To determine the association between functional impairment, as reported in a lay-administered structured interview (CIDI), and severity of depression, depressive symptoms and risk factors for depression.

We undertook a cross-sectional study of 5442 consecutive attendees at general practices in seven Spanish provinces participating in the PredictD-Spain study on predictors of depression. Participants were administered the depression section of the Composite International Diagnostic Interview (WHO-CIDI 2.1), allowing diagnoses by the ICD-10 and DSM-IV classifications for depressive episodes. Impairment was measured using the CIDI question about whether symptoms seriously interfered with important areas of functioning, such as work or looking after the house and family. We measured a set of 39 known risk factors for depression.

Firstly, the 6-month prevalence of a depressive episode according to ICD-10 was 28.7% (1563) and of major depression according to DSM-IV it was 13.6% (742). Secondly, out of the 1563 patients with a depressive episode according to ICD-10, nearly half (47.9%; n=749) had no impairment in important areas of functioning.

As the ICD-10 criteria for depressive diagnoses do not include the criteria that symptoms cause impairment in social, occupational or other important areas of functioning, a large number of false positive cases are included in reported prevalence rates; and secondly, the measurement of functional impairment, at least operationalized using a lay-administered structured interview such as CIDI, is not enough, in epidemiological research studies, to assess the clinical importance of depressive symptoms.

Long-term follow-up of the patients suffering of combat-related traumatic stress revealed that co-occurence of Posttraumatic Stress Disorder (PTSD) and Mild Traumatic Brain Injuries (TBI) proved to be “the rule rather then exception”.

The aim of the paper was to determine the possible influence of the mild TBI on the severity and on the duration of the PTSD.

Totaly 60 patients suffering of PTSD were assessed and divided in two groups: with mild TBI and without the history of head trauma. The presence and the severity of the PTSD and TBI were assesed using following instruments: The Clinician-Administrated PTSD Scale for DSM-IV (CAPS-DX) and Glasgow Coma Scale, respectively.The differences between groups were evaluated using Student t test

Results obtained showed that two groups differed significantly on the following items of the CAPS score: total severity, severity of the D cluster, functional deficits, and duration of symptoms.

Mild TBI might influence on the clinical course and severity of the PTSD, by diminishing the capacity to employ cognitive resources that would normally be engaged in problem-solving and regulationg emotions after trauma and leaving the individual more helpless and susceptible to persistent trauma related psychopathology.

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is a cerebrovascular disease, tht appears in 1.98/100,000. It´s caused by a mutation of the Notch3 gene and is characterized by accumulation of granular osmiophilic material in the middle layer of the small and median sized cerebral arteries.

Sypmtoms are migraine, recurrent cerebral ischemic episodes, dementia, neuropsychiatric disorders (anosognosia, character disorders, apathy and cognitive impairment). It usually appears between 30-60 years, although there is an important variability. There is no curative treatment, only palliative.

Clinical review of anosognosia and its presence in CADASIL disease.

Clinical case and literatura review.

We presented the clinical case of a 68-year-old man, who was diagnosed with CADASIL after a stroke 3 years earlier. In his family, his brother was diagnosed also with CADASIL. The patient had previously presented disturbances in impulse control (hyperorality) and important executive failures. He currently presented anosognosia, deficits in verbal memory, spatial perception and executive functions, in addition to behavioral alterations and apathy. Due to these deficits he was prohibited from certain activities (driving, hunting).

The patient was not aware of these deficits and becouse of his “no knowledge of his illness”, he disagreed with these prohibitions, so he showed rage and anger at the impotence of not understanding why certain actions are prohibited.

In the consultation, mnesic errors and in naming objects were also objectified, for which it was recommended to carry out cognitive stimulation on a daily basis. In addition, he presented failures of sphincter incontinence, especially of urine and occasionally also of the anal sphincter. He had previously had episodes of myoclonus or fasciculations.

A genetic study by massive sequencing confirmed the heterozygous presence of the pathogenic variant c.1819C>T p.(Arg607Cys) in the NOTCH3 gene, a CADASIL disease.

The anosognosia that many patients with CADASIL disease present constitutes a problem because it contributes to the delay in consultation and, therefore, the delay in the adequate diagnostic approach, therapeutic possibilities and family genetic counseling. Due in part to anosognosia, CADASIL is considered an underdiagnosed entity. Due to the lack of awareness and the consequent lack of recognition of the deficit, these people are often seen as stubborn and difficult to deal with by people in their immediate environment.

In addition, there is general difficulty in the rehabilitation process, since patients do not think the neccesity to be treated. This can generate frustration and despair both in their relatives and in the health personnel.

For all these reasons, both in anosognosia and in CADASIL disease, adequate psychological support is needed for both those affected and their families.

None Declared

An increasing number of young people in Sweden are diagnosed with mental disorders and there appears to be significant gender differences in disease pattern.

To more thoroughly characterize the increase in mental disorders among young people with focus on gender differences.

To increase the knowledge of age and sex-specific trends in incidence and prevalence rates of mental disorders among children and adolescents.

Data on psychiatric diagnoses for the last 10 years were obtained from Swedish national registers held by the National Board of Health and Welfare in Sweden.

Neuropsychiatric, depressive and anxiety disorders have increased markedly among young people the last decade. In addition, men are increasingly diagnosed with substance-related disorders whereas women with borderline personality disorder.

The increase in mental disorders among young people is marked and disease affects men and women differently. Because of greater awareness today, some conditions like ADHD are more frequently diagnosed. However, the increase in depressive and anxiety disorders appears genuine and represents an additional challenge.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

The capacity to accumulate information over time is crucial to our functioning in an ever-changing world. Recently, in healthy subjects, we showed that brain uses a distributed and hierarchical network of brain areas to process information over time. Specifically, we revealed hierarchy of information processing over time from early sensory areas toward high order perceptual and cognitive areas. Here, we investigate this issue in first-episode schizophrenia patients.

Previous studies posited that schizophrenia is the result of impairment of hierarchical temporal processing by the brain, claiming for impairment in use of context while being processing information. The hierarchical temporal deficit is a fundamental trait that may be a better target for the study of etiology and pathophysiology of the disease.

We intended to map, in schizophrenia patients, the topographical organization of temporal scales using an ecologically relevant auditory stimulus - a real-life story. In addition, we assumed that studying healthy siblings, who are at high-risk for cognitive dysfunctions, will enable to determine functional neuromarkers of predisposition to disorder.

The fMRI data were analyzed using inter-subject correlation approach. The time-courses within each brain area in schizophrenia patients were estimated against healthy controls and unaffected siblings of the patients.

Among patients, we observed impaired hierarchy with processing intact in low level but disturbed in high level. The sibling group showed an intermediate effect.

Better understanding of the underlying neural circuit involved in information processing in schizophrenia patients may assist in early identification of functional neuromarkers for the disease.

During the Eye Movement Desensitization and Reprocessing (EMDR) changes of brain electrical activity was recently demonstrated in victims of psychological traumas.

Thirty-one victims of psychological traumas were investigated at the first EMDR session (t0) and at the last one performed after processing the index trauma (t1).

To investigate differences in EEG source activity and EEG source functional connectivity (EEG-SFC) in eyes closed condition before the beginning of t0 and t1 EMDR therapy session.

Electrical source activity was computed by eLORETA from a 37-channel EEG. EEG-SFC analysis was based on the lagged phase synchronization (LPS), derived by a two-step eLORETA procedure: dimensionality reduction of inverse matrix from 6239 voxels to 28 regions of interest (ROIs); LPS indices computation, for each spectrum band, in all possible ROI pairs.

Resting-state EEG source activity resulted in a low frequency increase of posterior cingulate cortex and a high frequency (beta2 and gamma) decrease in right prefrontal and parietal cortex between t0 and t1. Significant enhancements of EEG-SFC were detected in t1 respect to t0 between ROI pairs of theta band right temporo-parahippocampal regions and alpha band fronto-parietal regions.

Significant modifications of resting-state electrical brain activity were present after EMDR therapy. These findings suggest that the elaboration of psychological traumas induced by EMDR produces, in a resting-state condition, an enhancement of activity and functional connectivity of cerebral sources involved in cognitive control and emotional processing.

Reactivity to acute psychosocial stress in the framework of a physiological multidimensional pattern affects several individual-level systems that include genetic factors and features related to personality development. The 5-HTTLPR genotype has been implicated in the modulation of susceptibility to environmental stimuli.

In the present study, 91 healthy young women were investigated (i) for their reactivity to a standardized psychosocial laboratory stressor (TSST), as measured by changes in salivary cortisol; (ii) in terms of 5-httlpr genotype and (iii) in terms of their personality profile according to the post-rationalist personal meaning organizations (PMOs), which are considered as adaptive modes of response to environmental stressors.

Participants were divided into three 5-HTTLPR genotype groups (s/s; s/l, and l/s). The quantitative and qualitative variables that may affect circulating cortisol were compared among the three groups. A multiple linear quantile regression analysis was then performed to evaluate the effect of the personality profile, as Outward/Inward PMO, and 5-HTTLPR genotype on the median level of cortisol, considered as dependent variable.

Comparison of the variables that may affect circulating cortisol no significant differences. Salivary cortisol changed significantly in the course of the TSST. Reactivity to stress was affected by personality profile and the 5-HTTLPR genotype and also by body mass index and age.

The present data suggest that the psychosocial stress response is a multidimensional physiological event that is affected by a variety of factors as diverse as 5-HTTLPR genotype, personality profile, BMI, and age.

The authors have not supplied their declaration of competing interest.

Schizophrenia can impair functioning and have serious individual and societal impact. Non-adherence rate to anti-psychotics is high due to side effects, raising the importance of adjuvant therapy. Artistic creation can help the patients expressing their illness experience and finding some order in their chaotic psychotic world.

To determine the differential effects of group art therapy on clinical symptoms and cognitive functions.

1. - Techniques taken from both art therapy and art expression provided as 24 group therapy sessions (2 sessions per week).

1. - Symptoms severity measured by the Positive and Negative Symptom Scale (PANSS)

2. - Executive functions and set shifting measured by Wisconsin card sorting test (WCST)

3. - Visual attention and task switching measured by the Trail making test

1. - Post treatment results showed significant decrease in PANSS sub-scales (positive p < 0.0001, negative p < 0.001, general p < 0.001, total p < 0.0001)

2. - Also significant increase in cognitive biases in WCST (number of categories) p < 0.05 and significant decrease in WCST (failure to maintain set) p < 0.01 and trail making B test (time spent p < 0.003 and number of errors p < 0.001)

Symptom severity and cognitive functions in stable schizophrenia can improve when art expression and therapy are provided.

Our aim was to investigate how age of achieving early motor developmental milestones differ among subjects with and without a history of parental psychosis and whether parental psychosis may alter the effects of the age of achievement on the risk of schizophrenia.

The study sample comprised 10,307 individuals from the prospective Northern Finland Birth Cohort 1966. A total of 139 (1.3%) cohort members suffered from schizophrenia by the age of 46 years. Out of them 19 (13.7%) had a parent with a history of psychosis, while among the non-psychotic cohort members this figure was 524 (5.2%).

Out of eight different motor milestones investigated, parental psychosis associated (p>0.05) with later learning of holding head up, grabbing object, and walking without support. In the parental psychosis group, significant risk factors for schizophrenia included later learning of holding head up and touching thumb with index finger. In the non-parental psychosis group risk estimates were lower and statistical significant milestones were different i.e. turning over, sitting without support, standing up, standing and walking without support. Interactions between parental psychosis and touching thumb with index finger and walking without support was found.

Although parental psychosis associated with delays in motor milestones in the first year of life, it does not explain the association between late achievement of motor milestones and later risk for schizophrenia

Internet addiction(IA) has been proposed to separate into three subtypes, gaming, sexual preoccupation and email/text messaging and since use for social networking has increased significantly it may represent a fourth subtype in this model.

To examine the effect of more than two hours/day use of the social networking with facebook application, in relation to negative emotions of depression, anxiety and stress.

To estimate the possibility of this use in leading to negative emotions.

257 adults(17-68 years old, Mean age=33.1±10.1; 76(29.6%) males and 181(70.4%) females) took part in the study. An online form of Depression Anxiety Stress Scale (DASS) was used for measuring negative emotions as well as sociodemographic characteristics. Statistical analysis was performed with SPSS 21.

Statistical significant differences were found between males(x=14.8±8.4) and females(x=18.5±9.9) in stress(t=2.886 p=0.004). Multivariate analysis revealed that age(beta=.143) and social activity(beta=.123), explained 18% of the variance in depression(adjusted R2=.188- p=0.028). In stress and anxiety, social activity(beta=.177 and .130) and education(beta=-.170 and -.216), explained 23% of the variance (adjusted R2=.231-p=0.004) and (adjusted R2=.239-p=0.037) respectively.

Odds ratio of depression for those who used the Internet for more than two hours/day was: OR=1.0254(95% CI:0.5682-1.8504 p = 0.9337), for stress OR=0.7826(95% CI:0.4352-p= 0.4130) 1.4074 and for anxiety OR=1.1140(95% CI: 0.6200- 2.0018 p=0.7180).

Results suggested that social networking users who are initially free of mental health problems but use the Internet pathologically do not develop negative emotions as a consequence especially when they have social activities as a protective factor.

Analysis data of sexual behaviour and sexual attitudes of adolescents in Serbia and Montenegro in context of traditional sexual upbringing and social transition.

The sample contained 203 participants, 101 males and 102 females, the age from 18-24, from Serbian language speaking area (Serbia, Montenegro, Republic Srpska). As an instrument of the research we used “Sexual Behaviour” questionnaire specially constructed for a National study of Serbian sexual behaviour. For our research we used questions about sexual behaviour divided in 5 parts: foreplay, coital behaviour, masturbation, sexual fantasy, sexual dreams, which we were statistically compared with 9 factors of sexual attitudes detached by factorial analyses.

Our findings showed that males have had significantly more coital experience than females (p<0,001), earlier beginning of coital activity (17,32±2,25yrs. vs. 19,78±2,73yrs, p<0,001), more sexual partners in general (5,4±7,6 vs. 1,7±1,5, p<0,001), more sexual partners in last month (1,7±1,7 vs. 0,7±0,7, p<0,001) more frequently masturbation (p<0,01), more dreams and fantasies about coital interactions, then females (p<0,001). But, males has less liberal sexual attitudes than females (p<0,001).

On the basis of received data, we concluded that sexual behaviour is in agreement with biological influences on genders and their social roles. We think that our findings showed hesitancy in adolescents to admit to having sexual experiences in context of social undesirable premarital sex. Regarding to contradiction of sexual attitudes and beginning of sexual activity we conclude that sexual attitudes are relatively changeable category then sexual behaviour, which is relatively stabile category.

Constipation is a very common and one of the most persistent side effects of opioids. In many cases constipation causes severe discomfort and puts limitations on methadone maintenance treatment (MMT). Conventional laxatives are not always effective and do not address the pathophysiological basis of constipation. It was suggested that opioid receptor antagonists with low oral bioavailability e.g. naloxone might reverse constipation while not affecting the course of MMT.

The aim of the study is to assess the feasibility and effectiveness of oral naloxone for methadone-induced constipation in MMT patients.

1. 1. To assess the changes in bowel functioning in constipated patients receiving oral naloxone

2. 2. To describe the opioid withdrawal symptoms due to oral naloxone administration

3. 3. To evaluate the changes in quality of life in patients receiving oral naloxone

Randomized placebo-controlled trial (n=20).

Five patients were enrolled into the study. All of them completed the 16-day study protocol. Mild opioid withdrawal symptoms (perspiration) that lasted for several hours were observed once in 3 out of 5 patients and did not affect the MMT. Constipation reversal was achieved in 4 out of 5 patients as well as significant reduction of laxative use. Over the course of the study substantial improvement in quality of life was observed in those patients whose constipation was relieved.

The preliminary results indicate that oral naloxone is a feasible treatment for constipation in MMT patients. Definite conclusions and evaluation of placebo effects will be possible after completion of the study and unblinding.

There is growing international interest in cross-cultural research of depressed patients to contribute to the aetiology discussion of the disorder and to find culture specific treatment strategies.

The aim of this study is to investigate the psychodynamic conflicts and structures of Chinese and German depressed patients and their influence on symptomatology.

A total of 111, SCID-I assessed depressed patients (57 Chinese and 64 German patients) were included in this study. the Beck Depression Inventory (BDI) and the conflict and the structure axes of the Operationalized Psychodynamic Diagnostics (OPD-2) were applied for evaluating the severity of the symptomatology and the psychodynamic profiles, respectively.

After controlling socioeconomic factors (age, gender, familial status and employment) German patients compared with Chinese patients showed significantly lower BDI total scores (24.16 ± 8.67 vs. 28.66 ± 11.01, p < 0.05). in terms of the OPD-2 parameters, German patients suffered from more frequent conflicts like the “desire for care vs. self-sufficiency conflict” (1.84 ± 1.13 vs. 1.12 ± 1.07, p < 0.01) as well as the “guilt conflict” (1.02 ± 0.85 vs. 0.65 ± 0.95, p < 0.05). in contrast, we found more frequent “dependence vs. individuation” conflicts in the Chinese sample compared with German patients (1.21 ± 1.19 vs. 0.78 ± 0.98, p < 0.05). there was no relationship between the psychodynamic profiles and the symptoms’ severity.

The findings suggest more culture specific psychodynamic psychotherapy strategies for depressed patients coming from different countries and cultures.