participants.

To our knowledge, this is the first study to report a significant cortical GSH deficit in vivo in MDD, a finding that supports a role for oxidative stress in the pathophysiology of the disorder, and suggests the viability of treatment strategies based on using synthetic GSH precursors, such as N-acetylcysteine, to spur in situ synthesis and elevation of the antioxidant and mitigate the pathogenic effects of oxidative stress.

Oestrogen fluctuations may be an important factor in the etiology of bipolar disorder and age at menarche is associated with the clinical course of BD. Moreover, it is associated with traits related to mood.

The aim of our study was to explore the differences in age at menarche between euthymic BD patients and healthy controls, as well as to explore the relationship between age at menarche and lifetime psychopathology within BD.

The study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.

Age at menarche in BD patients was similar to that in controls. After covarying for confounders, we observed that age at menarche is negatively related to number of previous depressive episodes in euthymic BD patients, but not other indicators of lifetime psychopathology.

BD patients with earlier age at menarche are more likely to present with more depressive episodes in the course of illness. Systemic, longitudinal monitoring of the course of illness, and potential hormonal fluctuations within particular groups of patients are warranted.

The authors have not supplied their declaration of competing interest.

Compassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.

The aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.

Using a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.

Results showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.

These findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.

The authors have not supplied their declaration of competing interest.

Asenapine is the most recent compound that hasbeen FDA- and EMA-approved for treatment of mania. Its efficacy and safety havebeen assessed in placebo-controlled trials, but little is known about itsperformance in routine clinical conditions. The MANACOR study assessed costsassociated with treatment of mania in several hospital settings acrossCatalonia, Spain. As part of the protocol, we compared cost-effectiveness ofasenapine versus other treatment options.

A combined prospective and retrospective datacollection and analysis was conducted from January 2011 to December 2013following a clinical interview and assessment of manic and depressive symptoms(YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST),sexual dysfunction (PRSexDQ) and health resource costs associated withtreatment with asenapine versus other antipsychotics.

152 patients from different university hospitalswere included. 53 patients received asenapine and 99 received otherantipsychotics. Considering inpatients (N=117), those treated with asenapinepresented a significantly less severe manic episode (p=0.001), less psychoticsymptoms (p=0.030) and, more comorbid personality disorder (p=0.002). Regardingoutpatients, those treated with asenapine showed significantly less severemanic episode (p=0.046), more previous mixed episodes (p= 0.013) and, moresexual dysfunction at baseline (p=0.036). No significant differences were foundin mean total costs per day.

Non-randomized study design.

Clinicians tended to use asenapine in patientswith less severe manic symptoms but more complex clinical profile, includingmore mixed episodes in the past, concomitant personality disorder, and sexualproblems. Treatment with asenapine was not associated with higher costs when comparedto other options.

Anorexia nervosa (AN) is showing the highest mortality in psychiatric illness, especially because of its somatic consequences. A special program for refeeding patients with extreme severe underweight has been established in Munich.

From 2000–2010 about 80 patients with any eating disorder were admitted. Data of 53 patients with AN were analysed. After admission most of the patients (n = 43) received a percutaneous gastric feeding tube. A high caloric solution (Fresubin energy) was administered adjusted to bodyweight aiming a weight gain of 700–1000 g per week. After reaching BMI 17 most patients were send for illness specific psychotherapy to a specialized clinic.

The sample consists of 50 (94.3%) females. Patients were diagnosed as having AN restrictive subtype in 25 cases (47.2%), AN binge/purge subtype in 24 cases (45,2%) and AN purging subtype in 4 cases (7.6%). Mean age at admission was 25.4 years (SD 7.0) and mean duration of illness until admission was 8.4 years (SD 5.7). Average length of stay in the intensive care unit was 135 days (SD 79.4). Mean BMI at admission was 12.3 (SD 1.6) and mean BMI at discharge 16.6 (SD 1.6). Thus, mean weight increase was 11.4 kg (SD 5.4).

This intensive care program was established to enable patients with extreme severe AN to participate in psychotherapeutic programs afterwards as it was reported that cognitive function changed in regard to bodyweight. Further evaluation has to consider the occurrence of a refeeding syndrome.

Socio behavioral consulting centers offer Methadone maintenance therapy which is a very useful method for drug dependents. These centers offer a wide range of services like education, consulting, prevention, take care of patient, and treatment for high risk groups like patients infected with AIDS. MMT is helpful in harm minimization and increases quality of drug dependent’s life, so as a result reduces infection in HIV patients.

This study intends to investigate importance of MMT on harm minimization between opioid dependents in Kerman.

The study was cross sectional and descriptive and it was done on 110 patients referred to sociobehavioral consulting centers no.1 and no.2 in Kerman city in 2005 and 2006. Data was gathered by questionnaires once on the beginning of the treatment and once 6 months after. Then data was analyzed by SPSS13 and chi square test.

MMT results in a reduction of 97.3% of common injections and 96.4% of police arresting to imprisonment and 80% in family problems and 68.2% drug abuse and negative morphine test in these centers. Also after 6 months of treatment, drug consumption expenses were lowered.

This study showed that the treatment with MMT in social behavioral consulting centers reduced dangerous behaviors and increased quality of life and controlled the transmission of Dangerous Diseases such as AIDS, Hepatitis and etc in the community.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

This study examines the association between the incidence of drug abuse (DA) and linking (communal) social capital, a theoretical concept describing the amount of trust between individuals and societal institutions.

We present results from an 8-year population-based cohort study that followed all residents in Sweden, aged 15-44, from 2003 through 2010, for a total of 1,700,896 men and 1,642,798 women. Social capital was conceptualized as the proportion of people in a geographically defined neighborhood who voted in local government elections. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance.

We found robust associations between linking social capital and DA in men and women. For men, the OR for DA in the crude model was 2.11 [95% confidence interval (CI) 2.02-2.21] for those living in areas with the lowest vs. highest level of social capital. After accounting for neighborhood level deprivation, the OR fell to 1.59 (1.51-1-68), indicating that neighborhood deprivation lies in the pathway between linking social capital and DA. The ORs remained significant after accounting for age, family income, marital status, country of birth, education level, and region of residence, and after further accounting for comorbidities and family history of comorbidities and family history of DA. For women, the OR decreased from 2.15 (2.03-2.27) in the crude model to 1.31 (1.22-1.40) in the final model, adjusted for multiple neighborhood-level and individual-level variables.

Our study suggests that low linking social capital may have important independent effects on DA.

A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis.

The major objective for the CapOpus trial is to evaluate the effects of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual compared with just treatment as usual.

The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are recruited through teams for early detection of people with psychosis, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months:

1. 1. specialized addiction treatment plus treatment as usual or

2. 2. treatment as usual.

The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case-manager of the patient.

The primary outcome measurement will be amount of reduction in cannabis consumption. other outcome measures will be improvements in psychosis symptoms, cognitive functioning, quality of life and social functioning, and cost-benefit of the treatments.