There is a significant prevalence of morbid obesity among the population in the United Arab Emirates (BMI>40kg/m2). This has been accompanied by a growth in bariatric surgery.

To study psychiatric co-morbidity in obese patients seeking Bariatric Surgery.

To identify baseline psychological characteristics such as symptoms of anxiety and depression that may potentially interfere or complicate the surgical procedure.

Eighty eight consecutive obese patients (F=69, M=19) seeking bariatric surgery were recruited at Tawam Hospital in Al Ain. Behavioral/psychosocial evaluations were conducted to screen for symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HAD). The impact on the degree of perceived disability was assessed on the four functional dimensions of the Sheehan Disability Scale (SDS). Statistical methods used Pearson Correlation to study correlation between scales and quantitative variables, while frequencies were determined for categorical variables.

The reported frequency of significant symptoms on the HAD were 26.7% for anxiety and 14.7% for depression. The average mean disability scores on the SDS were 21.3%. The relative frequency of disabilities on each of the 4 dimensions of functioning were 28.7%, 35.0%, 36.3%, 36.3% consecutively. Higher Depression scores were associated with marked disability on the dimensions of Social life, Family/home responsibilities and Religious duties (0.61, 0.38, 0.29 consecutively). Meantime, anxiety scores were associated with higher disability on social life, family/home responsibilities (0.39 and 0.3) but not on work/school or religious duties.

Anxiety and depressive symptoms are common among bariatric patients with morbid obesity in the UAE.

An international, randomized, double-blind, parallel-group study was designed to determine the efficacy and safety of quetiapine+Li/DVP compared with placebo+Li/DVP in the prevention of recurrent mood events (manic, mixed, or depressed) in patients with bipolar I disorder.

Patients with bipolar I disorder (DSM-IV, most recent episode manic, mixed or depressed) received open-label quetiapine (400–800 mg/day; flexible, divided doses) plus Li/DVP (target serum concentrations 0.5–1.2 mEq/L and 50–125 μg/mL, respectively) for up to 36 weeks to achieve at least 12 weeks of clinical stability. Patients were subsequently randomized to double-blind treatment with quetiapine (400–800 mg/day) plus Li/DVP or placebo+Li/DVP for up to 104 weeks. Primary endpoint was time to recurrence of any mood event defined by medication initiation, hospitalization, YMRS or MADRS score ≥20 at two consecutive assessments or at final assessment if the patient discontinued, or study discontinuation due to a mood event.

1461 patients entered the stabilization phase and 703 (48%) were randomized to double-blind treatment receiving at least one dose of study medication (ITT population). A markedly lower proportion of patients had a mood event in the quetiapine+Li/DVP versus placebo+Li/DVP group (18.5% vs 49.0%, respectively), with a risk reduction of 72% (hazard ratio 0.28; P<0.0001). The incidence of adverse events was similar between the two treatment groups.

Maintenance treatment with quetiapine+Li/DVP significantly increased the time to recurrence of any mood event compared with placebo+LI/DVP. Long-term treatment with quetiapine was generally well-tolerated.

Supported by funding from AstraZeneca Pharmaceuticals LP.

Involuntary admission of mentally ill patients tends to be related to clinical severity and worst therapeutic response.

To evaluate whether there is a relationship between involuntary admission and prescription of two or more antipsychotics (that is, polytherapy) among patients with schizophrenia and other psychosis.

A total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.

Out of the total sample, 150 (62.2%) patients were on polytherapy, and of the 241 patients 134 (55.6%) were involuntarily admitted. Involuntary admission was unrelated to age (p = 0.335), specific diagnosis (p = 0.452), or length of psychosis (p = 0.234). On the contrary, it was related to gender (61.8% of males vs. 46.4% of females were involuntary, p = 0.018) and to polytherapy/monotherapy prescription (62.0% of patients on polytherapy vs. 45.1% of patients on monotherapy were involuntarily admitted; and 53.3% of voluntary patients vs. 69.4% of involuntary were on polytherapy p = 0.010). After controlling for age, gender, specific diagnosis and length of psychosis the association between involuntary admission and being in polytherapy remained significant (p = 0.047).

Patients involuntarily admitted are more prone to be on antipsychotic polytherapy.

With the introduction of antiretroviral treatment, the survival rates of Human Immunodeficiency virus (HIV) patients have improved significantly. However, the incidence of HIV- associated neurocognitive disorders (HAND) gained importance and represents actually a significant public health problem.

Neurological soft signs (NSS) refers to subtle neurological abnormalities in motor and sensory performance. The presence of these symptoms has been widely described in patients with mental diseases like Schizophrenia or Alzheimer’s Disease, but have not been studied in HAND despite its known subcortical physiopathology.

To study the prevalence HAND in a Chilean cohort of HIV patients and describe its association to NSS.

HIV patients without history of head injury trauma or opportunistic infections of the CNS were recruited from the HIV clinic, underwent a thorough clinical interview and neuropsychological testing. Healthy controls were recruited from the community. All participants were assessed with the Heidelberger NSS scale. HAND was diagnosed using NIMH and NINDS criteria.

Until now, 35 HIV+ patients and 18 controls completed the described assessment. 11 patients were cognitive healthy, 11 with Asymptomatic Neurocognitive Impairment (ANI) and 13 with Mild Neurocognitive Disorder (MND). NSS total score differed significantly between groups (F= 2,92 (DF=3), p<0.05), with MND and ANI patients showing the highest score. Duncan post hoc test showed group differences in NSS total scores with Controls >ANI, MND and Cognitive healthy HIV>MND.

Our data supports the use of NSS as a marker of HAND. It should be considered in the clinical examination of HIV patients.

The association between cannabis and psychotic outcomes is systematically reported. Δ9-tetrahydrocannabinol (THC) is the main psychoactive component of cannabis products and studies emphasize the concentration of THC as the main measure of cannabis potency. Cannabidiol (CBD) is another component of cannabis and studies have suggested that CBD might have antipsychotic properties and could therefore modify the paradigm of pharmacologic treatment in psychotic disorders.

This work aims to describe the latest knowledge about CBD, its molecular targets and possible therapeutic use in psychiatric disorders.

This revision was based in articles published in PubMed/MEDLINE, using the following terms 'cannabidiol” 'cannabis”, 'psychotic symptoms”, 'molecular targets” and 'treatment”.

CBD has multiple molecular targets (CB1 receptors, vaniloid system, hydrolysis of anandamide, agonist in 5HT-1A receptors, nuclear receptors of PPAR family and other ion channels), but a full comprehension about them is lacking. Like other cannabinoid compounds, CBD has a biphasic effect in anxiety (lower doses tend to produce anxiolytic-like effect and higher doses produce an anxiogenic-like effect), though the mechanism is not completely understood. The use of high cannabidiol content cannabis and its association with significantly lower degrees of psychotic symptoms have been reported, nevertheless CBD’s antipsychotic properties are still controversial.

The higher concentration of CBD in cannabis preparations has been related with fewer psychotic symptoms, compared with a higher THC/CBD ratio plants. Further studies must be held to conclude about CBD’s antipsychotic properties, but its effects in anxiety disorders seems to be promising.

Niemann-Pick type C disease (NPCD) is a rare metabolic illness, withautosomal recessive inheritance. NPCD has a heterogeneous presentation, withnon-specific psychiatric symptoms, mostly affective and psychotic featuresand also cognitive deficits.

We present the case reports of two brothers with an adolescent-adult onsetand discuss the evolution of their neuropsychiatric manifestations.

The patients have now 35 and 31 years old and the youngest was the first todevelop clinical manifestations of the disease. From 16 years old, hedeveloped unspecified neurological impairment with gait imbalance. In thenext years, the neurologic manifestations exacerbated, with dysarthria,ataxic gait, and his academic performance declined. With 24 years old, hepresented acute psychosis, with unstructured delusion and auditoryhallucinations. The acute psychotic symptomatology remitted with olanzapinebut he revealed social withdrawal, apathy and progressive cognitive declinethat persist until now. His brother, whose diagnosis was made in the courseof the family genetic study, developed the first signs of the NPCD with 19years old. He presented neuropsychiatric compromise, with impaired learning,social isolation and insomnia. They are receiving specific treatment withmiglustat and symptomatic treatment for the psychiatric manifestations.

NPCD is a rare metabolic disease, with neuropsychiatric compromise. Nogeneral psychopathological profile has been associated to NPCD. Sometimespsychiatric symptoms dominate the initial clinical presentation, withneuro-visceral signs appearing later. An atypical psychiatric symptomatologyshould be extensively investigated in order to exclude organic causes,including metabolic diseases like NPCD.

The authors have not supplied their declaration of competing interest.

The aim of this study was to determine the association between Iron deficiency and ADHD and the impact and role of iron deficiency on the development of ADHD in children.

Case-Control design based on 630 ADHD and 630 healthy children and conducted at the School Health and Primary Health care Clinics. The health status of the subjects was assessed by ascertaining clinical presentations and symptoms, family history, BMI, iron deficiency, ferritin, serum 25(OH) vitamin D, calcium, magnesium, and phosphorus levels. Descriptive, univariate and multivariate statistical analysis were performed.

Mean age (± SD, in years) for ADHD and control children were 11.54±3.83 vs. 11.50±3.62. There were statistically significant differences between ADHD and healthy children control subjects with respect to paternal education level (p<0.001), occupation of father (p<0.002), educational level of mother (p<0.010), monthly income (p=0.034), consanguineous marriages of parent (p=0.019) and BMI in percentiles (p<0.001), child behaviour (p<0.001), and school performance (p=0.031). There were statistically significant differences between ADHD versus control children for vitamin D, serum iron, ferritin (36.26±5.93 vs 38.19±5.61 ng/ml), hemoglobin (12.02±2.13 vs 12.89±2.02 g/dL) magnesium, serum calcium level and phosphorous. Multivariate logistic regression analysis revealed that serum vitamin D level, serum iron, ferritin, serum calcium level, physical activity, nervous behaviour, consanguinity, BMI and child order were considered as the main factors associated with the ADHD after adjusting for age, gender and other variables.

The study indicates that low serum iron, ferritin levels and vitamin D deficiency may be associated with ADHD.

Mental disorders are associated with many harmful health behaviors such as smoking, abuse of alcohol or drugs, physical inactivity and overweight. Abdominal obesity has been positively associated with depressive symptoms independent of general obesity (BMI). Adult obesity has been associated with depression, especially in women. Recent evidence implies that causal link goes from depression to obesity. This study set out to investigate the relationship between depression, sleepiness, health behavior, BMI and inflammation.

The study based on a cardiovascular risk sample drawn from the participants of a population survey, (aged 45-70) which was carried out in in southwestern Finland. The subjects filled in several internationally known questionnaires: STAI-S (state-anxiety), BDI (depression), EQH5 and RAND-36 (health-related quality of life), Berlin, ESS and PSQI (sleep disorders), smoking and generic measures on health behavior (e.g. physical exercise, time spent watching TV and using PC, intake of calories and fat). Blood samples were drawn from the subjects to measure among other things hsCRP (n=1318).

We found a statistically highly significant correlation between BMI and hCRP (r=0.22, p< 0.001). Total daily minutes watching TV correlated with hsCRP (0.12, p< 0.001). Partial correlation between total minutes spent watching television and hsCRP while adjusting for depression or BMI did not render it the correlation insignificant not diminish its size.

High level of TV use was associated with silent inflammation despite BMI. Heavy use of TV may be an indicator of harmfully increased stress levels.

Self-administered questionnaires were given to 152 nurses employed in three Portuguese public hospitals. The questionnaire items included socio demographic and job-related data and two scales: the Portuguese version of TEMPS-A Scale (Akiskal, 2005) and the Personal Self-esteem Scale (Ribeiro, J.L.P 2006). For statistical analysis besides descriptive statistics, a correlation model was used.

Hyperthimic Temperament was the more prevalent subtype. Women presented a higher Self-esteem positively correlated with Ciclothymic and Anxious temperaments. The results also show that there is a correlation between marital status and Irritable Temperament, and between the years of professional experience and the Cyclothymic and Hyperthymic Temperaments.

An interaction between temperament subtypes, self-esteem and professional experience was observed. Gender differences are also significant. Further study is needed to investigate the potential relationship between temperament, self-esteem and professional satisfaction and resilience to job-related stress factors in Psychiatric Departments.

Cognitive and Behavioral Therapy (CBT) is recognized as a valid tool to improve Obsessive Compulsive Disorder (OCD) symptoms. The orbitofrontal cortex (OFC)-striatal circuit appears to play an important role in the pathophysiology of OCD. Neuroimaging studies suggest that CBT might change its abnormal activity in OCD patients.

The aim of this study is to use longitudinal functional Magnetic Resonance Imaging (fMRI) to assess the neural correlates of clinical improvement in OCD patients undergoing CBT.

Thirty-five OCD patients with checking compulsions undergoing 15 individual weekly CBT sessions were assessed on symptom severity with the Y-BOCS [1] at four stages of the therapies: before, during, at the end of therapy and six months later. On each assessment, patients also performed a symptom-provocation task in fMRI during which they reported their anxiety level upon watching neutral photographs, generic (validated in a population of OCD checkers) vs individualized (patient's photographs of personal objects) checking-provoking photographs.

Clinically, CBT resulted in a significant improvement (Y-BOCS scores: 24.8; 18,3; 13,7; 13.9). Behaviorally, the symptom-provocation task elicited anxiety that decreased through therapy (p < 0.05), even more so for individualized vs generic pictures (interaction p < 0.05). At the brain level, individualized pictures elicited activation in a distributed network specifically in right and left OFC, where neural response decreased during and after CBT, underlining the interest of tailoring individualized symptom-provoking items on the path to neuromarkers of response to psychotherapy.

Novel psychoactive substances (NPS) use is progressively increasing year on year. The new analogues of phencyclidine are frequently sold as legal dissociative anesthetic drug with hallucinogenic and sedative effects, a legal alternative to ketamine, acting as a high affinity and selective ligand of NMDA receptor antagonists.

To describe the presence of 3- and 4-MeO-PCP in samples delivered to Energy Control from 2009 to 2015 in Spain.

A total of 21,198 samples were analyzed from august 2009 to august 2015. Only those samples containing 4-MeO-PCP or 3-MeO-PCP were studied. They were analyzed by Energy Control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography–mass spectrometry.

All the samples resulted to be the acquired drug of the consumer. Three samples were adulterated with substances as tramadol, cocaine, acetone among others.

Three and 4-MeO-PCP consumption is not found to be an emerging issue according to the results of our samples. Even the potential harmful effects of these dissociative drugs, our indirect indicator seems to show that consumption has not increased. A more precise monitoring would make a better approach to the real consumption and the impact of these substances in our society.

The authors declare that they have no competing interest.

Sexting is sending / forwarding erotic-sexual content voluntarily through technological devices and / or the internet. (Fleschler-Peskin, 2013). Real Participation (RPS), Active Disposition (ADS) and Emotional Expression (EES) was studied.

Compare sexting in two groups of participants: female and male

Comparison of data means measured by the Cronbach alpha sexting behavior scale α = 0.92, (Chacon-Lopez, et al, 2016). Sample N = 900 (447 female and 453 male)

The ADS and RPS decrease between 18 to 20 years old and increase between 20 to 22 years old. EES decreases when increasing age, except in 20 years old. Applying multiple regression analysis, control variable sex and reference group age 18 old, presents statistically significant difference, excepting 19 years old in EES and 22 years old in RPS. (Figure 1)

Comparing age and gender, ADS men present higher levels than women, excepting 19 years old. EES and RP, no significant differences are observed. Comparing women’s mean show lower AD levels than men with Cohen’s effect size d = 0.62, (Cohen, 1988). Related to PRS averages, women present lower levels than men without statistically significant differences. Comparing means, women show lower ADS levels than men effecting d Cohen d = 0.46, (Cohen, 1988). (Figure 2)

Evidence difference between men and women, in ADS and EES, without pattern associated with age, young men and women sexting

With one in ten young people being affected by ill mental health and stigma regularly cited as a factor affecting access to early intervention services, focussing resources on school based stigma reduction strategies seems prudent. ‘Headucate’, a student society, designed a 50 minute workshop which aims to increase mental health literacy and decrease stigma.

Repeated, cross sectional surveys were carried out at three time points; 1) immediately before (n=77), 2) Immediately after (n=81) and 3) three months post workshop (n=73). The surveys were paper based versions of the Reported Intended Behaviours Score (RIBS) and Mental Health Knowledge Scale (MAKS) utilising a social distance scale.

Four year 10 classed (pupils aged 14-15) were recruited. Post hoc t-tests were carried out when one-way ANOVAS were significant.

Disorder knowledge (from MAKS) and intended contact (from RIBS) significantly increased between time points one and two (p<0.01 and <0.004 respectively) but then decreased.

Analysis of the question pertaining to knowing where to access help showed a statistically significant increase (p<0.001) between time points one and two and then a decrease at time three, albeit to a higher value than at time point one (3.45 compared to 3.13, P=0.088).

Headucate workshops offer a low resource option which is well accepted by students. Like other school based stigma reduction strategies, a dramatic increase was seen between immediately before and after indicating that the workshop resonates with the pupils, but there was little sustained change in attitudes.

Posttraumatic stress disorder is considered the “signature diagnosis” of trauma. Research has shown that PTSD has an abundance of psychiatric comorbidities. Comorbidity is said to be rule rather than exception. The most often psychiatric disorders comorbid with PTSD in combat veterans are alcohol use disorders, major depression, drug abuse, and Cluster B (especially antisocial, but also borderline personality disorders).

The aim of the study was to analyze depressive disorders and PTSD and their relationship, from the aspect of comorbidity.

A retrospective analysis of 347 war veterans' medical histories, who were treated between 1991–2009 at the Military Medical Academy:

The most frequent disorders were the depressive (n = 146/42.1%), among which the adjustment disorder (135/38.9%), followed by major depression (9/2.6%), and dysthymia (2/0.6%). PTSD was diagnosed in 91 veterans (26.2%), and alcoholism in 58 (16.7%). Comorbid disorders were registered in 55 (37.7%) veterans with depressive disorders. The most frequent were arterial hypertension (14/25%), PTSD (8/14.5%) and alcoholism (7/12.7%). In veterans with PTSD, the number of registered comorbid disorders was 27 (29.7%), 11 (40.7%) of them with other anxiety disorders, 8 (29.7%) with somatic and neurological illnesses, 6 (22.2%) with psychotic disorders and 2 (7.4%) with depressive disorders.

These findings suggest that war trauma produces broad psychopathological effects, as evidenced by multiple disorders arising independently in the wake of trauma. Multiaxial assessment of posttraumatic depression, especially considering first and fourth axis of the DSM-IV-TR, is necessary for a precise diagnostic process that allows the selection of appropriate treatments.