Firstly, we will speak on the violence against women from a Russian perspective. The selected reports from regional psychiatric services and police department reports of domestic violence cases will be presented.

Secondly, we will draw upon our work developing and providing a new educational program, «Women victims of domestic violence: Detection, clinic, help,» mainly based on teaching several modules, WPA International Curriculum for Mental Healthcare Providers on Violence Against Women.

In this present paper, we examine evidence-based practice from the starting points of research as illumination and psychiatry as a discipline with hermeneutic potential, to consider relationships between research and practice and the opportunities available within the current research agenda for psychiatrists and clinical psychologists working in clinical settings.

We contend that the quality of women’s mental health services will only improve when they can acknowledge the considerable impact that intimate partner violence and sexual violence, as well as social inequalities, especially those based on gender, have on women’s mental health. We do not underestimate the difficulty of providing practical help to women whose mental health has been profoundly affected by the violence, damage that is often further compounded by years of mistreatment and revictimization in services.

The paper provides commentaries and reflections on the steps that must be taken to create opportunities to foster dialogue, discussing and exchanging ideas on a diverse range of topics relevant to the advancement of the program in the broader context.

None Declared

Most students experience some level of anxiety during the exam. However, when anxiety affects exam performance it has become a problem. Test anxiety is a special form of anxiety, which is characterized with somatic, cognitive and behavioral symptoms of anxiety in situations of preparing and performing the tests and exams. Test anxiety becomes problematic when is so high that it interferes with test preparation and performance.

The objective of this study was to ascertain the presence of test anxiety in medical students and to analyze some aspects of test anxiety in medical students of different gender, different year of studying and possibility of falling the year of studying.

Study sample consisted of 198 students of Belgrade University School of Medicine of all grade years. The assessment of test anxiety was conducted by The Test Anxiety Inventory - TAI.

1. 1) Medical students generally present moderate level of test anxiety;

2. 2) female students have statistically significant more intense symptoms of test anxiety than male students;

3. 3) most intense symptoms are in III year and the least are at VI year of studies;

4. 4) there is no statistically significant difference in presence of symptoms of test anxiety between the students who repeated some year of studies and regular students.

There is considerable number of medical students who have intense symptoms of test anxiety and those students require help and support.

Deficient emotion regulation is a common and impairing area of difficulty among children and adolescents with externalizing disorders. Emotion focused cognitive behavioral therapy ECBT is a form of CBT that is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious youth.

Examine the efficacy of an Emotion-focused Cognitive-Behavioral Therapy (ECBT) inspired program on emotional regulation difficulties and behavioral problems in children and adolescents with externalizing disorders

We conducted a cross-sectional comparative experimental study. Subjects were 50 patients exhibiting behavioral disorders aged 9 to 18 years , with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD).Participants were assigned to ECBT and control groups. ECBT group contributed in 12-h weekly sessions within ECBT-inspired program. The control group received standard care. To assess emotion-related competencies, children were administered the emotion regulation questionnaire (ERQ-CA) and the alexithymia questionnaire for children(AQC). Parents completed the Child Behavior Checklist(CBCL) to measure youth externalizing problems. Tests were administered in pre- and post-test to all subjects. Both groups were matched for age, sex and educationnal level. Comparison of pre- and post-test results was performed using the Student’s t-test.

ECBT demonstrated a significant difference in the reduction of behavioral problems. ECBT effectively increased adaptive emotion regulation strategies (cognitive reappraisal) in the post-test. ECBT also reduced alexithymia scores, particularly difficulty identifying feelings, and externally oriented thinking.

ECBT demonstrated promising initial effectiveness in addressing emotion regulation deficits of children with externalizing behaviors

No significant relationships.

The concept of person is connected to personality and self-transcendence belongs to its structure, as core component. The assessment of self-transcendence as part of human personality opens the gate of self-awareness in personology. Robert Cloninger is a distinctive researcher because he states that the comprehensive assessment of the human being includes the moral-spiritual dimension which implies deep self-awareness, in the absence of which subjective well-being is not possible.

Thus, in Cloninger's view self-transcendence is a character dimension. Self-transcendent individuals are often described as un-demanding, fulfilled, enduring, creative, altruistic, spiritualized. High self-transcendence has adaptive advantages when the individuals deals with suffering and death, which are inevitable once the person grows older.

131 patients with personality disorder aged 19 to 62 were included in the study. Temperament and Character Inventory; Multicultural Quality of Life Index (J. Mezzich et all, 2000).

The assessment of the relationship between the scores in personality dimensions and the quality of life.

Significant correlations were ascertained between the character dimension Self-transcendence and the Multicultural Quality of Life Index. Thus, according to this correlation analysis, (r2 = 0,035) of the variation of the score on the Multicultural Quality of Life Index is given by variations of the Self-Transcendence score.

The assessment of the self-transcendence dimension as part of human personality opens the doors of knowledge in personology.

Human personality directly influences scores in quality of life scales through character dimensions.

The most common cause of vascular psychosis is cerebrovascular disease. Tipically a late-onset in the elderly is accompanied with multiple strokes (disruption of blood flow to the brain). Dementia is a clinical syndrome characterised by cognitive, neuropsychiatric, and functional symptoms. About neuropsychiatric symptoms there are multiple warnings concerning the use of antipsychotics in people with dementia due to an increased risk of death and stroke.

Presentation of a case of vascular psychosis with a literature review of antipsychotic drugs used in these cases.

We carried out a literature review in Pubmed electing those articles focused on antipsychotic treatment options.

A 81-year-old man was taken by his son seeking medical assistance due delusions of reference and auditory hallucinations. He believed that his family wanted to kill him. He had the sensation about how multiple voices were telling him about to scape from people who wanted to kill him. After a completelly study and CT, chronic microvascular infarctions where found. After onset of non effective treatment with haloperidol 1.5 mg during 1 week, we switched into risperidone 1.5mg. Effective treatment was found and now patient is under control of sypmtoms.

Different antypsichotic treatments are described in the literature. Risperidone, quetiapine and olanzapine were found as most used antipsychotic for psychosis in vascular dementia. Comparision of side effect profile of antipsychotic and effectiviness must be the target for an adecuate treatment.

No significant relationships.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized with ritualized behavior, difficulties in communication/ social interaction, restricted interests, and sensitivity to external stimuli. The ASD has gained attention in recent years, however it’s still difficult in geropsychiatric setting to identify high-functioning ASD, especially when patients’ coping mechanisms are successful. Not to determine high-functioning ASD structure in older age can lead to wrong diagnosis and inappropriate treatment trials.

The aim of this presentation is to emphasize the importance of the evaluation of ASD-structure in old-age-psychiatry through the case study of a 65-years-old man.

One case report from the inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be presented.

Case: The patient was referred to our acute-psychiatric-ward due to delusional thoughts, depressive symptoms and lorazepam dependency. Delusional disorder was diagnosed in the outpatient-setting since he had interpreted some external stimuli in an eccentric way. During the therapeutic process, some features of high-functioning ASD such as social difficulties, dislike of change and repetitive/restrictive habits were prominent. Developmental history of the patient and the Autism-Spectrum-Quotient-50 also supported the clinical diagnosis of the ASD. Delusional disorder was excluded, and the therapy organized according to the structure characteristics of the high-functioning ASD which yielded to significant amelioration of depressive symptoms and increased perceived life quality of the patient.

Although coping mechanisms of the patients can be successful, identifying high-functioning ASD-structure even in an old-age can be quite helpful in diagnostic/therapeutic processes. An elaborate discussion of the subject through contemporary literature will be presented.

No significant relationships.

Although obsessive–compulsive disorder (OCD) is highly prevalent in schizophrenia, its relationship with patients’ real-life functioning is still controversial.

The present study aims at investigating the prevalence of OCD in a large cohort of non-preselected schizophrenia patients living in the community and verifying the relationship of OCD, as well as of other psychopathological symptoms, with real-life functioning along a continuum of OCD severity and after controlling for demographic variables.

A sample of 327 outpatients with schizophrenia was enrolled in the study and collapsed into three subgroups according to OCD severity (subclinical, mild–moderate, severe). A series of structural equation modeling (SEM) was performed to analyze in each subgroup the association of obsessive–compulsive symptoms with real-life functioning, assessed through the Specific Levels of Functioning Scale and the UCSD Performance-Based Skills Assessment. Moreover, latent profile analysis (LPA) was performed to infer latent subpopulations. In the subclinical OCD group, obsessive–compulsive symptoms (OCS) were not associated with functioning, whereas in the mild–moderate OCD group, they showed a positive relationship, particularly in the domains of work and everyday life skills. The paucity of patients with severe OCD did not allow performing SEM analysis in this group. Finally, LPA confirmed a subgroup with mild–moderate OCS and more preserved levels of functioning.

These findings hint at a positive association between mild–moderate OCD and real-life functioning in individuals with schizophrenia and encourage a careful assessment of OCD in personalized programs to sustain daily life activities.

Modulators of the brain renin-angiotensin system (RAS) have been shown to improve cognitive functioning in several animal models of neuropsychiatric disorders. Moreover, the brain RAS has been considered a new target for the treatment of Alzheimer's disease (AD). However, there are no population-based follow-up studies supporting this hypothesis.

Cross-sectional and prospective relationships between cognitive decline and ARB treatment were examined in the population-based Kuopio Ischemic Heart Disease Risk Factor Study.

To evaluate procognitive/antidementia capacity of orally delivered angiotensin II receptor blockers (ARB).

The study was conducted on a sample of 1774 subjects (920 females, 854 males; age range at baseline: 42–61 years) from Eastern Finland. An established cutoff score of at least 2-point decrease in the Mini Mental State Examination over a 9-year follow-up was used to detect age-related cognitive decline in the cross-sectional setting. In the prospective setting, a hospital discharge diagnosis of dementia/AD was used as outcome variable. Cross-sectional relationships were determined with logistic regression and prospective analyses were conducted with the Cox proportional hazards model (both adjusted for relevant background variables).

Cross-sectional analysis displayed a decrease of the odds of cognitive decline (n = 87; 4.9% of participants) in those with ARB treatment; OR = 0.445, 95% CI: 0.22–0.90, P = 0.024. Furthermore, in the prospective setting, the risk of dementia/AD diagnosis (n = 149; 8.4% of participants) was significantly reduced in ARB treated participants; HR = 0.621, 95% CI: 0.40–0.98, P = 0.038.

ARB treatment is associated with a decreased risk for age-related cognitive decline and dementia/AD manifestation.

The authors have not supplied their declaration of competing interest.

Insight is a complex and multidimensional phenomenon. Metacognition, awareness of illness or anosognosia are some of the terms used to designate this feature of the mental state exam.

To attempt to explore the evolution of the concept of insight as a psychiatric symptom over the years and to bring up some up-to-date features on this theme.

Literature review, using the most relevant papers, with the keywords “psychiatric insight”, “awareness of illness”, “metacognition” and “phenomenology”.

The term ‘insight’ has been described since 1896 when Kraepelin had noticed that patients with dementia praecox were unaware of their condition. Nowadays, it is recognized in several psychiatric disorders, with different meanings in each one. Overall, insight in psychiatry involves an attempt to see one’s thinking and behaviour ‘objectively’ and comparing it to some representation of mental health. Impaired insight has been linked to poor treatment compliance and outcomes, overall symptom severity, higher relapse, lower self-esteem, and impaired psychosocial functioning. White matter and connectivity problems may be related to poorer insight, as well as impaired frontal lobe functioning. In psychotic disorders, lack of insight is a primary symptom with poorer outcomes. Regarding affective disorders, the lower the mood the better the insight. Neuroimaging has been correlating insight with the inferior frontal gyrus, anterior insula, inferior parietal lobule, and ventromedial prefrontal cortex. In everyday practice, there are scales used to assess insight.

Inferences about patients’ insight are important to evaluate severity of illness, suicidal risk, compliance, and response to treatment.

German mental health care providers report to encounter many cases of NSSI in their professional context, but only around 50% know about the treatment guidelines for NSSI of children and adolescents. Many consider professional training about NSSI as necessary for themselves. In response to this need, within the project Star Train different strategies of dissemination of the content of the guidelines were developed.

This study aims at comparing the effectiveness of different strategies of dissemination: printed material, e-learning and blended-learning.

Participants were randomly assigned to one of three different learning formats: printed material, e-learning, and blended-learning. Via online-survey participants provide pre- and post-training self-assessments of their knowledge of NSSI, practical skills, self-efficacy in handling cases of NSSI and attitudes towards NSSI and those affected. Additionally a multiple-choice-test of NSSI is assessed. For data-analyses between-group and within-group comparisons were conducted using a mixed design ANOVA. To ensure quality of learning formats, user-satisfaction was surveyed.

Data of the pretest-posttest comparison group design show that knowledge, practical skills, and self-efficacy in handling cases of NSSI raise for all participants and that attitudes towards NSSI and those affected are improved. There is no difference between the learning formats, thus all participants profit equally from their education. User satisfaction is high.

Results of this study suggest that the developed different training strategies can contribute equally to a better understanding and enhance skills of professionals regarding NSSI. The choice of training method could be driven by considering which goals want to be achieved and cost-value ratio.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by frequent comorbidity including mood, anxiety and psychotic disorders. Psychiatric comorbidity in ASD has been associated with poor prognosis.

To summarize clinical data regarding the relationship between autism spectrum disorder and psychosis comorbidity, namely its epidemiology, diagnosis, treatment and prognosis.

We conducted a non-systematic review of the literature relevant to the topic published in the PubMed database. Articles were selected based on title and abstract review.

Epidemiological studies report significant rates of comorbidity between ASD and psychosis. According to a recent systematic review, prevalence of non-affective psychosis in ASD has been estimated at 9,56%, despite heterogeneity across included studies.

The differential diagnosis of psychosis in a patient with ASD is frequently a challenge and depends on the severity of intellectual and language impairment, medical comorbidities (including epilepsy and associated pharmacological iatrogenic factors), psychiatric comorbidities and substance use. Conversely, establishing the diagnosis of ASD in a patient presenting with psychosis is not always clear, and clinicians must rely on collecting a detailed developmental history.

There are no large controlled studies regarding the treatment of psychosis in this specific patient group, but risperidone and aripiprazole have been used based on efficacy in primary psychotic disorders, as well as efficacy and safety profile in other symptomatic clusters of ASD, namely irritability.

ASD and psychosis comorbidity has been associated with lower response rates to antipsychotic treatment and negative long-term prognosis.

Psychosis is a common and serious comorbidity of ASD, with limited data regarding treatment options. Further research is needed to improve global outcomes.

None Declared

To evaluate the efficacy and tolerability of once-daily quetiapine XR (extended release) monotherapy in patients with MDD (unipolar depression) compared with placebo.

8-week (6-week active treatment, randomised phase; 2-week post-treatment drug-discontinuation/tapering phase), multicentre, double-blind, parallel-group, placebo- and active-controlled study (D1448C00002). 612 patients were randomised to quetiapine XR 150mg/day (n=152), 300mg/day (n=152), duloxetine 60mg/day (n=151) and placebo (n=157). Primary endpoint: baseline to Week 6 change in MADRS total score. Secondary variables included: baseline to Week 6 change in HAM-D total and Item 1 (depressed mood) scores. Safety assessments included AE reporting.

Mean MADRS total score (overall baseline mean, 30.15) was significantly reduced at Week 6 by quetiapine XR 150mg/day, 300mg/day and duloxetine versus placebo (−14.81, −15.29, −14.64, −11.18, respectively; p≤0.001).

At Week 6, mean HAM-D total scores (overall baseline mean, 25.25) were significantly reduced versus placebo (−10.26) by quetiapine XR 150mg/day, 300mg/day (−13.12, −14.02, respectively, p≤0.001) and duloxetine (−12.37, p<0.05). Mean HAM-D item 1 scores (overall baseline mean, 3.03) were significantly reduced versus placebo (−1.07) by quetiapine XR 150mg/day, 300mg/day (−1.49, −1.56, respectively, p≤0.001) and duloxetine (−1.53, p<0.001).

Incidence of serious AEs were low (≤2%) in all groups. Most common AEs (>10%) were dry mouth, sedation, somnolence, dizziness, headache and nausea with quetiapine; dizziness and headache with placebo; and dry mouth, sedation, somnolence, dizziness, headache, constipation, nausea, diarrhoea and insomnia with duloxetine. Most AEs were mild-to-moderate in intensity.

Quetiapine XR monotherapy at 150 and 300mg/day was effective and well tolerated in the treatment of patients with MDD.

Mental pathology is relatively prevalent in the women, and there is often a need for treatment with psychotropic drugs, with an impact on women’s reproductive health. The use of contraception is widely spread among this population and the choice between these methods must be considered carefully.

This review aims to present the main interactions between contraceptive methods and psychotropic therapy and its impact on psychiatric disorders, in addition to the precautions to be taken in their choice.

Literature review of relevant articles on Pubmed. Query: Contraceptive+(psychiatric disorder, depression, anxiety, schizophrenia, bipolar disorder, psychotropic drugs).

Based on current evidence, no statistically significant differences regarding unplanned pregnancy rates or the psychotropic treatment outcomes were found when using combined oral contraceptives and antidepressants, benzodiazepines or atypical antipsychotics (being clozapine the exception). The impact of contraceptive methods on mood was unclear, as some articles showed an association between contraceptive use and a higher risk of beginning antidepressants and others showing no differences or even as a protective factor. Although the interactions of the aforementioned drugs are infrequent, there are cases where important interactions occur, such as clozapine, valproic acid, lamotrigine and carbamazepine, as some herbal products as the St.John’s wort. With clozapine, there is an increased serum concentrations, while the opposite occurs in the case of valproate and lamotrigine with a decrease of 32.6% and 23.4%, respectively. Treatment with valproic acid in women of childbearing age has been discouraged because of its association with polycystic ovary syndrome, elevated testosterone concentrations and menstrual irregularities, in addition to the risk of fetal malformations. In cases where this drug is prescribed, it is recommended to use highly effective methods such as subcutaneous implants or intrauterine devices. Lamotrigine and carbamazepine reduce the effectiveness of some contraceptive methods, such as oral contraceptives, transdermal patch and vaginal ring, in which case the placement of a subcutaneous implant or intrauterine device is indicated.

The magnitude of the impact between contraceptives, regarding depressive disorders, is unclear. The evidence shows that some women report the appearance and recrudescence of depressive symptoms, evidencing the need of further studies to identify the risk factors in these cases. The importance of clear and simple information and a shared decision on which contraception to choose is crucial, as clarification about their interactions with psychiatric treatment. The clinician must also be aware of the implications for reproductive health, in order to reduce the risks and side effects associated with some drugs.

None Declared

While research on religious beliefs as an adjustment is on the rise, less is known regarding such process following stillbirth and no study has been conducted on a sample of Moroccan women.

The aim of the present study is to extend the current literature by:

– identifying a typology of Moroccan women who experienced stillbirth based on several dimension of religious coping strategies;

– examining whether these profile differ on grief, anxiety, posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) symptoms.

One hundred Moroccan women who experienced stillbirth were recruited through a Moroccan public hospital. At 6 weeks following stillbirth, they completed questionnaires assessing Religious Coping Strategies (RCS), PTSD, PTG, anxious and grief symptoms.

Five clusters were identified: one with high level of plead and religious avoidance coping strategies, one with high level of interpersonal coping strategies, one with multiple religious coping strategies, one with discontent religious coping strategies and one with low religious coping strategies. High levels of psychological symptoms were found in the 5 cluster and PTG symptomatology was as associated with increased RCS.

Our findings suggest that, while religious beliefs and practices as a coping strategy do not protect from short-term psychopathological symptoms in the immediate aftermath of stillbirth, they play an important role in the development of positive reactions. As PTG symptoms have been reported be a protective factor for long term psychiatric symptomatology further longitudinal studies focusing in this area is warranted.

The authors have not supplied their declaration of competing interest.

Several epidemiological studies revealed prevalence-rates of Internet Addiction (IA) - which was currently proposed as an independent disorder for DSM-5 - ranging from 0.5 to 1 per cent. Above all, patients with IA show psychopathological patterns (craving, tolerance, withdrawal, mood modification, relapses) comparable to substance-related disorders. Besides, IA is frequently accompanied by various comorbidities, such as anxiety, depression or personality disorders.

The aim of the present study was to assess typical clinical characteristics and disorder-specific cognitive styles in a subgroup of patients with IA and an underlying Borderline Personality Organization (BPO) in a consecutive sample of over 450 treatment-seekers in an Outpatient Clinic for Internet and Computer game Addiction.

20 patients, who fulfilled both: the diagnostic criteria of IA and a Borderline Personality Disorder were compared with a matched control-group of BPO-patients without psychopathological but extensive Internet use. Both groups were assessed with the FGG (Questionnaire on borderline-specific cognitions and feelings, Renneberg et al., 2004) and further psychological features (e.g. global assessment of functioning (GAF), self-efficacy (SWE) and sensation seeking).

BPO-patients with IA show an increased mean of the total score of the FGG as well as of further clinical measures. The results lead to the assumption, that BPO-patients with IA use more disorder-specific cognitions, show higher mental strains and lower levels of health-related well-being compared to BPO-patients with only an extensive internet use.

Internet addictive behavior in BPO-patients may serve as avoidance behavior in order to subdue the burden of the primary disease.

Identifying the risk factors for conduct disorder is important for the diagnosis, treatment and management of conduct problems. It is well-known that conduct disorder is associated with parental psychopathological conditions like maternal depression, paternal antisocial personality disorder, alcohol and drug abuse.

It's aimed to investigate the role of psychopathological characteristics like temperament, attachment styles and trait anger of parents in adolescents with conduct disorders and compare the results with respect to gender.

101 parents consisting of 35 mothers in both groups, 15 fathers in 35 female adolescents and 16 fathers in 35 male adolescents have been included in the study. Mothers and fathers in the sample group have been compared in terms of psychopathological characteristics. Parents included in the study have been evaluated using the Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire, Adult Attachment Scale, State Trait Anger Scale and Sociodemograhic Data Form.

Acumulative assessment has revealed that depressive and anxious temperaments, insecure attachment style are more common among mothers, compared to fathers. Anger-in scores in mothers were higher than the fathers. Hyperthymic temperament was more prevalent among fathers.

According to the obtained data, it can be said that, there are differences in the psychopathological characteristics of parents of adolescents with conduct disorder. The preservation, treatment and management of conduct disorder in adolescents requires an evaluation of the parents' Psychopathological characteristics.