General population surveys of the prevalence and associations of common mental disorders are necessary for the organization of effective mental health services.

To present data on the pattern and correlates of 12-month use of services by persons with common mental disorders from the recently completed general population survey of psychiatric morbidity in Greece.

The sample (n=4894; multistage random sample drawn from population of both mainland and insular Greece) can be regarded as representative of the Greek population aged 18–70. Participants were interviewed at their households by trained lay interviewers. Common mental disorders were assessed according to the ICD-10 criteria with the revised Clinical Interview Schedule (CIS-R), a fully structured diagnostic interview.

73,9% of participants with at least one common mental disorder (CMD) do not receive any treatment for their psychological health, 52% have never spoken to the family physician and 73.3% has not spoken to a mental health professional in the past year. The disorder associated with the most frequent use of general health services for any reason (>4 visits to any physician in the past year) was depression (43.7%). Regarding use of family physician services for a mental health issue, patients with panic disorder (54.4%) and generalized anxiety disorder (52.8%) were more likely to consult compared to other CMDs. The overall percentage of patients with CMDs that choose to talk to a priest or other spiritual for their mental health problem was comparable to that who talked to a mental health professional. Overall, 46.5% of all participants who meet the criteria for a common mental disorder had not spoken to a doctor or mental health professional, with men showing significantly higher rates of no use compared to women (54.6% men vs. 41.5% women).

The findings of the present study can help in the better organization of services with the aim to improve prevention and treatment of common mental disorders in Greece especially in a time of economic hardship.

Currently there is no consensus regarding how long anti-psychotics medication should be continued following a first/single psychotic episode. Clinically patients often request discontinuation after a period of remission. This is one of the first double-blind randomized-controlled studies designed to address the issue.

Patients with DSM-IV schizophrenia and related psychoses (excluding substance induced psychosis) who remitted well following a first/single-episode, and had remained well on maintenance medication for one year, were randomized to receive either maintenance therapy with quetiapine (400 mg/day), or placebo for 12 months. Relapse was defined by the presence of (i) an increase in at least one of the following PANSS psychotic symptom items to a threshold score (delusion, hallucinatory behaviour, conceptual disorganization, unusual thought content, suspiciousness); (ii) CGI Severity of Illness 3 or above; and (iii) CGI Improvement 5 or above.

178 patients were randomized. 144 patients completed the study (80.9%). The relapse rate was 33.7% (30/89) for the maintenance group and 66.3% (59/89) for the placebo group (log-rank test, chi-square=13.328, p<0.001). Relapse was not related to age or gender. Other significant predictors of relapse include medication status, pre-morbid schizotypal traits, verbal memory and soft neurological signs.

There is a substantial risk of relapse if medication is discontinued in remitted first-episode psychosis patients following one year of maintenance therapy. On the contrary 33.7% of patients discontinued medication and remained well.

Cognitive strategies have received considerable attention in the field of pain management, together with more traditional approaches based on physical interventions and behavior modification. Distraction is a technique that lately has been often studied.

Distraction is based on an individual's limited attention capacity; it diminishes attention aimed to a painful stimulus with a subsequent pain reduction (Wismeijer & Vingerhoets, 2005).

To study the effect of VR as a distraction technique in an experimental pain task.

37 healthy participants were induced pain through two consecutive immersions using the cold-pressor test. All participants went through two experimental conditions: VR and black screen. The order of conditions was counterbalanced and a design of repetitive measures was used.

A virtual environment “Surreal World” was developed based on distraction techniques designed to surprise participants. The effect of VR as a distraction technique was evaluated using objective measures of pain (threshold, tolerance, pain intensity and time estimation) and other cognitive measures (self-efficacy and catastrophic thinking in vivo).

VR significantly decreased tolerance and pain intensity, influenced participants to underestimate the length of immersion. A higher self-efficacy in VR and a lower rumination and helplessness were registered in the pain experience. Thus, VR may help improve the efficacy of cognitive strategies.

The study shows the relevance of VR as an adjunctive method in the treatment of acute pain and allows studying its efficacy in patients with chronic pain.

Childhood depression is a serious medical problem that causes an agonizing feeling of sadness and loss of interest in activities. It affects adolescents thinking, feeling and behavior, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults.

This cross section study assessed the prevalence of childhood depression from age 12 through 16 years and examined using Revised behavioral problem checklist (RBPCL) as a screening instrument. Prevalence rates were estimated on the basis of clinical diagnoses and other measures as MINI-KID and Childhood Depressive Inventory (CDI).

A representative population sample of 739 children and adolescents aged between 12 and 16 years were assessed for ICD 10 fordepressive disorders

From the sample studied results reveal that 353 males and 386 females and was divided according to the presence or absent of depressive symptoms into Group 1 without depression (89%) and Group 2 (10.5%) with depressive symptoms according RBPCL . further analysis of group 2 showing that mean age was (14±1)year, where (67%) were males (33%) females regarding the academic achievement of depressed adolescents denoting that (74%) were average, (20.5%) below average,(5%) failed in academic records. Using CDI for assessing severity of depression revealing that(40%) have mild, 24% moderate, 36% severe depression

The prevalence rates obtained vis-a-vis the availability of mental health services in Egypt reflected a major public health problem

Eating disorders (ED) are severe psychiatric disorders affecting mainly teenage girls and young women. There is evidence that family aspects play important role in the etiology and outcome of ED. Aspects related to the patients’ father have been poorly studied.

To understand emotional experiences and life events of father of adolescent girls diagnosed with anorexia nervosa or bulimia.

Qualitative in-depth interviews were carried out with men, fathers of adolescent girls in outpatient treatment at a southern Brazilian general hospital.

Sample was composed mostly by men who spent their childhood in the countryside. All of them had lived with their parents at least until the adolescence. Contrary to what clinicians often hear from mothers of ED patients, subjects were concerned about their daughters’ health, wished to see them overcome ED and were well informed about the disorder. They reported that one of the most important events of their lives was their daughter birth. Subjects also reported feeling of powerlessness. They tended to blame the mother for the ED emergence or maintenance, but recognized some relation between the disorder onset and a certain distance in father-daughter relationship. They recognized that their aggressive temper might have interfered with family relationships.

Findings may contribute to understand life experiences and emotional characteristics of fathers of ED adolescents and this may help to keep them motivated to the treatment. This understanding can contribute to therapists to help fathers to regain their ability to care for their daughters, getting close to them again and improving father-daughter relationship.

Depression in older adults is often under-diagnosed and consequently under-treated, despite association with higher rates of morbidity and mortality, increased healthcare utilisation and greater economic cost compared to younger populations. Better identification will be imperative in the future because of the estimated growth in the older adult population. Screening could improve identification; a well-known screening tool tis the Geriatric Depression Scale (GDS).

To evaluate the diagnostic accuracy of the brief GDS-15 and ultra-brief versions in the detection of major depression.

Seven electronic databases and unpublished literature were searched, using predefined criteria, from 1982 to April 2014. Primary study quality was assessed using the QUADAS-2. Pooled diagnostic performance data was calculated using bivariate meta-analysis. Subgroup and sensitivity analyses were pre-planned. Heterogeneity was explored through meta-regression.

Of 6635 records identified 32 studies were included. Meta-analyses were possible for the GDS-1, GDS-4 and GDS-15. For the GDS-15, at the recommended cut-off score of 5, the diagnostic odds ratio was highest in a community setting and for older adults aged ≤69 years. A cut-off score of 4, however, provided better diagnostic accuracy. Diagnostic data was less favourable when depression prevalence was ≥10%. Better diagnostic properties were found in non-Western countries. Meta-regression revealed country and language were predictive of diagnostic accuracy.

Further research is needed to explore diagnostic properties of ultra-brief GDS versions. GDS-15 findings suggest selective reporting of cut-off scores, which requires cautious interpretation and a need for greater methodological rigor in primary studies.

It is well recognized that both acute and chronic alcohol use are among the major behaviorally modifiable factors that are associated with suicidal behaviour. High suicide rate in the former Soviet Republics and its profound fluctuation over the past decades have attracted considerable interest. There is mounting evidence that the role of alcohol is a crucial in understanding this phenomenon.

To estimate the aggregate level effect of alcohol on the suicide rate in the former Soviet republic Belarus.

Trends in alcohol consumption per capita and suicides rate from 1979 to 2007 were analyzed employing ARIMA time series analysis.

According to Bureau of Forensic Medicine autopsy reports the number of BAC-positive suicides increased by 47.7% (from 10.7 to 15.8 per 100.000) and number of BAC-negative suicides increased by 31.4% (from 7 to 9.2 per 100.000). Alcohol in blood was found in 62% suicide victims for the whole period, with the minimum figure 49.3% in 1988 and maximum 68.5% in 1981. The results from the time series analysis indicated the presence of a statistically significant association between the alcohol consumption and BAC-positive suicide rates, while changes in the number of BAC-negative suicides were not related to fluctuation in alcohol consumption level. The analysis suggests that a 1 litre increase in alcohol consumption per capita would result in a 10,9% increase in a number of BAC-positive suicides.

The results of present study support the idea that alcohol was responsible for the fluctuation in suicide rate in Belarus.

Obsessive phenomena, when present, are usually seen in the depressive phase of bipolar disorder.

The peculiar case with aggravation in ruminative and obsessive thinking with simultaneous hypomania may widen our understanding of the phenomenology of antidepressant induced hypomanic symptoms.

We present a case of ruminative hypomania induced by high dose venlafaxine. Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Yale Brown Obsessive Compulsive Scale (YBOCS) were used for symptom ratings.

The patient was 30 years old and she had treatment history of depression for 3 months. She had two consecutive suicide attempts with drugs in the week before she was hospitalized for suicidal risk. She was using venlafaxine 300 mg/day and olanzapin 2,5 mg/day; continuous ruminative thinking about the past and imaginary sexual affairs with former friends were apparent with an unremitting pattern, leading to intense psychomotor agitation and suicide attempts. Irritable mood, and increased energy was observed with continuous ruminations. She was diagnosed with bipolar-II-disorder, with mixed features and anxious distress (YMRS:17, HAM-D:22, YBOCS:34). After discontinuing venlafaxine and starting anti-manic treatment with haloperidol 10 mg/day in the first week, both affective symptoms and ruminations were improved (YMRS:2, HAM-D:4, YBOCS:8). Aripiprazol 20 mg/day and quetiapine 100 mg/day which were given for continuation treatment were also effective for preserving full remission.

When prescribing high dose venlafaxine for treatment resistant depression, it should be remembered that this may induce hypomanic symptoms and prominent ruminative thinking which can be ameliorated with anti-manic treatment.

No significant relationships.

Developmental studies in infancy remain rare. Studies measuring depressive symptoms in gifted children are contradictory, considering more anxiety or depression than in non-gifted children. Furthermore, questionnaires or anxiety scales are used without taking into account all aspects of mood disorders and thus, rarely depression scales have been conducted.

To refine the developmental trajectory of depression in a national sample of French gifted children by identification of the specific risk and protective factors.

A self-reported depression scale MDI-C (Multiscore-Depression-Inventory-for-Children) were sent to families to be administered to their gifted children from preschool to high school, aged from 4 to 20 years-old (IQ >125) looking for help from gifted associations. A larger wave of data collection on different aspects of child and family history was collected (pregnancy, term and delivery mode, neonatal period, psychomotor development, health, schooling, interpersonal relationships with family and friends, personality, parental socio-economic status).

438 children (> 130) were eligible. Regarding anamnestic fields, Exploratory-Factor-Analysis highlighted six predictive factors of depression with eigenvalues from 1.09 to 3.17. Major factors explaining 62.96% of total variance are: Factor-1 “motor skills disorder” (14.53%). Factor-2 “positive family relationships” (14.04%). Factor-3 “positive social relationships with peers” (14.02%). Factor-4 “integration of social codes” (11.23%). Factor-6 “Learning disabilities and rehabilitation” (10.1%).

Our findings highlight specifics risk factors of depression in the field of learning disabilities or social cognition, while a good quality of social relationships since childhood seems to be a preventive factor.

No significant relationships.

The new adoption law, which was introduced in Greece in 2018, brought radical changes in adoption.

This presentation aimed to investigate the emotions of the prospective stepparents, based on the changes which were effectuated by the new law of adoption.

This survey was conducted through mixed methodology. Quantitative research was addressed to investigate the emotions of the to prospective stepparents. Qualitative research was addressed to social workers and its goal was to depict their opinion about the new law and the prospective stepparents’ expressed emotions.

The findings of the survey have demonstrated that the stepparents had a variety of emotions that changed throughout the adoption process. The dominant feelings of parents at the first visit with the social worker were stress and anxiety. However, at the end of the training process, these feelings were replaced by confidence and impatience. This emotional rotation of prospective stepparents was confirmed in the social workers’ interviews. In addition, social workers interviews highlighted the importance of the amendment of the old law of adoption’s process.

To sum up, this research has shown the importance of the new law and therefore the significance of its right application from all children’s placements in Greece. Nevertheless, it seems that due to the recent application of the new law, many placements have not yet complied with it and therefore there is urgent need for reinforcement of its application, according to the guidelines of the European Union that demanded gradual deinstitutionalization using the alternative types of child care.

No significant relationships.

The characteristics of the Autistic Spectrum Disorder involve deficits in social communication and repetitive patterns of behavior and that there is a growing interest in the use of new technologies for neurorehabilitation.

This research aimed to verify the possibility of using Virtual reality for the treatment of Autism.

Scientific publications were selected from the PUBMED, ScieLO, LILACS and Google Scholar databases, written in Portuguese and English, with free access, between 2014 and 2019.

A total of 19 publications were identified. Concerning their design, 26,3% of them were experimental, 21,1% qualitative, 21,1% one-group pretest-posttest, 15,8% quasi-experimental, 10,5% descriptive and 5,2% of them were exploratory research studies. The studies focus on anxiety and phobias reduction, as well as teaching strategies to deal with stessful events. Eleven of the studies focused on the enhancement of independende and sef-confidence of the subjects. In five ot the studies the virtual reality was used with other technologies. In two of them the EEG was used along with virtual reality for detecting the cerebral region in activity during action.

Virtual reality was defended in most of the studies because it can provide a safe environment and offering high control of variables. Although the results indicate the use of virtual reality for the reduction of anxiety and the promotion of self-confidence and independence which aims the social deficits in autism, more research is needed to investigate the use or impact of VR on repetitive behavior.

The strong comorbidity between depression and epilepsy is widely acknowledged. However, depression in epilepsy can manifest atypically, leading to its low detection rate and lack of access to treatment in patients with epilepsy

To study the specifics and pattern of depression in epilepsy for its timely diagnosis and therapy and to prevent suicide risk and improve the quality of life in patients with epilepsy

Clinical, statistical, psychometric. A total of 149 patients, mean age 45.0 ± 11.7 years, 74 males, 75 females, were examined

It was found that depression was manifested in 46.3% of patients before the onset of epileptic seizures, and in 20.8% of patients it developed after treatment with some AEDs. The incidence of symptoms characteristic of depression in epilepsy, such as unstable mood, irritability, euphoria, episodes of pain and sleep disturbances, and its’ impact on the quality of life in patients with epilepsy were analysed. Gender differences were identified for a range of symptoms

The authors expanded their understanding of the clinical specifics of depressive manifestations in patients with epilepsy to allow timely detection and medical and rehabilitative care for these patients

No significant relationships.

Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessive thoughts and recurring compulsive acts. The prevalence is 1-3% in the general population. The treatment consists of Cognitive Behavioral Therapy (CBT) alone, or in combination with antidepressants.

Provide an overview of the elements of CBT in this disease and the techniques used.

The authors did a non-systematic review in Pubmed with the words: “Obsessive-Compulsive Disorder” and “Cognitive Behavioral Therapy”.

According to the cognitive-behavioral model model, in this disease intrusive thoughts arise spontaneously, normally and universally, interrupting the normal flow of thought. They are usually neutral and form the basis for vulnerable people to develop obsessive problems. CBT uses techniques that aim to correct dysfunctional thoughts and beliefs, as well as behavioral techniques that aim to change compulsive behaviors. It aims to help people to come to the conclusion that the problem is not in the intrusive thoughts, but in the meaning they attribute to them, and in the various strategies they adopt to try to control them. It basically follows the following steps - patient assessment, through one or more semi-structured interviews; initial phase that includes the assessment of motivation for treatment and psychoeducation; intermediate phase, with the continuation of monitored exercises and reinforcement of cognitive and behavioral techniques; discharge, with discharge preparation working on relapse prevention and maintenance therapy.

Currently, CBT is considered the first-line therapy for the treatment of this disorder, however some patients are still refractory, and very little is known about its predictors of response.

Psychiatric disorders have a remarquable frequency in multiple sclerosis. The leading group of these disorders consists of affective disorders. These psychiatric conditions can worsen the outcome of multiple sclerosis, thus contributing to increase the burden of the disease to both patients and relatives. Managing such a complicated situation needs a focus on the underlying links between affective disorders and multiple sclerosis.

To examine the hypotheses proposed to explain the high prevalence of affective disorders in patients with multiple sclerosis.

Literature was reviewed using the Medline database and the following keywords “bipolar disorder” “affective disorder”, “mania” and “multiple sclerosis”.

PubMed research returned 13 results. After manual inspection, 10 articles were retained and examined. The cause of the high comorbidity between multiple sclerosis and mood disorders is regarded as being multifactorial: the medication used in multiple sclerosis possibly inducing/exacerbating mood disturbances, the demyelinazing brain lesions which could bring about depression or mania, genetic overlapping with affective disorders and last the psychological reactions and adjustment difficulties to the neurological handicap.

Despite the fact that the higher prevalence of affective disorders in multiple sclerosis is well established, these disorders still remain underdiagnosed and undertreated. A shift towards a better assessment of the psychiatric comorbidity in multiple sclerosis patients and the optimal treatment of those disorders is fundamental.

The authors have not supplied their declaration of competing interest.

Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.