In Japan, a lot of people used to be prejudiced against gay men, lesbians or bisexuals despite the fact that “homosexuality” as a category was eliminated from diagnostic criteria. Still, there is little investigation into the relations between individual's personality and the attitudes toward homosexuals.

A total of 164 heterosexual students of health and welfare (91 men and 67 women) with a mean age of 19.7 (SD = 1.0) years participated in the questionnaire survey. They were asked to complete the Index of Attitudes toward Homosexuals (IAH) and a short form of Five Factor Personality Questionnaire as well as an inquiry about their encounters with homosexuals.

Factor analysis of IAH resulted in three-factor solutions with factors identified as “avoidance of homosexual neighbors”, “avoidance of contacts with homosexuals” and “avoidance of approach from homosexuals”. Logistic regression analysis showed that “encounters with homosexuals” (=yes, OR = .15, 95%CI: .05–.46) and personality traits such as “extroversion” (OR = 1.12, 95%CI: 1.05–1.19), “emotionality” (OR = 1.14, 95%CI: 1.07–1.21) and “playfulness” (OR = .85, 95%CI: .79–.93) were predictors of “avoidance of homosexual neighbors”. Similarly, “avoidance of contacts with homosexuals” was associated with sex (=male, OR = 2.73, 95%CI: 1.38–5.42), “extroversion” (OR = 1.05, 95%CI: 1.00–1.11) and “playfulness” (OR = .92, 95%CI: .86–.98), and “avoidance of approach from homosexuals” was associated with sex (=male, OR = 6.90, 95%CI: 3.25–14.64), “emotionality” (OR = 1.08, 95%CI: 1.02–1.14) and “playfulness” (OR = .92, 95%CI: .86–.99). These results indicate that personality traits weakly but significantly influence the development of attitude toward homosexuals among Japanese adolescents.

It has been suggested that there is a relationship between BMI and suicide. Thus, BMI of subjects who commit suicide would be lower than the BMI of other unnatural deaths (Flaig 2013).

Explore the possible relationship between BMI and suicide.

A total of 1197 suicides and 473 unnatural deaths (not by suicide) were collected systematically for 60 months at the Institute of Legal Medicine of Seville. Age, sex, weight, height and cause of death were recorded. Statistical analysis was performed using SPSS v19.0.

(Figure 1)

In our study we found that suicide (of all age groups and both sexes) have a lower BMI than controls. However, the relationship between these two variables is complex and not all studies support it. Moreover, the relationships between depression, suicide and overweight point in different directions. More and more studies indicate the existence of a relationship between depression and overweight, suggesting that perhaps the “epidemic” of depression and overweight that we see in Western societies has some connection. In addition, depression is a risk factor for suicide well established. Our results indicate that suicide group tends to have lower BMI (less weight in relation to its size) than the controls.

The authors have not supplied their declaration of competing interest.

Matricide is the murder of the mother and it is one the rarest reported homicides with rates varying between 1% and 4% of all murders. In our country, few studies have focused on this issue.

To precise circumstances of matricide in psychotic patients and the offender and victim’s profiles.

We report three clinical cases who were hospitalized in the department of Psychiatry “A” at the Hedi Chaker university hospital in Sfax, Tunisia, because of non-judicial proceedings for dementia during the year of 2019.

Among 3 cases, two patients were male and they were aged respectively 26 and 48 years old. The third was female. All of them had very low educational and income levels and they lived with the victim. In 2 cases, the victim-offender relationship was conflictive and there was already exhibited violent behavior towards victim.Two patients had a psychiatric follow-up and many hospitalizations. The diagnoses were schizophrenia and schizoaffective disorder. However, it was a poor compliance and an interruption of treatment. In the third case, the medicolegal procedure was inaugural. His diagnosis was schizophrenia.All the victims were illiterate and unemployed. Their middle age was 64 years.In all cases, the crime was not premeditated, motivated by persecution delusions including the mother. It was committed in the family house while using a blunt object. The post homicide reaction was marked by coldness.

Matricide has always been considered one of the most abhorrent crimes. Regular evaluation of psychotic patients’ dangerousness signals is needed to reduce the acting out.

No significant relationships.

Patients suffering from both psychiatric disorders and substance abuse (SA) are titled "dual diagnosis patients" (DDP). SA is associated with suicidal behavior. Although our knowledge of SA and suicide behavior is increasing, we lack sufficient knowledge of suicide among DDP.

To compare the suicide attempts rate among DDP and non-DDP; To compare the suicide attempts rate according to gender in DDP and non-DDP; To compare the suicide attempts rate according to substance in DDP.

Analysis of consecutive admissions: men and women ages 18–65 in our center (06/2003–06/2005).

Of 848 DDPs' admissions, 197 (23.2%) were after suicide attempt, whereas 403 of 2558 non-DDP's admissions (15.8%) were after suicide attempt (OR=1.6; 95%CI=1.3-1.9). The OR in multiple analysis was 1.4 (95%CI=1.1-1.8).

There is higher risk for suicide attempt among females in non-DDP (OR=.6; 95%CI=.5-.8), no differences according to gender in DDP (OR=.7; 95%CI=.5-1.1).

Opiates (OR=1.6; 95% CI=1.01-2.5) and Cocaine (OR=1.9; 95% CI=1.1-3.2) were found to elevates, but Cannabis were found to lower (OR=.4; 95% CI=.3-.6) the risk of suicide attempt.

DDP have grater risk for suicide attempt than non-DDP. In non-DDPs females have grater risk for suicide attempt than males, however in DDPs there were no differences. DDP with Opiates or Cocaine abuse are in risk group for suicide attempts. These findings suggesting that preventive efforts that have shown promise in non-DDP may need to be tailored differently to address the risk factor profile of DDP.

Two thirds of all persons, who comit suicide have an appointment with their family physician (FP) in the preceding month. One third of them reports depressive thoughts and less than a fifth talks about his suicidal ideations and plans. FP are basically aware on the association of suicidality with psychiatric disorders i.e. deression. However, they hesitate to communicate about this topic mainly for insecurity. Additional factors might be that physicians themselves are prone to burnout or suicide more often than the general population.

Problem-centered semistructured interview following the grounded theory. Complete transcription of the interview tapes for analysis. Recording of demographic and practice data.

N=24 physicians were interviewed. They saw problems regarding time consuming contacts, stigma of compulsory admission, acceptance of suicidality especially in the older population. More problems would occur in non-depressed patients, especially in those suffering from chronic pain and/or addiction. Interview training was regarded as helpful.

This is the first qualitative study on the primary care management of suicidal patients. It shows e.g., that stigma of psychiatry also influences crisis management.

Delirium is a common neuropsychiatric syndrome, particularly in elderly hospitalized patients, and is associated with an increase in morbidity and mortality. Although these negative consequences are well documented, only a few studies describe the experience of delirium from the families’ perspective.

To analyze studies regarding the experience and distress caused by delirium in the families/caregivers of adult/elderly hospitalized patients.

A non-systematic review of published articles until October 2015 in the database PubMed was carried out. The keyword “Delirium” was combined with: “experience”, “distress”, “anxiety” and “family”, “carer” and “relatives”. Inclusion criteria were: standardized diagnosis of delirium, systematic/prospective assessment of distress level. Clinical cases were excluded.

Sixteen studies met the inclusion criteria for analysis. In most of them, family members (mostly younger) showed high levels of distress, even higher than health care professionals and patients. Several predictors of family distress were found, including poor functional status, psychomotor agitation, delusions, emotional lability, incoherent speech, inattention and disorientation. Higher distress was associated with long-term consequences (e.g. generalized anxiety). In the qualitative research, family members interpreted delirium as a sign of approaching death, result of pain/discomfort or an effect of medication. In addition, distress was associated with rapid and unexpected changes or unable to recognize the loved ones.

Delirium in patients was associated with significant distress in family members. These findings underline the importance of providing information and the development of appropriate supportive and psychoeducational interventions in order to help families throughout this process and reduce the associated distress. This work is supported by FCT (SFRH/BPD/103306/2014).

The authors have not supplied their declaration of competing interest.

The term endophenotype was first used by Gottesman to describe a trait that may be intermediate on the chain of causality from genes to diseases. An endophenotype may be neuropathological, neurocognitive, emotional, neuro-physiological or neurobiological in nature. There is dearth of studies about the use of neurocognive dysfunction as endophenotype marker of BPAD, particularly from developing countries.

We aimed to evaluate neurocognitive dysfunctions as endophenotype markers of bipolar affective disorder (BPAD) in first degree relative of BPAD patients. We hypothesized that first degree relative of BPAD patients differ significantly in regard to neurocognitive dysfunction from matched controls.

A cross sectional study was carried out. Sample was drawn from first degree relatives (FDR) of patients of BPAD and controls. After assessment of neurocognitive function first degree relatives of BPAD were compared with controls on measures of attention, verbal working memory, auditory verbal memory, Visuo spatial working memory, visual attention and executive functions.

Results indicated that, first degree relatives of BPAD scored poorly on measures of neurocognition then controls. On conducting comparison over composite neurocognitive score 'we found that cognitive index in combination better discriminate the first degree relatives of BPAD from controls.

Neurocognitive dysfunction on measures of attention, verbal episodic memory, auditory verbal working memory, visuospatial working memory and executive functions significantly differentiated first degree relatives of BPAD patients from controls.

The goal of the study is to determine the problems that the nurses tend to look and to constitute a common language in the acute care unit.

In the study, document analysis method was used. The observation forms filled by both nurses and physicians for the risky patients were examined. For the examination and categorization, a coding chart containing the problems in both forms was used. Risky patient assessment form of thirty two patients (filled by the physician) and three hundred fifty five nurse observation forms used for same patients were included into the study.

The mean of days in which observations recorded by the nurse were 15.29 ± 6.98 (min.4-max.29). The risky patient form was filled by the physician generally in the day that the patient was hospitalized. The majority of the patients for which observation form was filled had psychotic disorders. It has been seen that “self-care deficit” (70.7%) was mostly marked and, “eating the meal” (74.1%), “anxious facial expression” (44.5%) and “sleeping at night” (52.7%) were tagged mostly in nurse's form. In the physician's form, aggression and agitation was mostly marked (63.1%).

The problems declared in the nurse observation form are rather concerned with the daily life activities not including sufficient information in terms of the risk creating characteristics. It has been concluded that the changes should be assessed quickly and clearly. The observation forms do not provide practical information about the course of the disease although these are kept daily.

Multiple articles highlight the role of some organic pathologies causing depression. One common organic cause of depression is hyperparathyroidism, with hypercalcemia associated or not. The neuropsyquiatric symptoms related to primary hyperparathyroidism involved different types of presentations (anxious, affective, cognitive and psychotic). The most characteristic manifestations are depression with apathy and minus cognitive impairment.

Describe a case of depression by hyperparathyroidism with hypercalcemia to remark the importance of some organic factors in some types of depression.

Suggest re-evaluating the criteria of parathyroidectomy, in which are not included depression and cognitive impairment.

Male aged 71 affected by diabetes mellitus type 2, hypertension and Parkinson's disease.

In the last 2 months, the patient progressively became more apathetic, sad (with occasional crying), with hyporexia, 4 kg weight loss in the last month, and important reduction of water intake. Analysis detects hypercalcemia.

Psych evaluation shows slightly time disorientation, hypophonic language, bradilalia with increased latency of response and hypotimia.

Diagnosis of moderate depression episode is made and escitalopram 10 mg/day is prescribed.

This reported case is a challenge, not only in a therapeutical level, but in a diagnostic level too because several organic depression ethiologies are involved. It's interesting to observe how the decreased water-intake, caused by depression, worsened hypercalcemia, showing a continuum between both, mental and organic pathology.

We think is necessary to re-evaluate the criteria of surgical intervention for parathyroid adenoma with hypercalcemia associated to establish whether psychiatric symptoms could be one of them or not.

Parricide (referring as parental homicide) is a rare event among homicides, yet challenging and intriguing from psychiatric point of view. Still, literature concerning parricide is sparse and most studies concern small or heterogenous samples or anecdotal cases.

To analyze differences in parricide offenders among forensic psychiatric inpatients at the university psychiatric hospital Vrapče's centre for forensic psychiatry.

To test some differences between parricide offenders with regard to specific type of parricide.

Available retrograde data of 50 years forensic inpatients (n = 430). We identified parricide cases of matricide and patricide included.

The analysis included a total of 22 parricide offenders. All parricide offenders were male adults. Matricide was more prevalent then patricide (13 vs. 9). Matricide offenders were in average younger when committed crime, had more prevalence of psychotic disorders and earlier onset of symptoms in comparison with patricide group.

We identified differences and similarities between these two parricide offenders groups. It is important to expand research further including different types of motives and family dynamics regarding the type of parricide victim.

The authors have not supplied their declaration of competing interest.

Studying defensive styles is typically associated with dynamic theory and therapy. The present study was designed to examine the efficacy of adding two individual sessions of Motivational Interviewing (MI) and Thought Mapping (TM) to cognitive-behavioral group therapy (CBGT) to promote changes in the use of defense mechanisms among obsessive-compulsive disorder (OCD) patients.

Forty outpatients meeting OCD DSM-IV criteria were randomly assigned to either a MI+TM group or a control group, before 12 weekly CBGT sessions. To evaluate changes in defense mechanisms, the Defense Style Questionnaire (DSQ) was administered before and after treatment.

The use of the mature defense mechanisms increased in the MI+TM group at post-treatment, and there were significant differences in the decrease of use of the neurotic defense mechanisms. In addition, patients who achieved full remission differed in the use of the immature defense mechanisms. The control group presented no significant decrease in the use of any defense mechanisms.

These findings suggest that adding two individual sessions of MI and TM to CBGT can facilitate changes in use of defense mechanisms in OCD adult outpatients, as measured by a specific instrument.

More than 40 years after the introduction of the construct in the literature, the status of “burnout” remains unclear. Whether burnout is anything other than a depressive syndrome has been increasingly discussed in recent years.

We examined the extent to which burnout can be considered distinct from depression.

We reviewed the literature dedicated to burnout-depression overlap over the last decade.

Recent research suggests that burnout and depression overlap in terms of (a) etiology, with (chronic) unresolvable stress a common, key causal factor, (b) clinical picture and course, with burnout and depressive manifestations inextricably linked such that they increase or decrease together over time, (c) cognitive biases, with burnout and depressive symptoms similarly predicting increased attention to negative stimuli and decreased attention to positive stimuli, (d) dispositional correlates (e.g, neuroticism, rumination, pessimism), and (e) allostatic load—an index of the biological cost of adaptation to life adversity. Hypocortisolism has been linked to both burnout and depression with atypical features—a highly prevalent form of depression. The often-invoked argument that burnout is singularized by its job-related character is actually invalid given that (a) depression can also be job-related and (b) the “job-relatedness” of a syndrome is not nosologically discriminant in itself.

Robust evidence that burnout overlaps with depression has accumulated in recent years. The burnout construct is unlikely to capture a distinct pathological phenomenon. We propose that burnout be characterized as a depressive syndrome for the sake of conceptual parsimony, theoretical clarity, and effective public health policies.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

Catatonia is one of the most common severe motor syndromes, with an estimated prevalence among psychiatric inpatients of about 15 %. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods recommended as first-line therapy. We present the case of a 55-year-old female patient with paranoid schizophrenia and severe life-threatening catatonia who remitted under a short series of rTMS.

s. Introduction

The point of resting motor threshold (RMT) for the musculus rectus femoris was determined for the left hemisphere. A straight line 3 cm anterior and parasagittal from that point defined the SMA. A total of three sessions, each with 1000 pulses at intensity 66 % of the RMT, were performed within 24 and 120 hours apart. Stimulation protocol was set to 1Hz in the area of the left SMA with 25 series of 40 pulses, pulse width 25 ms, angle of attack 45°. Hardware: MagVenture, 8-coil “cool-B65 butterfly-shaped coil from Medtronic.

Within 24 hours after the first session, a marked improvement of catatonic symptoms like independent locomotion and verbal communication was recognized. One week after the whole rTMS treatment, a food intake without a gastric tube was possible.

The present case demonstrates that pronounced catatonia may be successfully treated with inhibitory rTMS. Our results underline the importance of non-invasive brain stimulation as a valuable addition to the existing treatment spectrum for catatonia. Future research is empowered to path the way for a significant expansion of treatment.

No significant relationships.