Demographic changes with the aging of the worldwide population imply an increase in prevalence of chronic diseases, such as diabetes mellitus. Many studies have suggested that depression is higher in diabetic patients, and that this association often contributes to under-recognition of the illness, limiting adequate metabolic control.

To study the association between depression and adherence to treatment in elderly diabetic patients.

A cross-sectional study was conducted with elderly outpatients (≥65 years) from the Internal Medicine Department in São João Hospital (CHSJ, Porto). Patients unable to communicate were excluded. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale/HADS, and adherence to treatment with a clinical interview and from medical records.

The final sample included 78 patients, with an average of 75.3 (sd = 6.75) years. They were mostly female (80%), married (66.7%) and with low education level (62.8%). The mean number of comorbidities was 5.76 (sd = 1.6) and 98.7% took ≥5 drugs. In this sample, 23.1% had cognitive impairment, 16.7% depression and 24.4% anxiety. Patients not adhering to treatment presented a higher depression score, when compared with adherents (median 6vs3), even without statistical significance (P = 0.56).

Diabetic patients not adhering to treatment tend to present more depression, in spite of the lack of statistical significance. These results suggest that depression can limit the adherence to treatment, which is in line with previous studies. In this context, the early diagnosis and treatment of depression seems to be an important target in the management of diabetes, particularly in elderly patients.

The authors have not supplied their declaration of competing interest.

The major objective of current study is to assess the level of job burnout among librarians of public libraries in the city of Ardabil in Iran and to exposure the relationship demographic difference and the level of occupational burnout. all librarians working in the public libraries of Ardabil were requested to complete the Maslach Burnout Inventory (MBI),

The questionnaire of Maslach Burnout Inventory (MBI) was administered among all librarians working in the public libraries of Ardabil city in Ardabil province of Iran.

All 51 librarians working in the public libraries of Ardabil were taken into consideration in the study. the response rate was 100%.

A total number of 51 librarians returned the fulfilled questionnaires (response rate, 100%). Analysis of data showed that the librarians experienced low level of emotional exhaustion and moderate levels of depersonalization and personal accomplishment. Regarding to the background characteristic the findings indicated that there is no relation among age, occupied duration as well as the level of education, but there was significance correlation between marital status and the level of job burnout.

The study indicated that at least a low level of emotional exhaustion was relatively common among public librarians in Ardabil city of Iran. There was difference level of occupation burnout between men and women; the level of job burnout among married women was higher than the married men. This pheromone seems to be due bidimensional responsibility of women in house and in office.

There are high rates of substance use disorders (SUD) amongst first episode psychosis (FEP). SUD have been linked to better premorbid adjustment, more severe positive and negative symptoms at presentation and poorer symptomatic and functional outcome [1]. Moreover, shorter duration of untreated psychosis (DUP) has been described as an important predictor of outcome in FEP [2].

With this study, we want to know which baseline characteristics and clinical outcomes differ between FEP patients with and without substance use.

One hundred and seventy-five FEP were consecutively admitted to Hospital del Mar since January 2008 to September 2014 and entered the FEP programme of the institution. The included evaluation was socio-demographic and clinical data at baseline and 1 year follow-up. We studied differences in age, gender, DUP, GAF scores at baseline and 1 year follow-up and PANSS subscale scores at base and 1 year follow-up between substance users and non-users.

Cannabis: we found that users were significative younger (P < 0.01), had a higher proportion of males (P < 0.01) and a significative shorter DUP in users (P = 0.008).

Alcohol: we found that users were significative younger (P < 0.009), had a higher proportion of males (P < 0.003) and a significative lower PANNS negative scores at baseline (P = 0.01) and 1 year follow-up (P = 0.03).

In our sample of first episode psychosis, cannabis and alcohol use is linked with a younger age and a high proportion of males. Moreover, it seems that cannabis use could be associated with a shorter DUP.

References not available.

The authors have not supplied their declaration of competing interest.

Venlafaxine is a serotonin-norepinephrine inhibitor, mainly metabolized by CYP2D6 to its active metabolite ODV. Depending on CYP2D6 activity, patients may be identified as Poor, Intermediate, Extensive or Ultrarapid Metabolizers. There is some evidence that a PM phenotype is associated with poor tolerance more often than an EM; while a UM patient would only respond to a greater dose of Venlafaxine1.

To evaluate the impact of CYP2D6 phenotype on the efficacy of Venlafaxine XR in depressed patients.

This observational study evaluated 27 Caucasian adult patients (F = 18, M = 9), satisfying DSM-IV criteria for Major Depressive, Bipolar Disorder or Personality Disorder receiving treatment with Venlafaxine 75–300 mg/die.

CYP2D6 alleles were evaluated with INFINITI CYP2D6 assay, which employs AutoGenomics proprietary film-based microarray technology.

Most patients were identified as EMs, 4 as PMs, while only one was identified as UM. The only statistically significant difference between Extensive and Poor Metabolizers was, in contrast with current literature, the need of a greater mean dose of Venlafaxine in the second group (225 mg/die vs 159.38 mg/die, t student: p = 0.01).

Likewise, in contrast with literature, the UM patient was responsive to average doses of Venlafaxine.

On the contrary, we found no statistically significant differences as far as efficacy, adverse events or duration of treatment are concerned.

In our sample, CYP2D6 metabolizer status does not seem to affect treatment response nor adverse events related to Venlafaxine.

Addressing the interaction between mental and physical health to provide more integrated healthcare has been highlighted as an international priority for health and education systems. Educational interventions focusing on multi-disciplinary, interprofessional approaches to integrated mental and physical healthcare are an essential part of transforming health systems. Simulation training is one tool by which such training can be delivered, in contrast to traditional teaching methods. However, simulation training can be high-cost and clarity over the impact is required.

To compare simulation training for integrating mental and physical health to role-play and didactic teaching, on their effect on confidence, knowledge, and attitudes of participants.

Participants in simulation training (n = 24) and role play plus didactic teaching (n = 87) both completed self-report measures of confidence and knowledge in working with mental and physical health needs, as well as the Readiness for interprofessional learning scale (RIPLS) collecting attitudes towards interprofessional collaboration. All participants also completed post-course qualitative feedback form with open questions.

T-tests found statistically significant increases in confidence and knowledge following both educational interventions. T-tests showed statistically significant increases in attitudes to interprofessional collaboration (RIPLS) following simulation training, while there were no statistically significant changes after role-play and didactic teaching. Thematic analyses of post-course open questions demonstrated differing learning outcomes.

Simulation training appears to have a different and beneficial impact to role play and didactic teaching alone, when training participants on integrating mental and physical health.

The authors have not supplied their declaration of competing interest.

Clinical and experimental findings suggest that Obsessive-Compulsive Disorder (OCD) is due to an abnormality of the cortico-striato-thalamo-cortical circuit. Bradykinesia and mental slowness can be present in patients with basal ganglia disorders affecting the cortico-striato-thalamo-cortical circuit. Aim of this study is to investigate whether bradykinesia and mental slowness are present in patients with OCD.

Participants comprised 19 non-depressed anti-psychotic free patients with OCD.

Bradykinesia was assessed with the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). Mental slowness was investigated with the WAIS-R and the Y-BOCS. Psychiatric evaluation was performed with: SCID-I, Y-BOCS, HAMD, HAM-A, and MMPI. Cognitive functions were assessed with the WAIS-R.

Bradykinesia and mental slowness were present respectively in the 39% and 89% of the patients. Bradykinesia was positively correlated to Y-BOCS mental slowness score (rho=0.48, p< 0.05), and inversely related to the WAIS-R Performance IQ score (rho=-0.65, p< 0.01). Patients with bradykinesia scored significantly lower in the Similarities and Digit symbol coding WAIS-R subscales as compared to non-bradykinetic patients. in our sample pathological doubt was not associated with IQ measures nor with bradykinesia. Twelve out of 19 patients (63%) showed impairments in the nonverbal function scores.

The novel findings of this study is that bradykinesia can be present in patients with OCD, and it is correlated with mental slowness and nonverbal performance impairment. These preliminary data support the notion that dysfunction of basal ganglia is possibly present in OCD patients.

The author declares that he has no competing interest.

Emotional avoidance is a target process, offered by modern psychotherapies. Emotional exposure is often difficult to put in place when there is a major cognitive and behavioral avoidance. Education on emotional processes is necessary but often insufficient during individual follow-up.

The longitudinal study seeks to verify whether work on exposure and emotional identification influences the decreased level of anxiety and depression.

Introduction of interoceptive exposition in psychotherapy decreases the frequency of emotional avoidance.

Group psychotherapy composed of two modules: interoceptive exposure and emotional identification was proposed to patients with anxiety and depressive disorders. A group of 6 participants was evaluated at three times: T0 before the start of the group, T1 post-module 1 and T2 post-group. Assessments of HAMA anxiety, MADRS depression, QEC cognitive avoidance, UPPS impulsivity, MCQ-30 metacognition and emotional regulation REQ-21 have been proposed.

Significant differences were observed between pre- and post-intervention scores (Friedman test). The HAMA anxiety rate (P = 0.006) and the MADRS depression (P = 0.047) decreased. Participants in the group were less likely to use QEC thought substitution (P = 0.009) and urgency in their UPPS reactions (P = 0.03). Moreover, their external dysfunction REQ. 21 decreases (P = 0.03).

Faced with emotional avoidance, work on emotional identification requires prior interoceptive exposure. It is a first stage of work that involves sensitizing to the presence of emotional bodily sensations. Group work facilitates exposure to emotion and its identification; decentration leading to emotional intensity decrease. The work on the interoceptive exhibition facilitates the emotional exposure while participating in the deactivation of the associative emotional network.

The authors have not supplied their declaration of competing interest.

In the recent decades, there is a growing interest in gender differences in psychotic disorders. Also, in the field of acute and transient psychosis, according to various studies, women seem to have higher prevalence and long-term diagnostic stability.

To determine whether there are gender differences in clinical features of acute and transient psychotic disorders (ATPD).

Descriptive cross-sectional study in the adult patients with ATPD were admitted between 2011 and 2015 in our acute psychiatric ward. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Descriptive and inferential statistic procedures for clinical symptoms and diagnostic subcategories were performed, using the MedCalc software, version 15.8.

Thirty-nine patients met the inclusion criteria. Males were (MG) 41%, females (FG) 59%. There were some statistically significant differences between gender in the polymorphic features group (>FG, P = 0.048), and in the presence of acute stress (>FG, P = 0.0277). Length of stay was also different, but without statistical significance (>MG, P = 0.0607). In contrast, symptomatic sets, family history of psychosis, and type of onset (sudden or acute) were similar for both groups.

The gender differences seem to be in favour of a higher prevalence of polymorphic psychotic symptoms, in relation to stressful events in women. Somehow, these factors could be a condition, which would determine a greater diagnostic stability in female patients, even in cases of recurrences.

The authors have not supplied their declaration of competing interest.

The caregivers of the psychic patients experience decreased quality of life (QOL).

The aim of this study is the determination of the effect of coping skills training on improved quality of life of these caregivers compared to traditional treatments.

The samples consisted of 82 caregivers of psychiatric patients who were admitted in the educational hospital of Tehran for the first time from 2015 to 2016. The caregivers were randomly divided into two groups including Interventional group (n = 41) who received an educational booklet in addition to coping skills training, and control group (n = 41) who received usual care. A two-group randomized controlled trial was conducted, including WHOQOL-BREF questionnaire used to collect the data before and after 90 days.

The results demonstrated that there were significant changes in the quality of life of family after training (P = 0.05). But this change was not seen in the control group. The comparison of the two groups after intervention indicated, that the scores of the intervention group were higher than the control group in all dimensions. But these scores were significantly different in the psychological health and the environmental health.

To educate the coping skills interventions can have a positive effect on the quality of life of caregivers than usual care.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

To identify possible differences in the ways that women and men are first texposed to drugs, in thier risks of abuse and the pattern of drug dependence.

Four hundreds and fifty seven of drug dependence who attended Outpatient clinic of Neuropsychiatry Department in Tanta University Hospital along the period from june 2006 to june 2009 were classified into two groups according to gender. The two groups (319 males and 138 females) were assessed using DSM IV structured interview and compared together regarding; age, age of starting drug use, duration of abuse, educational level in years, occupation, marital status, first drug used, number of abused drugs, route of use, possible risk factors, causes of asking help, numer of previous treatment trials and comorbid psychiatric disorders.

Males started drug abuse earlier in age than females with longer duration of addiction. Single males are more vunerable to abuse specially in illitrate group. Drug abuse is more common in female students and in male workers. Drugs that are more commonly abused by males are cannabis followed by opiates then alcohol while in females Tramadol ranked first followed by followed by anticholinergics then cannabis. Peer pressure was the most common motivating factor for drug abuse in males contrary to family troubles and sexual abuse in females. Anxiety disorders are more common in females while depressive disorders were common in males.

Gender differences in drug abuse stresses the importance of strategies of treatment, motives for treatment and prevention of drug abuse in females.

Negative symptoms (NS) of schizophrenia were usually described as a unitary construct and as a separable domain of pathology; however recent studies suggest, that they encompass 2 separable domains: Diminished Expression (DE) and Avolition-Apathy (AA). Research into the relationship between internalized stigma and NS have yielded mixed results up to present.

The objectives of this study was to assess the factor structure of NS and to examine the relationship between these factors and internalized stigma, global functioning and sociodemographic characteristics.

The broad aim of this study was to gather greater understanding of the relationship between internalized stigma, NS and global functioning.

A sample of 50 consecutive subjects were recruited from outpatient psychiatric hospitals meeting the criteria for schizophrenia according to ICD-10. The patients were evaluated using the Positive and Negative Symptoms Scale (PANSS), Negative Symptoms Assessment-16 items (NSA-16), Global Assessment of Functioning (GAF), Clinical Global Impression-Severity Scale (CGI-s), Internalized Stigma of Mental Illness Scale (ISMI) and were interviewed to assess sociodemographic characteristics.

A two-factor structure for the domain of NS was found: an AA and DE profile group. AA and DE subgroups significantly differed on clinically relevant external validators and greater resistance to stigma is related to both fewer AA and DE symptoms in people with schizophrenia.

Our findings suggest that the different subdomains of NS can be identified within the broader diagnosis of schizophrenia and that they should be analyzed as distinct domains and that stigma resistance can be a possible intervention target to ameliorate NS.

The authors have not supplied their declaration of competing interest.

Primary care providers are the main source of mental health services for the majority of patients around the world. Therefore providing continuous mental health education to primary care providers can positively affect health outcomes.

To develop and test creative mental health educational initiatives for primary care audience.

To enhance primary care providers’ knowledge and awareness of countertransference reactions.

A half-day workshop was designed with the emphasis on education about countertransference reactions that “difficult” patients invoke. Case examples encouraged reflection and reframing the problem from “difficult” patient to “difficult” clinician-patient interaction. Pre-, post-workshop and satisfaction evaluation questionnaire were done.

Participants were highly satisfied with the workshop. Their self-perceived knowledge of transference and countertransference and strategy to manage difficult encounters improved post workshop.

Educating primary care providers and building their skills will improve clinician-patient encounters and health outcomes.