Sexuality is an important part of health, quality of life and general well being. Most of the studies have concentrated on male sexual dysfunctions and very few studies are done on female sexual dysfunction. But sexual dysfunction is more prevalent in women than in men. Studies from India have reported prevalence of female sexual dysfunction varies from 33.3% to 73.2%.

To study the prevalence of sexual dysfunction in females.

This is a cross sectional study of descriptive and exploratory design, conducted at JSS Hospital, Mysore. A total of 938 female subjects were taken for the study after they fulfilled inclusion criteria and informed consent was obtained from the patients. The method of sampling has been random. All the study subjects were assessed for psychiatric disorders using MINI PLUS.A detailed socio-demographic data was then obtained from the patients. They were further assessed on Arizona Sexual experience scale to screen for sexual dysfunction. This was followed by detailed evaluation of sexual functioning using Female Sexual Function Questionnaire(SFQ 28). Detailed analyses of all the above was done using the statistical package(SPSS) version 16.0. Ethical committee clearance was obtained from the institution for the above study.

This is the first epidemiological study to report prevalence rate of sexual dysfunction in females in general population. The study revealed that sexual dysfunction is prevalent in 26.97% of female subjects. Lack of desire was the highest reported dysfunction(26.8%) followed by arousal difficulty(22.6%),difficulty in Enjoyment(20.8%),Lubrication difficulties(16.5%),difficulty in reaching Orgasm(15.5%) and Pain during intercouse(10.7%) of the subjects.

Sexual dysfunction is widely prevalent in women in India, suggesting it as a public health concern. Low reporting rates and low treatment rates were identified in the sample. Further, women with sexual disorders should be encourged to seek help and treatment from the professionals.

Depression is the most prevalent mental health condition with high morbidity and mortality. rTMS is an alternative treatment of acute depression validated in controlled trials. rTMS was approved by FDA for treatment of unipolar non-psychotic depression in patients who have failed one adequate antidepressant trial (Lisanby, 2009). Maintenance application of rTMS in depression remains under – researched.

To investigate published evidence of maintenance rTMS in unipolar and bipolar depression.

Systematic review of maintenance rTMS studies in unipolar and bipolar depression was conducted. An electronic search was carried out including The Cochrane Library, MEDLINE (1988-2014), EMBASE (1974-2014), and Psych Lit (1980-2014). References of selected articles were searched manually. English-language case reports, case series, cohort studies and controlled trials were selected. Studies reporting maintenance rTMS equal or less then 3 month were excluded.

8 case reports, 5 case series, 1 retrospective cohort study and 4 prospective open-label studies were critically appraised. No RCTs were available. Most patients reported had prolonged treatment-resistant depression. Considerable heterogeneity in maintenance rTMS frequency and parameters was observed. All studies reported short-term prolongation of remission period or preservation of acute treatment gains. Few rTMS studies reported longer-term maintenance treatment.

rTMS appears to be a viable well-tolerated option for maintenance treatment of unipolar and bipolar depression either as monotherapy or as an adjunct to maintenance pharmacotherapy. Absence of consistent stimulation parameters makes it difficult to discuss rTMS relapse prevention effectiveness in systematic way. Large sample long-term sham control studies are needed.

Electroconvulsive therapy (ECT) remains a valuable treatment for major depression with psychotic symptoms. However, it is necessary to pay special attention when there is a history of fractures.

Through the description of the following clinical case, we will emphasize the importance of screening for vertebral fractures within ECT and the different procedures that must be taken if that occurs.

We undertook a narrative literature review by performing a search on PubMed for English-written articles. The query used was “Electroconvulsive Therapy” AND “Vertebral Fractures”.

A 71-year-old woman was admitted with an episode of psychotic depression. Basic tests were performed and were all normal. After not responding to pharmacologic treatment, she was referred for ECT. The patient had a full recovery after 4 weeks of biweekly sessions. She was discharged and proposed for maintenance ECT. However, she started complaining of back pain after falling and did an X-ray and CT scan which revealed fractured L1 and L2. It was suggested conservative treatment with a Jewett orthosis. Within this period, the ECT was suspended and after a 4-week treatment, the fracture was consolidated. As there was no risk of neurological compression, the treatment was restarted with the same dosage of succinylcholine, and it was achieved complete muscular relaxation. The patient fully recovered without any orthopedic sequel.

Electroconvulsive therapy can be safely performed after conservative treatment of vertebral fractures, if special attention is provided to complete muscular relaxation. For this effect, the dosage of succinylcholine can be adjusted.

No significant relationships.

Although antipsychotics improve positive symptoms effectively, their utility is limited by adverse effects and poor efficacy for the treatment of cognitive symptoms. Nevertheless, cognition is considered a core feature of schizophrenia. For this reason the focus of treatment research in schizophrenia has shifted towards cognitive enhancement the last ten years.

Earlier trials suggest that nicotine ameliorates attention and working memory deficits seen in schizophrenia.

The present study aimed to replicate these earlier findings using a strict methodological design. Additionally, we assessed the effects of nicotine on measures of social cognition and psychomotor functioning, domains that has never been investigated before in this research field. Furthermore an additional study compared the effect of age in relation to the responsivity to nicotine.

In a three-way crossover double blinded randomized placebo-controlled trial, we investigated the effect of 0, 1 and 2 mg nicotine on several cognitive domains (standard cognition, arousal, psychomotor tasks, and social cognition) in 16 smoking and 16 non-smoking schizophrenic patients and in 16 young and 16 elderly healthy volunteers.

Nicotine improves attention in both patients groups and has detrimental effects in the elderly in some cognitive and psychomotor tasks. There is no effect of nicotine on psychomotor functioning, working memory and emotion recognition in patients. Decision making seems to be influenced by nicotine in non smoking patients.

This study brings us a step further in the delineation of the cognitive effect of nicotine.

Sexual abuse of children and adolescents is a public health problem with potentially dire mental health consequences. Studies suggest that the first sexual experience of one out of three girls in sub-Saharan Africa is forced. However the relationship between sexual abuse and mental health problems among children and adolescents is grossly under-researched in Nigeria.

This study determined the association between sexual abuse and mental health problems in a sample of adolescents attending secondary school in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, Global School-based Health Survey Questionnaire, Strength and Difficulties Questionnaire, Suicidality module of the Mini International Neuro-Psychiatric Interview and the Hospital Anxiety and Depression Scale.

The mean age of the participants was 15.9 (± 1.3) years, and 58.7% were males. A fifth (21.9%) of the respondents had experienced sexual abuse in the past year. Less than a tenth of the victims reported the abuse, and none had accessed mental health service. On regression analysis, being a victim of sexual abuse was independently predictive of depression (p=0.041), anxiety (p=0.007), peer problems (p=0.014), emotional problems (p=0.005) and suicidal ideation (p=0.014).

Exposure to sexual abuse is under-reported and un-detected among Nigerian school children, despite its association with several mental health problems. There is need for interventions targeted at facilitating the access of victimised children to timely supportive care and appropriate mental health intervention. Furthermore, efforts to protect children from sexual abuse must be intensified.

This study evaluated the efficacy and safety of venlafaxine extended-release (XR) in preventing recurrence of depression.

Outpatients with recurrent unipolar depression (N=1096) were randomly assigned in a 3:1 ratio to 10-week treatment with venlafaxine XR (75 mg/d to 300 mg/d) or fluoxetine (20 mg/d to 60 mg/d). Responders (HAM-D17 ≤12 and ≥50% decrease from baseline) entered a 6-month, double-blind, continuation phase on the same medication. Continuation phase responders enrolled into maintenance treatment consisting of 2 consecutive 12-month phases. At the start of each maintenance phase, venlafaxine XR responders were randomized to double-blind treatment with venlafaxine XR or placebo; fluoxetine responders continued on fluoxetine. Time to recurrence (HAM-D17 >12 and <50% reduction from acute phase baseline at 2 consecutive visits or the last valid visit prior to discontinuation) was evaluated using Kaplan-Meier methods and compared between groups using log-rank tests.

In the second maintenance phase, the cumulative probabilities of recurrence through 12 months in the venlafaxine XR (n=43) and placebo (n=40) groups were 8.0% (95% CI: 0.0, 16.8) and 44.8% (95% CI: 27.6, 62.0), respectively (P<0.001). The probabilities of recurrence over 24 months for patients assigned to venlafaxine XR (n=129) or placebo (n=129) for the first maintenance phase were 28.5% (95% CI 18.3, 37.8) and 47.3% (95% CI 36.4, 58.2), respectively (P=0.005).

An additional 12 months of venlafaxine XR maintenance therapy was effective in preventing recurrence in depressed patients who had responded to venlafaxine XR after acute, continuation, and 12 months' initial maintenance therapy.

To describe a cohort of adolescents presenting to an emergency department with mental health problems.

An Emergency Department (ED) computerized record system and hospital records were used to obtain data on adolescents aged from 12 to 17 years who presented to an ED of a General Hospital with emotional or behavioural problems.

There were 213 presentations of 182 adolescents in a 12-month period. 77% were female, 56% were 16 or 17 years old, 8% did not live with immediate or extended family. There was a wide variety of presenting symptoms including anxiety, self-harm, suicide attempts (14,5% presented with suicidal behaviour), behavioural disorders, depression, eating disorders, acute psychosis, developmental disability, substance abuse. Psychosocial problems were frequent. Medication was prescribed in 38% of the presentations and 7.5% of the cases were admitted to a psychiatry ward. 54% had no previous psychiatric history.

Many adolescents with mental health problems had no previous or current treatment and were referred to local mental health resources for further evaluation. Psychiatric ED evaluations are an opportunity for recognition of risk factors, screening and early intervention in youth with mental health disorders and their management involves collaborative efforts with multidisciplinary services.

There have been a growing interest in the effectiveness of task-shifting as a strategy for targeting expanding health care demands in settings with shortages of qualified health personnel.

To explore the reasons for task-shifting and the healthcare settings in which task-shifting are successfully applied as well as the challenges associated with task shifting.

Literature searches were conducted on PubMed and Google Scholar using the search term – ‘Task shifting’ and Task-shifting’.

Reasons for task-shifting including: a reduction in the time needed to scale up the health workforce, improving the skill mix of teams, lowering the costs for training and remuneration, supporting the retention of existing cadres by reducing burnout from inefficient care processes and mitigating a health system's dependence on highly skilled individuals for specific services. Clinical settings in which task-shifting models of care have been successfully implemented, include: HIV/AIDS care, epilepsy and tuberculosis care, hypertension and diabetes care and mental healthcare. Finally, challenges which hinder the successful implementation of task-shifting models of care, include professional and institutional resistance, concern about the quality of care provided by lower lever health cadres and lack of regulatory and policy frameworks as well as funding to support task-shifting programmes.

The review brings to light important health policy and research priorities which can be explored to identify the feasibility of using task-shifting models of care to address the critical shortage of health personnel in managing emerging communicable and non-communicable diseases, including opportunities for expanding mental health care in conflict and under-resourced regions globally.

The author has not supplied his/her declaration of competing interest.

Current trends that integrate neuroscience, attachement theory and clinical psychiatry suggest that traumatic attachments are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. On the other hand addiction is caused by long lasting changes in brain function as a result of pharmacological insult (repeated drug use), genetic disposition and environmental association made with drug use (learning).

From our clinical work it is known that experience of any sort of attachement abuse is not uncommon in alcohol addiction. Issues of violence and sexual abuse in early personal history deeply influence not only partners' relationship, the capacity for intimacy and mutual trust, but also parental function and cooperation. Attachement traumas in addicted patient were supposed to be very resistant in treatment because of mutual reinforcement of both problems (early trauma experience and addiction): such patients were prone to relapse in addiction treatment either because detached traumatic experiences become a source of long lasting manipulation of addicted patient for retaining the “right for drinking” either because of seriously comorbide disorders without appropriate pharmacological treatment.

In our clinical experience, we found attachement trauma psychotherapeutically accessible only after period of stable sobriety and secondly, that routine combination of intensive psycho- and pharmacotherapy gives an optimistic attitude in treatment which is illustrated by clinical vignettes.

The family members of a person with serious mental illness experience social, economic, emotional and environmental problems as a result of their caregiving responsibilies. The mental status arising from these problems is considered as the burden of the family. To be aware of what can be called as burden to the family members or the caregivers and the severity of the burden provides important clues in the treatment.

The aim of this study is to investigate the burden of the caregivers of bipolar disorder patients and the relationship of this caregiving burden with sociodemographic and psychopathological variables.

Forty chronic Bipolar patient's caregivers were participated in this study. The patients symptoms were assessed with Clinical Global Impression Scale. The aim of the study was explained in a plain language before they were asked to complete the Zarit Burden Interview.

Educational status of the caregivers (p = 0.037), the severity of the illness (p = 0.06), caregiver relationship to patient (p = 0.01), the precence of a psychiatric disorder of another individual from the family (p = 0.01) were found as important variables that increase the burden of the caregiver.

To uncover the the factors that affect the burden of the caregivers is important for predicting relapses. Bipolar disorder significantly affects not only the patients but also their family (or caregivers). At this stage the responsibility of the clinician is not only the prescription but also to educate the patients and their families as well with particular emphasis on identifying and modifying burdensome symptoms.

In the UK, Black and minority ethnic (BME) patients have been reported to be disproportionately detained under the Mental Health Act.

Systematic review of all UK literature on ethnicity and detention with meta-analysis of detention rates for BME patients, to determine range of explanatory hypotheses and examine the evidence for these hypotheses

Electronic data bases searched for all date-based studies (1984-2005). Meta-analyses performed where data available. Explanations offered for any excess categorised and evidence examined.

49 studies identified, 19 included in meta-analyses. Compared with White patients, Blacks were 3.83 times, BME patients 3.35 times and Asians 2.06 times more likely to be detained. Racial stereotyping and discrimination against BME patients was the most often cited explanation (53% studies); followed by alienation and mistrust of psychiatric services (28%); higher rates of psychosis (22%); delay in help seeking (18%); and misdiagnosis/ under recognition of illness (16%). There was no primary evidence provided by any study to confirm any of these explanations, while some papers presented data that contradicted these explanations.

BME patients experience higher rates of detention under the MHA than White patients. Available explanations offered for this excess are largely unsupported. Explanations such as ‘institutional racism’ in psychiatry neither accurately account for the excess, nor help find ways of reducing detention rates.

To investigate patients double diagnosed with psychosis and substance addiction (especially cannabis) treated with risperidone long-acting injectable (RLAI) for their psychosis: characteristics of treatment and psychosocial reintegration.

Adults with psychosis were changed to RLAI from their previous medication. Starting doses varied but most patients received 50 mg every two weeks. Patients were regularly followed-up by their psychiatrist from 6 months to more than 2 years after starting treatment with RLAI. A reintegration program adapted to the needs of each patient was started as early as possible with support from all available healthcare services of the department. This program focussed on family, social and professional reintegration.

Of 60 psychotic patients, 27 patients (mean age 27.7±6.1 years) had a double diagnosis of psychosis and substance addiction (especially cannabis), and were enrolled in this follow-up study. After six months, 26 out of 27 patients had no relapse of substance addiction. Patients participating in the reintegration program were able to live with their family or at home (10 patients), undertake professional education courses (7 patients), or even return to their jobs (3 patients).

Treatment with RLAI has a positive effect on patients double diagnosed with psychosis and substance addiction (especially cannabis). The association with a reintegration program adapted to the needs of each patient must be started early and maintained for as long as possible in order to have a good clinical outcome, positive impact on the addiction, improve compliance with treatment, and diminish the risk of relapse.

According to statistics released by the World Health Organization, each year nearly one million people (one person every 40 seconds.) Lose their lives to suicide. In recent decades, suicide and its consequences has created basic problems in ground of general health. (Granbam and et, al.2000) we have this phenomenon in Iran, too and generalized recognition study showed the amount of suicide prevalence in Iran society does have ascending trend especially in the youth and teenagers

Present study was purpose to compare the intolerance of uncertainty and rumination with worry in suicide committed individuals and healthy individuals in Sari.

The descriptive comparative-casual study (retrospective study) was carried out. Statistical population were consisted of all suicide committed male and female in second half of year 2014 referred to health centers in Sari and also healthy people who were matched in terms of gender, age, academic level and other features with target population.

fiding showed that there is significant difference between intolerance of uncertainty, rumination and worry among suicide committed individuals and healthy individuals.

Therefore, the degree of intolerance of uncertainty, rumination and worry among suicide committed individuals is more than healthy individuals.

New designer benzodiazepines such as phenazepam, etizolam, diclazepam, clonazolam and flubromazolam have appeared in the recreational drug market due to that they provide an attractive alternative to prescription-only benzodiazepines as they are readily available over the Internet.

To describe the presence of new designer benzodiazepines in samples delivered to energy control since 2010 to 2016 in Barcelona.

From 2010 to 2016, 24,551 samples were delivered to energy control. Among this samples 43 (0.175%) were analysed as benzodiazepines. 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.

From the 43 samples analyzed as benzodiazepines, 1 (2.32%) was delivered in 2010, none in 2011, 2 (4.65%) in 2012, 2 (4.65%) in 2013, 1 (2.32%) in 2014, 15 (34.88%) in 2015 and 21 (48.83%) in 2016.

The data shows that new designer benzodiazepines use is increasing in Barcelona, especially in the last two years. Abuse an addiction to these drugs may be a new public health problem in Barcelona. Unknown side effects may appear due to lack of information about pharmacokinetic profile of these drugs.

The authors have not supplied their declaration of competing interest.