Recent estimates suggest Bipolar disorder (BD) affects approximately 1% of the population, with diagnosis often made during late adolescence and early adulthood, and that it is lower in the elderly (up to 0.1%). The initial onset of BD generally presents with depressive episode, but an initial maniac episode is not uncommon, although it becomes less likely with increasing age. In spite of the fact that elderly is a growing population in developed countries there are only few studies on late-onset BD (LOBD). Its etiopathogenesis and heterogeneity are complex, sharing several commonalities with organic brain diseases, which is denoted on frequent neuroimaging white matter hyperintensities, and involves higher medical and neurological burden.

To provide a comprehensive review reporting prevalence, features, course and comorbidity on LOBD. Additionally to report one selected case, intending to better understand this patient's subgroup.

The literature was systematically reviewed by searching on PubMed and reference psychogeriatric textbooks. We have selected one case of an elderly woman with LOBD with inaugural acute mania episode associated with previous diagnosis of Parkinson disease.

Distinguishing older adults with BD by early or late age at onset have limited clinical usefulness, although LOBD patients are more likely to have an organic mental disorder superimposed and more extensive and severe cognitive impairments, as well as vulnerability to extrapyramidal symptoms.

This case-report and literature review suggests that LOBD as a distinct diagnostic entity by its different presentation and etiology, and consequently different treatment, needs further investigation.

Research consistently has evidenced the association among alexithymia, somatosensory amplification (SA) and functional somatic symptoms (FSS). Yet, the underlying mechanism of such relationship has not been explored among Chinese adolescents. This study aims to evaluate whether SA exerts a moderating or mediating effect on the alexithymia-FSS link.

Analyses were based on 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15) recruited from a school-based study. They completed the Somatosensory Amplification Scale (ChSAS), the Somatic symptom subscale of CES-D and the Toronto Alexithymia Scale-Short form (TAS-9-C). Three facets of alexithymia (difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT)) were force-entered in each univariate regression model. Facets of alexithymia that were found significant (p < 0.05) were subsequently included in regression models to test the mediating and moderating effects of SA on FSS.

Results of hierarchical regression analysis found that both DIF (standardized β = 0.37, p < 0.001) and DDF (standardized β = 0.12, p = 0.043) were significant predictors of somatic symptoms. A moderate mediating effect was observed for SA on the DIF-somatic symptoms (Sobel test z = 2.13, p = 0.03). The results also showed a significant moderating effect of DIF×SA on somatic symptoms (standardized β = 0.49, p < 0.001).

SA qualifies as a mediator and a moderator between alexithymia and FSS. It indicated that adolescents with alexithymia are likely to report more FSS due to the tendency to amplify their somatic sensation. These results suggest that alexithymia-specific psychotherapeutic methods should be further developed using emotional validation and processing techniques.

Factitious disorder (FD) is defined by the intentional production or feigning of physical or psychological symptoms with the objective of assuming the patient role. It's frequently difficult to adequately diagnose this disorder when the faked symptoms are those of a psychological or a psychiatric disorder. In these cases, there is often high comorbidity with other mental disorders, thus making it difficult to differentiate between real and factitious symptoms.

To present a case-report of FD with hallucinations and a review study regarding the theme available in Medline.

Brief literature review.

A case report is presented and literature of this theme shortly reviewed.

The case involves a 23-year-old female, a psychology student, born in destructured family. She had attempted suicide many times since she was 16 years old, one of them with high lethality. One month before her admission to our inpatient clinic in order to allow a clear diagnosis to be made, she began active auditory hallucinations, persecutory delusional ideation with disorganized behavior and consequent social isolation. A suitable dose of atypical antipsychotic drug was administered but Psychotic disorder was ruled out and she was dignosed with FD. After the factitious symptoms that prevented any type of therapeutic approach disappeared, the real symptoms of the patient were those characteristic of a borderline personality disorder.

This case emphasizes the need for the careful observation of these patients in order to establish the diagnosis and to improve a specific management strategy for them.

Pragmatic language skills were examined in schizophrenia patients compared to IQ-matched control subjects measured by the decoding of the flouting of the four Gricean maxims.

19 schizophrenic patients and 19 matched controls were evaluated. Five experimental conditions (all included four stories) were used, such as „quantity maxim” (QNM) condition, „quality maxim” (QLM) condition, „relevance maxim” (RM) condition, „manner maxim” (MM) condition and "control” (C) condition. An investigator presented the stories and asked for the hidden communicative intentions. PANSS scores and general intelligence were also measured.

Patients with schizophrenia performed significantly worse than controls in each of the conditions containig the flouting of the Gricean maxims. The response accuracy in the C condition was not differed significantly between the two groups (QNM:p< 0.001; QLM:p< 0.001; RM:p< 0.001; MM:p< 0.001; C:p=0.487). Significant positive correlations were found between QLM and IQ (p< 0.001) and between RM and IQ (p=0.025), and there was no significant correlatios between PANSS scores and response accuracy. Full scale IQ was not differed significantly between the two groups (p=0.095).

We found that a complex pragmatic language deficit exists in schizophrenia. The impairment do not seem to have a relationship with symptom severity. Besides, it seems, that good intellectual function supports pragmatic language skills in schizophrenia.

Social interactions dysfunctions make up core symptoms of many mental disorders and have been extensively studied through cognitive paradigms gathered under the concept of social cognition. Nevertheless, a growing body of literature have demonstrated that motor coordination is an important feature of these human social interactions but has been little studied in the context of mental diseases.

In this study, we propose to compare the processes of inter-agent coordination in healthy and socially impaired clinical populations (e.g. schizophrenia and social phobia patients).

20 schizophrenia and 20 social phobia patients were compared to 20 healthy subjects using an hand-held pendulum paradigm in intentional and unintentional interpersonal motor coordination, with different leadership conditions. All participants had psychopathological and neuropsychological evaluations.

Our results demonstrated that each group of subject was characterised by specific signature concerning interpersonal motor coordination. More specifically, instability of the coordination and temporal delay between patient and controls revealed that schizophrenia impaired intentional coordination but not spontaneous non-intentional coordination whereas social phobia only affected leader conditions.

Taken altogether, these preliminary results give evidence that motor control through motor coordination behaviours is a fundamental part of social interactions deficits in schizophrenia and social phobia. These results lead us to examine if the evaluation of motor coordination during a social interactions could help to discriminate the deficits in social interactions and to propose specific therapy for their rehabilitation.

This research was supported by an Agence Nationale de la Recherche grant (Project SCAD # ANR-09- BLAN-0405-03).

Considering the excessive contacts of the hospital staff with death and the ability of death anxiety to reduce functional ability in an individual.the aim of this study was to evaluate the prevalence of death anxiety among a state hospital staff.

This is a descriptive study that conducted in an overall of 612 individuals received a questionnaire at a state hospital in Sari(Iran) during spring 2008. The questionnaire was consisted of two parts; demographic part and Templer Death Anxiety Scale (DAS; Templer, 1970). The data were analyzed by SPSS software version 16.0 using t test and chi-square test.

The range of age was 20-53. About 42.2% of the participants had mild death anxiety while 57.8% had severe death anxiety. The mean scores achieved by the individuals was 7.70 ± 3.133 in women and 6.19 ± 2.552 in men. The severity of death anxiety had a significant correlation with sex while having no correlation with age, marital status, having or not having children, educational level and occupation.

Due to high levels of death anxiety among the staffs, mental Health interventions are recommended to the same population in order to improve the mental health Quality. Additionally, performing comprehensive studies in the general population is needed.

Violence gender has caused considerable social alarm. Better awareness of the characteristics and problems of the female victims is necessary to be able to provide adequate psychological attention.

To identify the specific characteristics of PTSD in female victims of gender violence, stating what are the symptoms of this disorder are usually present, identify some of the most important variables that characterize women seeking assistance this problem.

The goal of this study is examining PTSD in battered women.

Participants: 100 Chilean and 170 Spanish battered women.

Instruments:

1. - Semi-structured interview for victims of abuse: assesses sociodemographic characteristics of victims and circumstances of abuse, it was designed for this research.

2. - The PTSD Symptoms Severity Scale (Echeburúa et al., 1997): assesses the severity and intensity of the symptoms of this disorder according to the diagnostic criteria of the DSM-IV-TR in victims of different traumatic events.

The results show that the most typical symptoms of PTSD are: re-experiencing (the presence of unpleasant and recurring memories about the abuse and psychological and physiological distress on recalling the events); avoidance symptoms (avoidance of thoughts, feelings or conversations related to what has been experienced, loss of interest in significant activities and restriction of emotional life); and hyperactivation symptoms (permanent state of hypervigilance and startle response).

This data will be useful to understand the problems and consequences of abuse and to target interventions to be made to alleviate the plight of these women in cases where it appears PTSD.

The role of social factors in suicidal behaviour is long established. There is growing evidence supporting the Interpersonal Theory of Suicide (ITS), as developed by Joiner et al., which postulates that two psychological dimensions linked to thwarted fundamental interpersonal needs, perceived burdensomeness and thwarted belongingness are linked to the onset of suicidal desire. The Interpersonal Needs Questionnaire (INQ) has been designed to assess those dimensions for use in research on the aetiology of suicidal behaviour and as a component of risk assessment in clinical settings. There is currently no available French version.

Our objective was to provide a French adaptation of the INQ. We translated the INQ, and then examined the construct validity of INQ-F in a clinical setting.

The INQ was translated and administered to 50 patients admitted for suicide attempt or suicidal ideation. Scales with validated French versions were used to assess the following dimensions: suicide risk (Ducher Suicide Risk Assessment Scale (RSD), depression (BDI-SF and MADRS), hopelessness (Beck Hopelessness Scale (BHS) and social vulnerability (EPICES).

INQ-F was significantly correlated with suicide risk (rho= .737, p < .001), depression, hopelessness and social isolation. Internal consistency was high (Cronbach's alpha = .9137).

Our results support the construct validity of the INQ-F, although complementary studies are needed to further establish it, as well as the relevance of the ITS for suicide risk assessment in clinical settings.

Suicide is a major public health problem. Although suicide statistics have always been difficult to determine, there is no doubt that deaths caused by this psychiatric challenge are similar to the ones caused by homicide or road traffic injuries. The presence of a personality disorder has often been related to suicide.

In the present work we analyze the presence of personality disorders (PD) in suicide victims and controls, in order to determinate such axis II disorders were more common in the suicide group.

We compared the results of two samples (271 suicides and 142 sudden-death controls), which were studied using a psychological autopsy. Personality disorders were diagnosed using the SCID-II. Data were analyzed using the SPSS software 19.0 version.

Although age differences were found between both groups, they were almost not statistically significant (p=0’049). There were no differences in gender results (p=0’289). The prevalence of PD was statistically significant (p=0’00) among the suicide group. When we studied the suicide group, we found that the existence of previous suicide attempts and PD was statistically significant also.

Although PD were more frequent among suicide victims, we found that PD also had more previous suicide attempts. Therefore, the presence of more PD among suicide victims may be due to the higher rates of suicide attempts

The combination of lithium and neuroleptic is frequently used in the treatment of bipolar disorder. After a febrile episode, some patients exhibited neurological sequelae including cerebellar, pyramidal and extra-pyramidal signs. Lithium may be the main factor of neurotoxicity but hyperthermic states are probably involved in determining brain damage.

58 year-old Tunisian women with a medical history of bipolar disorder treated by combination of lithium carbonate (700 mg/day) and levomepromazine (50 mg/day), was presented to the hospital with complaint of fever, cough, walking instability, choreic and dystonic abnormal movements. Physical examination found a temperature of 39 C°, rhino- bronchial, cerebellar, pyramidal, and extra-pyramidal syndrome. The additional diagnostic tests such as brain scan, MRI brain and lumbar puncture were normal. Desperate the corticoid treatment the cerebellar syndrome persisted.

This case and some literature reviews illustrate the role of hyperthermic states in brain damage of the neuroleptics-lithium combination. Neuropathological findings showed selective degeneration of cerebellar purkinje cells. Research on this topic is recommended.

An analysis of the literature on eating disorders (ED) indicates that Eds are often comorbid with the diagnosis of Personality Disorder (PD). This seems to be a psychopathological feature, characteristic of this patient population. However, the double classification seems to be often insufficient when describing a very complex psychopathological picture. These observations have informed our intention to investigate these two distinct nosographic groups by means of a single construct.

The aim of this study is to identify and describe (through tests that evaluate defense mechanisms) the defensive styles that characterize the two groups of patients, in order to outline a defensive profile that can assimilate or differentiate the psychopathological groups.

The study was carried at the Department of Psichiatry of the San Gerardo Hospital in Monza. The Defence Style Questionnaire-40 (Farma Cortinovis, 2000) was administered and analysed. The sample consisted of 40 participants with eating disorders, recruited among the outpatients for eating disorders, and 40 patients with personality disorders recruited from two Psychiatric Outpatient Services.

The data analysis showed a statistical significance in the use of Immature defense mechanisms and Neurotic defence mechanisms in both clinical samples.The patients with PD used a significantly higher number of psychotic defense mechanisms than patients with ED. These results may suggest that in ED patients, the symptoms can be themselves considered as defense mechanisms, or a defensive style that characterizes and makes specific the psychopathological picture.

Although the lifetime prevalence of bipolar disorder is not different between men and women, some of the features of the disease vary between the genders.

To compare the clinical and sociodemographic features of bipolar disorder according to gender.

In this study the data of 125 bipolar disorder tip I patients who had been admitted to Department of Psychiatry of Gulhane Military Medical Faculty between 2009–2011 were examined. Data of these patients were obtained by examining the patients files.

95 of 125 patients (%76.0) were male, and 30 (%24.0) were female. Age of disease onset in bipolar male patients was 22,5 ± 6,9; %6.3 had a history of suicid attempt and %11.6 had a history of substance abuse. Age of disease onset in bipolar female patients was 28,7 ± 9.7. %23.3 had a history of suicide attempt. There was no history of substance abuse in female patients. Psychotic features and history of substance abuse were more prominent in men. The later age of disease onset and longer duration of hospitalization were determined in women.

Our results were appeared to be in line with the results of the studies about gender differences in bipolar disorder. Making prospective studies about this subject is considered to be useful to determine the epidemiological characteristics of mood disorders.

Greece presents the highest prevalence of smokers among Western European countries with a percentage of 37.6%. Studies investigating the psychological parameters associated with habitual smoking, both among the general population as well as among health professionals are focused on anxious and depressive symptoms, without taking into account other possible psychological parameters.

To assess the implication of psychological parameters in the preservation and termination of habitual smoking.

One hundred and four health professionals were randomly selected and asked to fill out the Symptom Check List - 90 - R (SCL-90R) [1]. Participant demographics, smoking habits, amount of daily cigarette consumption, and whether or not participants displayed an intention or effort to quit smoking were all taken into account.

Among smokers, 50% displayed an intention to quit smoking. Smokers who intended to quit displayed the highest levels in subscales of somatization, anxiety, depression and anger. Daily cigarette consumption, among smokers, showed a positive correlation to subscales of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety as well as of anger, paranoid ideation and psychoticism.

The fact that one in two smokers indicates an intention to quit smoking is both interesting and optimistic regarding possible termination of the smoking habit. Habitual smoking is positively correlated to psychological parameters that should be taken into account when drafting a smoking intervention programme.

A new generation of synthetic compounds, readily available on the web, has recently come on the market. Designer Drugs are produced with the intent to elicit effects similar to controlled substances getting round the drugs laws. Two of the most recent Designer Drugs are “Spice” and “Bath Salts”. They produce psychoactive reinforcement, are highly attractive, perceived as safe drugs and not easily detectable in urine and blood samples.

The study focused on quantifying the presence of these compounds among the possible illicit substances usually consumed among adolescents and young adults. Besides we aimed to evaluate the existence of websites related to Designer Drugs and aimed at dividing their positions towards drug use in three main categories : Anti Drugs, Pro Drugs and Harm Reduction Approach.

The diffusion of the phenomenon is still at his beginning, although most of the subjects interviewed had some knowledge of the phenomenon. A web mapping has underlined the preponderance of Pro Drugs websites. As regards “Spice”, 77 is the total number of related websites: 53 (69 %) Pro Drugs, 17 (22%) Anti Drugs and 7 (9 %) Harm Reduction Approach.

Although the internet provides a wide range of information about the side effects of Designer Drugs and many Countries have banned them, there is still a high number of Pro Drugs websites that actively promotes their consume. However, the level of use in Italy is still low, according to the data emerging from the sample recruited.

Low assertiveness and difficulties in emotion's regulation can perpetuate symptoms and worsen the outcome in patients with eating disorders (ED).

Cognitive-behavioral-therapy (CBT) is the most effective treatment for bulimia nervosa (BN) and binge eating disorders (BED). Group training helps patients to cope with interpersonal difficulties.

To examine the effects of a CBT-group-training on assertiveness, emotion's regulation and binge behaviors in patients with ED.

Scale for Interpersonal Behavior (Arrindell et al, 1984; Sanavio, 2002), Difficulties in Emotion Regulation Scale (Gratz et al, 2004; Sighinolfi et al, 2010), Bulimic Investigatory Test of Edinburgh (BITE) were administered at baseline and one and three months after a CBT-training to 20 patients with ED (BED, NES, BN, EDNOS) (90% women, age 25-69 years).

Patients who took part in the training improves assertiveness and emotion's regulation.

[SIB]

[DERS]

CBT-group-training increases assertiveness, improves emotion's regulation, has little effects on binge behaviors severity.