Both Attention Deficit Hyperactivity Disorder (ADHD) and suicidal behaviour are common psychiatric conditions with significant social and emotional morbidity. Although completed suicide in ADHD has been assessed in a previous meta-analysis, other domains of suicidal behaviour such as attempts and ideation have been documented only in individual studies. This review provides a summary of these studies in order to examine the relationship between attention deficit and risk to self.

Electronic and manual literature search of MEDLINE, EMBASE and PSYCHINFO, using a range of search terms around suicidality, attention-deficit and hyperactivity. Articles included both those looking at diagnosis of ADHD in suicidal populations, and those looking at suicidality in pre-diagnosed ADHD populations.

Wide variation was seen in all dimensions, with the main determining factor being co-morbid diagnoses.

In populations completing suicide, ADHD was present in 4 to 25.9%. In suicide attempt and ideation populations, 1.6 to 65% and 10.5–31.8% respectively had ADHD. Attention deficit disorders were diagnosed more frequently in suicidal males than females. Age and location differences were not consistent across groups.

In those with diagnosed ADHD, 9.1–70% had attempted suicide and 15.8–66.3% described suicidal ideation. Higher rates were seen in prison inmates and drug dependent subjects.

Although there is a positive relationship between ADHD and risk to self, the magnitude can vary greatly between different populations. Further research on larger samples is necessary to firmly establish this. The process of risk assessment in ADHD needs to take into account the possibility of intentional self-injury and provide management strategies.

The aim was to:

1. 1) identify the prevalence of depression in diabetic women presenting in a primary care clinic;

2. 2) determine if the primary care physician detected depression in these patients; and

3. 3) determine if a relationship existed between depression and glycemic control (Hgb A1C) in these patients.

Prospective, convenience sample. All women with a diagnosis of Type I or II Diabetes Mellitus were included. Participant's charts were audited for documentation of Hgb A1C levels, and the diagnosis of depression. Patients were asked to complete Beck Depression Inventory (BDI II) scale. Participants who score 16 or higher on the BDI were considered depressed. Participants' scores on BDI II and their Hgb A1C levels were compared with demographic data, and chart verification of depression. Statistical analyses was accomplished using Chi-Square for categorical variables and student's t-test for independent variables all analyses was run using SPSS v. 10

61 patients participated. When prevalence of depression in diabetic participants was compared with BDI II scores, 47% (N=24) of participants were found to be depressed. Primary care physician recognized and documented depression in 4% (N=2) of the depressed participants. The mean Hgb A1C was higher for depressed participants (9.31%) when compared to non-depressed participants (8.03%), but was not statistically significant I II (p =.788).

Depression was a major problem for patients with diabetes presenting to primary care clinic, and that diabetes was under diagnosed. Contrary to previous studies, patients in this study with diabetes and depression had similar glycemic control.

Dual control model of the sexual response (DCM) indicates, that there are two separate, but cooperating systems of sexual excitation and inhibition. Previous studies using DCM concept have shown, that MSM (men having sex with men) had higher excitation (SES) and one of the types of inhibition (SIS1) levels, in comparison to the exclusively heterosexual men. MSM also reported more frequent occurrence of sexual disorders (erectile disorders, premature ejaculation and decreased sexual desire).

Comparison of the MSM and heterosexual men groups in order to verify erenow observed differences in sexual excitation/inhibition propensity and prevalence of sexual problems.

The sample consisted of two groups: 47 heterosexual men and 60 MSM. The participants have anonymously filled up questionnaires (Polish version of the Sexual Inhibition/Sexual Excitation Scales SIS/SES and the author's survey) via internet. Then statistical analysis was executed.

Our findings have shown, that both groups were similar in their propensities for sexual excitation (SES) and inhibition due to the risks of failure in sexual performance (SIS1), while MSM scored higher on the inhibition scale, related to the threat of negative consequences of sexual response (SIS2). Heterosexual men more frequently suffered from premature ejaculation and less commonly reported decreased desire. There were no differences in the erectile disorders report between MSM and heterosexual men.

Our findings are mostly in conflict with previous DCM studies results. Several issues, just like method of sexual orientation assessment or cultural differences may had its impact on such results. More detailed studies on these issues are required.

The authors have not supplied their declaration of competing interest.

The use of animals as a therapeutic resource has increased over the past years, especially for patients suffering from chronic conditions associated with high levels of distress, and animal-assisted therapy (AAT) stands out in this scenario.

To assess the impact of an AAT program for children outpatients in oncological treatment according to psychological, physiological, and quality of life indicators.

Children aged 6–12 years attended an AAT program (weekly open group with a duration of three meetings). The activities followed a pre-established script and children were assessed before and after the intervention with instruments that measure stress, pain, mood, and quality of life, in addition to heart rate and blood pressure records. Two trained therapy dogs were used and the program followed the “Guidelines for animal assisted interventions in health care facilities”.

Ten children completed the intervention (70% females, 50% with Ewing's sarcoma/neuroblastoma). There was a significant reduction in anxiety and depression indicators after the intervention (effect size = -0.73 e – 1.27) and a tendency to stress reduction.

Despite the small sample size, the partial analyses already provided favorable results regarding the use of AAT in the oncological context. We highlight the total absence of adverse events during the intervention, which speaks in favor of its safety. The expansion of the sample will probably strengthen the results found so far, suggesting that the technique can be an important ally in the management of emotional conditions associated with oncological treatment in childhood.

The authors have not supplied their declaration of competing interest.

Along with other neurodevelopmental disorders, recently, interest in studying the comorbidities of autism spectrum disorders (ASDs) has grown. According to previous findings many ASD children often do experience a number of comorbid medical conditions and about 60–70% of them present with additional neuropsychiatric Disorders.

We aimed to examine the comorbidities of autistic children and identify whether or not the comorbidities affect their social and behavioral profile.

One hundred and seven children with ASD were surveyed. For all subjects, their parents were asked to complete three forms as the ATEC (autism treatment evaluation checklist), Vineland Social Maturity and a checklist for general and biomedical information.

We then compared the subjects as two groups with and without comorbidities.

Fifty one (44.3 %) of subjects had at least one comorbid condition, and thirty six (31.3%) had at least one additional neuropsychiatric condition. Children with comorbidities showed significant lower score in social quotient against the others without comorbidities (p < 0.05, CI 1.6: 20.5). There was a significant correlation between number of comorbidites and physical-behavioral profile of children (r = 0.172, p < 0.05). Comparison of means between two groups showed a trend of higher severity in all dimensions of ATEC in Children with comorbidities but not significantly.

Our results extended the autism literature in association of comorbidities with lower performance in social and behavioral issues.

Despite its high effectiveness, electroconvulsive therapy (ECT) is not a widely used method to treat depression. One of the reasons for this could be the fear of cognitive side effects. The aim of this study was to investigate effects of ECT on cognitive function.

We conducted a prospective study with a sample size of 23 patients (10 male), who met the criteria of treatment-resistant depression according to ICD–10 and gave their informed consent for ECT treatment. Before and after ECT, the following investigations have been performed: Beck depression inventory (BDI), Montgomery-Asberg depression rating scale (MADRS), Mehrfachwahl-Wortschatz-Intelligenztest (MWT-B), trail making test (TMT) A and B, stroop-test, mini mental state examination (MMSE) and the German version of the California verbal learning test (MGT).

After ECT treatment, we found highly significant changes of depression-scales BDI (P = 0.028) and MADR-Scale (P = 0.001). IQ as measured by the MWT-B (P = 0.851), executive functions as measured by trail making test A (P = 0.568) and B (P = 0.372) and stroop-test, memory functions as measured by the MGT (P = 0.565) (Figure 1) and MMSE (P = 0.678) did not differ significantly after ECT treatment.

There were no significant differences in cognitive function before and after ECT treatment. To confirm these findings, it would be necessary to perform larger studies.

The authors have not supplied their declaration of competing interest.

Patients with dissociative identity disorder (DID) present two or more identities, where one of them is the main one. Although it is a widely questioned diagnosis, it is currently found in the main DSM-5 and ICD-10 diagnostic manuals.

Present a case of dissociative identity disorder.

46-year-old woman who attended the CSM referred for her MAP due to anxiety-depressive symptoms. Throughout the interviews the patient brings up to 4 identities with alterations in memory, consciousness, multiple dissociative symptoms, sound thinking, constant fluctuations in mood. She is separated, has two children, takes care of them, although she is not able to maintain work functionality. The patient is seen once a week for 45 minutes. Psychotherapeutic treatment is carried out, the objective of which is to establish a safe therapist-patient bond to favor the integration of their parts, and pharmacological treatment, which was carried out with haloperidol, lorazepam and desvenlafaxine.

Throughout sessions, the anxious symptoms diminished, being able to carry out psychotherapeutic work. Dissociative symptoms were slightly reduced, partially integrating some of the identities. There was a slight stabilization in mood and decrease in psychotic symptoms.

There is no well-established treatment for DID. Combined therapy (psychotherapy and pharmacological) may be an option for these patients. The therapeutic framing of the sessions, working the link, and the low-dose antipsychotic treatment were favorable.

dissociative identity framing link

Kleefstra syndrome [OMIM: 610253] is caused by a 9q34.3 micro-deletion or an intragenic mutation in the EHMT1 gene. Its core phenotype comprises intellectual disability, childhood hypotonia and distinct dysmorphisms. The syndrome can be associated with congenital anomalies, epilepsy, cardiac arrhythmias and a typical sleep pattern. Starting from adult age, a regressive phenotype may develop.

Further delineation of the neuropsychiatric phenotype.

Formulating a comprehensive treatment approach.

Detailed examination of two patients with EHMT1 mutation.

Patient 1, male aged 34 years, showed recurrent behavioral problems with aggression and self-injuries as well as obstipation. Elsewhere, a diagnosis of autism was established. Aged 24, he suffered from some epileptic seizures. Recently, paroxysmal atrial fibrillation was diagnosed. Neither treatment with pipamperone and risperidone nor with valproate was effective for behavioral control. Array analysis and metabolic screening did not reveal abnormalities. Whole exome sequencing revealed an intragenic EHMT1 mutation. Patient 2, female aged 53 years, was known with childhood epilepsy and developed gradual decline of general functioning with motor slowing from her third decade. In her thirties, a mood/anxiety disorder was suspected for which several antidepressants were given without any effect. Array analysis was normal. A pathogenic nucleotide deletion was identified resulting in a frame-shift in exon 21 of the EHMT1 gene. In both patients marked apathy was observed (AES = 62 and 64, respectively).

Apathy syndrome in Kleefstra syndrome should be differentiated from depression and autism. Apart from treatment with selected psychotropics, individually targeted contextual measures should always be implemented.

The authors have not supplied their declaration of competing interest.

The difficulties in the clinical antidepressant treatment lead to the pursuing of more effective methods such as transcranial magnetic stimulation (TMS). Mixed findings from DLPFC targeted TMS result in the exploration of optimal stimulation location. Disturbed function of obitofrontal cortex (OFC) has been indicated in depression, which is involving in the remission of depression. However, whether it could be a more specific treating target is not tested. Simultaneously, disturbed reward network (RN) has been confirmed in depression, however, whether this could be improved by TMS treatment remains unclear.

Fourteen patients with major depressive disorder (MDD) were allocated in a four-week course of OFC targeted TMS. Motivated by the literature, before and after the treatment, the function connectivity of RN with the seed of ventral striatum was conducted. The results were also compared with the data from 33 healthy controls.

The OFC targeted TMS improved the clinical depression significantly and enhanced the function connectivity within the RN effectively. Specifically, lower baseline dorsolateral striatum connectivity predicted strong therapeutic effect of TMS on depression, while lower baseline insula connectivity predicted weak therapeutic effect on depression.

The findings offer the first experimental evidence of the therapeutic effect of OFC targeted TMS on clinical depression, enhanced function connectivity within RN might be the potential neural mechanism (Fig. 1). Lower dorsolateral striatum connection might be a reliable neural biomarker of strong responding for TMS treatment, which helps to identify the patients who will be cured by TMS most effectively.

To evaluate the subjective well-being of a group of patients who were hospitalized at the Institute of Psychiatry (Novara), compared to the severity of illness.

Patients are evaluated at admission and discharge through self-administration of the SWN (Subjective Well-being under Neuroleptics) scale, which contains five subscales (emotional regulation; self-control; mental functioning; social integration and physical functioning) assessing patients’ psychophysical and emotional well-being, calculating a value for each subscale and a total score. The clinician fills in the CGI (Clinical Global Impression) for each patient, which provides a global judgement in three areas: severity of illness, global improvement and therapeutic effectiveness.

From June 2009, 51 patients were evaluated at admission and discharge: 26 diagnosed with psychosis and 25 diagnosed with personality disorders. Preliminary data suggest a meaningful improvement of the physical functioning in the psychotic group, a tendency to improvement of the social integration area in the personality disorders group. Among the psychotic group, the schizophrenic patients (n°=14) have shown an improvement in the self-control subscale.

Literature suggests that a high SWN score is associated with a better compliance and an early improvement of subjective well-being is a major predictor of the chance of remission. This study will allow to compare the subjective well-being evaluated by SWN with the clinical judgment of the CGI and above all if this can represent a predictor index for the compliance and the chance of remission.

The prevalence of ASD among the adult population is estimated to be 1 percent. Despite high rates of anxiety and depression among adults with ASD, treatment methods for these comorbid conditions have not been systematically studies or compared in this patient population. Recently, MBSR and CBT protocols were adapted for adults with ASD and could be excellent candidate therapies for reducing anxiety and depression.

We wanted to study the ability of both treatment methods to reduce anxiety and depression symptoms among adults with ASD, and to determine which therapy is best suited for which patient.

A three-arm RCT among 90 adults with ASD (30 MBSR, 30 CBT, and 30 treatment as usual, (TAU)), was conducted in an outpatient setting with measurements at the start and end of the 14 week treatment period, and at 3 months follow-up. Prior informed consent and medical ethical approval was obtained. Instruments included the hospital anxiety and depressions scale, rumination, irrational belief and mindfulness scales, and an autism symptom checklist.

Preliminary results indicate that both MBSR and CBT lead to a significant reduction in anxiety and depression among adults with ASD. Both MBSR and CBT were superior to TAU. There was no gender or age effect. Effectiveness in relation to patient characteristics will be discussed.

Mindfulness and cognitive behavioral therapies are promising treatment methods to reduce comorbid anxiety and depression in adults with ASD.

Thomas Gargot was paid by the French ministry of research (Doctoral school), French ministry of health (médaille d’argent, CCA-AHU) for a PhD and CCA position. During his PhD, he prepared several scientific presentations with Dr Asselborn. This work led

The presentation considers the peculiarities of late adulthood, different views on the periodization of older ages (World health organization, I. Burnside, H.S. Pryazhnikov).

The research is aimed at studying the peculiarities of late adulthood.

The method of work is a bibliographic analysis.

Reveals the structure of psychological age (concept by L.S.Vygotsky), the specificity of the development in late adulthood and features of the social situation of development. Reveals modern ideas of ageing as a process not only of involution and loss, but also a process of continued development. The greatest attention is paid to the peculiarities of development tasks at older ages and the difficulties faced by older people trying to cope with them. There are the brief overview of the positions of C.G.Jung, A.Adler, E.Erikson, R.Peck, G.M.Bryugman, A.G.Liders, N.S.Pryazhnikov, E.E.Sapogova, I.V.Shapovalenko, V.I.Slobodchikov, G.A.Zuckerman, etc. regarding the development tasks in late adulthood. The comparison of the development tasks of early and late age periods by G.M. Bryugman, which shows that the tasks of aging worse defined, at least sequentially ordered, and the results of solution of development tasks is less predictable than in earlier ages.

We can say that in old age is important not only the task of adjusting to different changes of pace of life, quality of life, social circle, etc., and overcome the negative aspects of aging but also issues of self-development. As the primary development task in late adulthood is considered an achievement of his own integrity and finding the meaning of life.

No significant relationships.

In a previous study (Senín-Calderón et al., 2010) we observed that the REF scale of referential thinking (Lenzenweger et al., 1997) didn’t discriminate among different mental disorders.

We try to verify if self-references in various disorders are related to the severity of psychopathology (patients from public hospital and a private clinical). We predict that there will be differences between patients and controls, but not between the clinical samples. Psychotic disorders will be characterized by a significantly greater presence of self-references.

Participants: 287 subjects, 47 patients from a private clinical center, 57.4% women (mean age = 35.02, SD = 12.69), 30 patients from a public hospital, 53.3% women (38.36 years, SD = 9.53), and 210 controls selected from the general population, 50.5% women (33.80 years, SD = 11.79). Cross-sectional design, correlation method. All analysis were accepted at p < .05.

There are significant differences in self-references between patients and controls in frequency (t (285) = 2.33, p = . 021) and intensity (t (83.98) = 3.59, p = . 001). No significant differences between patients groups (p>.05) (REF-intensity without homogeneity, p < .05). No significant differences in self-references between types of diagnoses except psychotic patients versus adjustment disorder (frequency and intensity).

Self-references are highlighted in psychosis but, with the exception of adjustment disorders, doesn’t discriminate between personality, mood or anxiety disorders. Differences are more related to the clinical severity (BPRS) than with referential thinking.

Mindfulness refers to a process that leads to a mental state characterized by non-judgmental awareness of the present moment experience, including one´s sensations, thoughts, bodily states, consciousness, and the environment, while encouraging openness, curiosity, and acceptance.

The purpose of this paper is to review the ways in which cognitive and behavioural treatments for depression and anxiety have been advanced by the application of mindfulness practices.

Brief non-systematic literature on the topic.

Mindfulness has spread rapidly in Western psychology research and practice, in large because of the success of standardized mindfulness-based interventions, consequently research on mindfulness based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfullness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), which incorporate the essence of Eastern mindfulness practices into the Western cognitive-behavioral practice. MBIs have showed efficacy in reducing the severity of anxiety and depressive symptoms in a broad range of treatment seeking individuals. MBIs have also been showed to perform with not so different results to cognitive-behavioral therapy (CBT).

MBIs have been showed to be important co-adjuvants to pharmacological treatment and psychotherapy of depression and anxiety. To prove this point without doubts and create adequate guidelines that include these forms of treatment more research needs to be done on the matter.

None Declared