The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) introduced severity indices for Eating Disorders (ED).

This study assessed in a male ED sample the DSM-5 severity indices for Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) and compared them to an alternative transdiagnostic drive for thinness (DT) severity category and a combined DSM-5/DT severity categorization

178 males with EDs were classified using: a.) a DT categorisation based on the EDI-2 DT subscale; b.) the DSM-5 severity categories for AN, BN and BED and c.) a combination of the DT and the DSM-5 severity categorisation. These severity classifications were then compared based on psychopathology and personality.

For the DSM-5 severity indices, the “mild” category was most prevalent for AN and BN, and the “moderate to extreme” group for BED. For the EDI-2 DT severity classification, the “mild” category was overrepresented in all subtypes. For the combined DSM-5/DT categorization, the “mild combined” severity group was the most prevalent for AN, while for BN and BED the “severe/extreme” combined group was most prevalent. Clinically significant findings were strongest for the DT categorization followed by the combined DSM-5/DT approach. Almost non-significant findings were revealed for the DSM-5 severity categories for all ED subtypes. These findings were most pronounced for AN and BN and almost non-existent for BED.

Our findings provide support for DT as an alternative transdiagnostic severity category for EDs in males that may be more meaningful than the DSM-5 severity indices for AN and BN, but not BED.

No significant relationships.

Suicide in children and adolescents is commonly underreported and studied. It is an interplay area of multiple static (sociodemographic), and modifiable (impulsivity, psychiatric morbidities, adverse life events (ALE), abuse, bullying) variables.

To assess and identify relative significance of dependent and independent risk factors in youngsters attempting self-inflicted poisoning.

Consecutive recruitment of patients aged 7–18, with normal IQ, admitted to poison control centre over 13 continuous months, with self-induced poisoning. All were assessed after guardians’ written informed consent for different risk factors identified for suicidal behavior using appropriate scales (PPS, SRRS-Y, FSSCS, BIS-11, J-TCI, Mini-Kid). Controls with no history of suicidal attempt were matched for age, sex and sociodemographics among their families.

One hundred and twenty cases (16.7 years ± 1.6 SD, 91% females) and 100 controls (age 16.4 years ± 1.7 SD, 90.8% females) were assessed. In cases, 90.8% were of low/middle socioeconomic status, 73.5% had previous attempt, average within 10 months, 17.5% planned their attempt, 10.8% had a witnessed attempt. Stressor within 2 days was reported in 75.9%, severe in 40%. Impulsivity was more in its cognitive, planning and motor components (P = 0.001 in each) among attempters. Cases scored more on Novelty seeking, harm avoidance and reward dependence than controls who had more persistence, self-directedness and cooperativeness. Attempters had significantly more past medical and psychiatric history (P = 0.001, 0.05 respectively), 77.5% had a working psychiatric illness, 2% in controls.

Repeated suicidal attempts were the majority, with impulsivity as a predictive risk, especially if psychiatric morbidity or ALE in youths were encountered.

The authors have not supplied their declaration of competing interest.

Psychopathy has been individuated as an important predictor of criminal recidivism. As a consequence, a growing number of studies has examined factors associated with psychopathic traits in criminal population. While spitefulness has been associated with a range of destructive behaviors, there is a paucity of instruments that evaluate the spitefulness (Marcus & Zeigler-Hill, 2015).

Testing the validity and reliability of an Italian version of the Spitefulness Scale.

Correlate Spitefulness Scale scores and other indices of psychological functioning. We recruited an offenders sample (n = 400) and a community sample (n = 400). We administered the Spitefulness Scale (Marcus, 2014), along with the following measures: Dirty Dozen (Carmines & Zeller, 1979), Aggression Questionnaire (Buss & Perry, 1992), Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), and SRP (Hare, 1980).

Offenders participants showed higher levels of spitefulness. Further, the construct validity of the scale was confirmed by associations with measures of psychopathy, emotion dysregulation, and interpersonal problems.

The use of the Italian version of the Spitefulness Scale seemed promising for the study of emotion recognition in both clinical and nonclinical samples.

The authors have not supplied their declaration of competing interest.

Studies have indicated antidepressant effects of anti-inflammatory treatment; however, results have been conflicting and side effects may contraindicate anti-inflammatory treatment.

To systematically review the antidepressant and possible side effects of anti-inflammatory interventions.

To include trials published prior to December, 31st 2013, and evaluate depression scores after treatment and side effects.

We identified randomized, placebo-controlled trials assessing efficacy and side effects of pharmacological anti-inflammatory treatment in adults with depressive symptoms including adults fulfilling depression-criteria. We calculated standard mean difference (SMD) and Odds ratios (OR).

10 publications covering 14 trials (n=6,262) were included: 10 on non-steroidal anti-inflammatory drugs (NSAIDs) (n=4,258) and four on cytokine-inhibitors (n=2,004). Anti-inflammatory treatment reduced depression (SMD=−0.54; 95%-CI:-1.08 to −0.01; I2=68%) and depressive symptoms (SMD=−0.27; 95%-CI:−0.53 to −0.01; I2=93%). Sub-analyses particularly emphasized antidepressant properties for the selective cyclooxygenase-2 inhibitor celecoxib in general (SMD=−0.29; 95%-CI: −0.49 to −0.08; I2=73%), on remission (OR=7.89; 95%-CI: 2.94 to 21.17; I2=0%) and response (OR=6.59; 95%-CI: 2.24 to 19.42; I2=0%). Among 6 studies (n=2,523), we found no evidence of an increased number of gastrointestinalor cardiovascular events after 6 weeks nor infections after 12 weeks of anti-inflammatory treatment. All trials were associated with high risk of bias.

Anti-inflammatory treatment, in particular celecoxib, decreased depressive symptoms without increased risks of side effects. However, a high risk of bias and high heterogeneity made the mean estimate uncertain. This study supports a proof-of-concept concerning use of anti-inflammatory treatment in depression. Identification of subgroups that could benefit hereof might be warranted.

Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.

We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.

We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis.

The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use.

Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing.

The authors have not supplied their declaration of competing interest.

Electroconvulsive therapy is widely used for treatment-resistant psychiatric patients. There is controversy about the minimum seizure duration required for clinical efficacy.

Characterize socio-demographically the electroconvulsive therapy unit of CHPL; find a correlation between improvement on PSAS, PANSS and HAM-D and both mean seizure duration and mean electric charge used; evaluate outcome in patients with seizure < 20s.

Three groups of patients were created according to ICD-10 diagnosis. The scales mentioned were applied at the beginning and end of the treatment: depressed (F31.3-5; F33; F20.4; F25.1) - HAM-D; schizophrenic/ schizoaffective/ bipolar-manic or mixed (F20.X, F25.X, F31.0, F31.6) - PANSS; with any of these diagnosis: PSAS. The correlation between the improvement on each scale and both mean seizure time and mean electric charge was investigated using the Pearson product-moment correlation coefficient. The groups were subdivided by seizure duration (cut-off 20s) and the mean improvement on the different scales was determined for each subgroup.

There is no correlation between any of the variables analyzed (α = 0,05). HAM-D variation (N = 102): seizure duration (r = 0,004) and electric charge (r = 0,106). PANSS variation (N = 43): seizure duration (r = 0,07) and electric charge (r = 0,046). PSAS variation (N = 147): seizure duration (r = −0,043) and electric charge (r = 0,143). There is no difference statistically significant in mean HAM-D, PANSS or PSAS improvement between subgroups >20s and < 20s (11.29 vs 13.94; 30.85 vs 29.19 and 19.07 vs 22.65, respectively).

Mean seizure duration and electric charge didn’t correlate with clinical outcome. Seizure duration below 20 seconds didn’t imply poorer outcome.

Psychotic symptoms are the most important non-motoric symptoms of the Parkinson disease (PD). The quality of life of those patients can be significantly improved with an appropriate therapy. In this article we provide evidence about the etiology, differential diagnosis and therapeutic possibilities with a work-up for the clinics.

To provide a case report of patient with PD who developed a paranoid psychosis after administration of levodopa/carbidopa, followed by a literature review on psychotic symptoms evoked by psychotropic medication by patients with PD.

An English-language literature search was conducted using Pubmed, EMBASE searching for case reports and observational studies reporting iatrogenic psychotic symptoms by patients with PD.

Ms. C. was a 65-year old woman with PD who was observed in a polyclinic setting and who used a levodopa/carbidopa combination. She developed paranoid psychosis with a following admission to the psychiatric ward. We have gradually lowered the dose of anti-Parkinson medication. Subsequently, treatment with clozapine was initiated and the psychotic symptoms resolved within five months.

Parkinson psychosis is due to a complex interaction of neurodegenerative changes and pharmacological therapy. Therefore, the role of iatrogenic factors must be always carefully assessed. Psychosis inducting agents should be lowered or stopped before the treatment with antipsychotic medication.

The authors have not supplied their declaration of competing interest.

Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar patiens in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission.

Ascertain if ANS decrease with the age of the patient; ascertain relation between activity of ANS and level of dissociation, and other components (age of patients, and age of disorder, dosage of psychotropic medication).

Autonomic nervous system (ANS) has been evaluated during orthostatic change in three positions (1- lie down 5 minutes, 2 - stand up 5 minutes, 3 - lie down 5 minutes). The functioning of the ANS has been measured by the diagnostic systems that are using the power spectral analysis which quantifies the heart rate variability (HRV) was assessed using time domain, frequency domain, and nonlinear analyses in 23 bipolar patients in remission.

We found highly statistically significant negative correlations between level of dissociation measured by DES and most of parameters of ANS. We found negative correlations between the age of the patient and activity of ANS, and negative correlations between activity of ANS and duration and onset of disorder.

Autonomic dysregulation is associated with bipolar disorder in remission and has relation to level of dissociation and probably to age of patiens and age of onset and duration of disorder.

By grant IGA MZ ČR NT11047.

Four psychotherapies have been recognized as effective with scientific evidence for the treatment of BPD, but are long term techniques. It is necessary to explore new time limited psychotherapies in order to be more accessible.

We have developed a specific manualized psychotherapy for BPD named Psychic Representation focused Psychotherapy (PRFP)

To assess the efficacy of the PRFP in BPD in an outpatient care setting compared to a control group receiving psychiatric treatment “as usual” in several specific symptoms and in diminishing the disability due to the illness.

60 subjects with BPD were randomized to one of the two treatment groups. The study group has received PRFP with 20 sessions on a weekly basis; the control group has received treatment “as usual”. Both groups may receive psychopharmacological treatment. The assessment is done in four time-points: at baseline, after the psychotherapy or conventional treatment (six months), and at a six and twelve month's follow-up period.

Preliminary results of the first 30 patients (control group 17, experimental group 13, without significant differences, Age 18–35 years; 70% women) assessed at the baseline and at the end of the intervention (six months). Experimental group reached a statistically significant clinical improvement over the controls in all measured variables: Scales: SCL-90; Zanarini ; MDRS; Barrat; STAI anxiety state; Rosemberg self-esteem and SASS social adaptation.

The preliminary results are encouraging and reveal that this method could be effective. This study state the interest in develop more studies about time limited psychotherapy for BPD.

The heritability of the brain’s structure and function in schizophrenia remains elusive

To assess the influence of genetic and environmental factors on executive function in schizophrenia.

A twin-sibling study of 206 subjects; 163 twins, varying in their zygosity and concordance for schizophrenia, and 43 singletons from sibling clusters varying in their concordance for schizophrenia. We assessed performance and regional brain activation using functional magnetic resonance imaging, during a phonological verbal fluency task.

Patients and their unaffected relatives developed greater activation in the left inferior frontal gyrus, and greater deactivation in the middle temporal gyri bilaterally. These features were maximally evident in subjects with schizophrenia. When the analysis was restricted to the unaffected relatives and healthy controls, a similar pattern was evident. Heritability was greatest in the left hippocampus and the right middle temporal gyrus. Genetic modelling indicated a phenotypic correlation between schizophrenia and increased activity in the inferior frontal gyrus and reduced activity in the left middle temporal gyrus and left hippocampus, which appeared principally due to shared genetic effects.

Both schizophrenia and its familial vulnerability were associated with altered frontal, parahippocampal and temporal activation during verbal fluency. The altered left inferior frontal activity was particularly associated with schizophrenia, while altered left medial temporal and right middle temporal activity were more heritable. The latter was more intimately linked to the genetic risk for schizophrenia, and thus the better candidate intermediate phenotype.

The aim of the study was to evaluate sexual satisfaction during pregnancy using the Hudson's Index of Sexual Satisfaction (ISS) questionnaire.

One hundred and thirty seven couples who met the study criteria were recruited by voluntary participation. Participants anonymously completed a self-administered questionnaire (demographic questions, Hudson's Index of Sexual Satisfaction (ISS), Hospital Anxiety and Depression Scale (HADS)). Demographic data, ISS and HADS scores were analyzed and compared among trimesters.

Data of 38 couples for the first (28%), 40 for the second (29%) and 59 for the third (43%) trimesters of pregnancy were collected for the analysis. The median age was 28 (25 – 30 years) for women and 29 (26-32 years) for men. Women's ISS score was influenced by age of woman (b=0,12), woman's HADS score (b=0,25), and ISS score of the partner (b=0,55).

Women's HADS score (b=-0,18), women's ISS score (b=0,63) and men's HADS score (b=0,25) were factors influencing men's ISS score. Women's level of sexual satisfaction (ISS scores) didn't differ among trimesters. For men, the highest level of sexual satisfaction was reported in the third trimester.

Our results don't support previous observations that the level of sexual satisfaction decreased significantly throughout pregnancy.

Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar patiens in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission.

Ascertain if ANS decrease with the age of the patient; ascertain relation between activity of ANS and level of dissociation, and other components (age of patients, and age of disorder, dosage of psychotropic medication).

Autonomic nervous system (ANS) has been evaluated during orthostatic change in three positions (1- lie down 5 minutes, 2 - stand up 5 minutes, 3 - lie down 5 minutes). The functioning of the ANS has been measured by the diagnostic systems that are using the power spectral analysis which quantifies the heart rate variability (HRV) was assessed using time domain, frequency domain, and nonlinear analyses in 23 bipolar patients in remission.

We found highly statistically significant negative correlations between level of dissociation measured by DES and most of parameters of ANS. We found negative correlations between the age of the patient and activity of ANS, and negative correlations between activity of ANS and duration and onset of disorder.

Autonomic dysregulation is associated with bipolar disorder in remission and has relation to level of dissociation and probably to age of patiens and age of onset and duration of disorder.

Supported by: Grant IGA MZ CR NT11474

The concept of “highly sensitive person” is a cultural concept, which has become popular in western societies including Sweden. A highly sensitive person (HSP) is usually described as having hypersensitivity to external stimuli, different cognitive processing and high emotional reactivity. Although the concept lacks diagnostic validity, psychiatric patients may refer to this concept.

To examine the feasibility of the Cultural Formulation Interview (CFI) and the clinical relevance of cultural concepts of distress among patients with bipolar disorder that report being a HSP.

A case series of three patients with a diagnosis of bipolar disorder that report HSP. The CFI was conducted with all patients and the applicability of the DSM-5 cultural concepts of distress tested.

In all three cases, the CFI facilitated the clinical consultation as reported from the patients and in one of the cases also increased the treatment engagement. The HSP-concept could be conceptualized as a cultural syndrome, idiom of distress and as an explanatory model.

The CFI and the cultural concepts of distress proved to be useful for understanding the concept of HSP as also they increased the cultural validity of the diagnostic interview. The three cases illustrate the challenges when encountering patients with other cultural references than clinicians. This highlights the necessity to integrate anthropological thinking in our current diagnostic work in order to reduce the “category fallacy” and promote a more person-centered approach in psychiatry.

The authors have not supplied their declaration of competing interest.

Depression occurs frequently in patients suffering from Parkinson's disease (PD). However, the neural basis of depression in PD remains unclear. Diffusion magnetic resonance imaging (DMRI) connectometry is based on the spin distribution function (SDF), which quantifies the density of diffusing water.

The aim of this study was to assess the microstructural changes in the brain connectivity of PD patients with and without depressive symptoms.

DMRI was used to assess microstructural abnormalities in the brains of 16 PD patients with depressive symptoms compared to 11 PD patients without depressive symptoms. Data used in the preparation of this paper were obtained from the Parkinson's progression markers initiative (PPMI) database (http://www.ppmi-info.org/data/). This dataset was acquired on a 3-Tesla scanner (Siemens), producing 64 DWI at b = 1000 s/mm2 and one b0 image. Diffusion MRI data were corrected for subject motion, eddy current distortions, and susceptibility artefacts due to magnetic field inhomogeneity. DMRI connectometry was conducted in a total of 27 patients using percentage measurement.

PD Patients with depressive symptoms showed decreased anisotropy (FDR < 0.05) in the fornix bilaterally, left inferior longitudinal fasciculus (ILF) and corticospinal tract bilaterally compared to PD patients without depressive symptoms.

Lesser WM integrity of the left ILF fibers, which connect visual face recognition areas to the amygdala and hippocampus, seems to be associated with depressive symptoms in PD patients. Our study supports the hypothesis that neurodegenerative processes in projections from the somatosensory, cingulate, and insular cortices may be related to depression in PD.

The authors have not supplied their declaration of competing interest.