This study used proton magnetic resonance spectroscopy (1H MRS) to evaluate neurochemistry of the frontal cortex in adolescents with symptoms of sleep and depression.

19 non-medicated adolescent boys (mean age 16.0 y; n = 9 clinical cases with depression/sleep symptoms and n = 10 healthy controls) underwent 1H MRS at 3 T. MR spectra were acquired from the anterior cingulate cortex (ACC), the dorsolateral prefrontal cortex, and frontal white matter. Concentrations of N-acetyl aspartate, total creatine, choline-containing compounds, total glutamine plus glutamate, and myo-inositol (mI) were compared between the two subgroups and correlated with sleep and clinical measures in the total sample. Sleep was assessed with self-report questionnaires and ambulatory polysomnography recordings.

Concentrations of mI were lower in both frontal cortical regions among the depressed adolescents as compared to healthy controls. No statistically significant differences in other metabolite concentrations were observed between the subgroups. Frontal cortex mI concentrations correlated negatively with depression severity, subjective daytime sleepiness, insomnia symptoms, and the level of anxiety, and positively with total sleep time and overall psychosocial functioning. The correlations between mI in the ACC and total sleep time as well as daytime sleepiness remained statistically significant when depression severity was controlled in the analyses.

Lower frontal cortex mI may indicate a disturbed second messenger system. Frontal cortical mI may thus be linked to the pathophysiology of depression and concomitant sleep symptoms among maturing adolescents. Short sleep and daytime sleepiness may be associated with frontal cortex mI independently from depression.

The authors have not supplied their declaration of competing interest.

A 21-year-old man was admitted to our clinic due to treatment resistant cervical dystonia attributed to neuroleptics. During the last five years he had been treated for depressed mood, somatic delusions and aggressive behaviour. He had been given SSRIs and atypical antipsychotics at low doses; six months prior to his admission he had been switched to risperidone.

Present clinical examination revealed torticollis, motor stereotypies, vocal tics (sniffing, repetition of words), mental koprolalia and obsessive-compulsive symptoms. He complained of repetitive intrusive thoughts of harming his sister and thoughts of a ‘delusional’ nature regarding somatic complaints were also present. The patient was diagnosed as TS and was successfully treated accordingly.

TS can mimic many hyperkinetic states. Whether patients with TS are at higher risk of developing dystonia, or tics and dystonia share a common pathophysiological mechanism (dopamine-inhibiting processes are probably involved in both conditions) is still debatable.

One of the current concerns in the research on schizophrenia is the relationship between social functioning and emotion recognition abilities, more specifically of the role that this can have, as a potential pathway for building subsequent psychosocial intervention methods.

To establish the precise role that the ability to recognize emotions has on social functioning in subjects with a diagnosis of Schizophrenia.

To help develop psychotherapeutic intervention programs that will increase social functioning.

This paper analyzed a sample of subjects (N=31) with a diagnosis of Schizophrenia (according to the WHO ICD 10), who were selected based on inclusion/exclusion criteria. The following parameters were assessed: socio-demographic (gender, age of onset, level of education, family and professional status), social functioning (SFS scale) and the ability to identify emotions in the eyes (‘Reading the Mind in the Eyes’ test).

The ability of recognizing the emotion ‘anger’ is directly correlated with the ability to communicate and keep interpersonal relations (Spearman R = 0.310, p <0.05), the ability of independence/performance (Spearman R = 0.471, p <0.05), as well as the ability to relax (Spearman R = 0.456, p <0.05) and to engage in social activities (Spearman R = 0.473, p <0.05).

We noted that ‘anger’ is the only emotion that was correlated with social functioning. Anger must be understood beyond its negative connotation, also as a positive element, in the sense of positioning the individual in the society and of taking action in regard to personal needs.

Studies from Pakistan reveal a high prevalence of depression in women. Evidence based and effective treatments are available, yet there is a significant gap between the number of women in need of treatment for depression and those who receive the services. This qualitative study identifies the barriers in access to mental health services for women with depression in Karachi from key informants' perspectives.

19 key-informant interviews were conducted with psychiatrists, psychologists, general health practitioners, pharmaceutical representatives, a government health department official and NGO workers working on women health issues.

Key-informants reported lack of awareness, misconceptions, self-medication, being young and unmarried and financial status as barriers for women in accessing mental health services. In addition, provider's lack of medical education about depression, mismanagement of cases by GPs, opposing mental health care and lack of referral system are also considered barriers to mental health services. Larger societal issues are stigma, gender bias, as well as poor resource allocation and management.

Key-informants considered women's education, mental health literacy and referrals as facilitators for women.

The study highlights the need for multipronged and multi-sector approach for increasing the access to mental health services for women in an urban context of developing country where mental health services are present but not accessed by women.

To describe a case of Ekbom Syndrome with Folie à Deux, between mother and daughter, that has the mother as the “primary patient” even with borderline intelligence and the daughter as the induced patient, but without any cognitive deficits.

To highlight that some cases of Folie à Deux can occur in a strictly affective dominance fashion relationship.

Case report.

MRC, 46 years old, illiterate, was referred to the outpatient psychiatric clinic of the University Hospital of the Federal University of Alagoas-Brazil, by a dermatologist of the same hospital because of hyperchromic scaly pruritic skin lesions in legs and back with no findings at skin biopsy that the patient attributed to “bugs” under her skin and that her daughter also believed that existed even when her mother showed her desquamative skin as being the bug.

The dominance between the primary patient and the induced one can be of affective nature only but not cognitive nature in Folie ... Deux with Ekbom Syndrome.

Research aims to understand how psychological mechanisms influence mental health. Accordingly, much of the studies in this field has been dedicated to clarifying how emotion regulatory strategies may be associated with increased psychopathology (Gross & John, 2003). Individuals regulate their emotions in a wide variety of ways.

We focus on two commonly used emotion regulation strategies: reappraisal (changing the way one thinks about a potentially emotion-eliciting event) and suppression (changing the way one responds behaviorally to an emotion-eliciting event).

We analyze emotion regulation strategies (Gross & John, 2003) in order to examine their relation with a broad range of psychological problems and symptoms of psychopathology.

Emotion regulation was assessed by means of the Emotion Regulation Questionnaire (ERQ, Gross & John, 2003), which taps two regulatory strategies, suppression and reappraisal. The psychopathological distress was assessed by the 90- item Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994) by indicating the degree of distress on a scale of 0 (not at all) to 4 (extremely) caused by a list of problems during the past 7 days. The sample consisted of 548 individuals (age: M=32.97; DS=3.55 for male; M=31.29; DS=3.64 for female).

Individuals who reported low levels of suppression reported the lowest levels of psychopathological symptoms.

Our findings highlight that the capacity to regulate emotions may be associated with reduced psychopathology and more adaptive functioning

Forensic Psychiatry and Mental Health Service as new field in our country needs strategies for management and rehabilitation programs.

To evaluate socio-demographic characteristics and prevalence of psychiatric diagnosis of inpatients hospitalized in last three year period time from January 2009 up to December 2011. Specific objectives of this study were to identify the rehabilitation programs of treatment and specific training needs of mental health professionals according to our results findings.

This retrospective study used the method of socio-demographic data collection, review and study of documented diagnosis based on ICD-10 criteria for mental disorders and Structured Clinical Interview (SCID), data records by court and other hetero-anamnesis data of all forensic inpatients who underwent psychiatric forensic evaluation and assessment according to court request. Descriptive approach for analyses was used.

Subjects were referred either directly from prison (23,2%) or from court (76,8%) for forensic psychiatric evaluation, diagnosis and treatment. The majority of offenders (85,7%) were under trial, and physical threatening being the most common charge than domestic violence and murder. Prevalence of psychiatric diagnosis was 94,6%, the most common being psychosis 69,1%. Drug abuse and personality disorders including high-risk behaviors were also common.

Rehabilitation programs of treatment and management with specific focus on psychotic disorders, sever personality disorder and drug abuse are needed. Establishment of Forensic Mental Health System in Kosovo will fulfill the implementation of legal framework including the rights and human treatment of all mentally ill offenders.

Forensic psychiatry is a branch of psychiatry which emphases on the interface between law and psychiatry. It may include psychiatric consultation in a wide variety of legal matters, as well as clinical work with perpetrators and victims.The objective of current study is to visualize the scientific activities in the field of Forensic psychiatry through 2006–2012.

The Science Citation Index Expanded (SCI-E) and Social Science Citation Index from the database of Web of Science were used to obtain all publication entitled as“Forensic psychiatry” through 2006–2012. Restriction of publication entitled into Forensic psychiatry cause to obtain the most relevant papers in the field of Forensic psychiatry.

Analysis of data showed that a total number of 248 papers entitled as Forensic Psychiatry were published in the journals which indexed in Web of Science during the period of study. The most majority of publication came from North America and west Europe. USA sharing 23% of global publication in the field is the most productive country followed by Germany (19%), England (14%), and Canada (7%). More than 63% of global publication came from these four prolific countries. A total number of 271 organization have contributed their works in the field of Forensic Psychiatry, the American private University of Yale was the most productive among them.

National and International telepsychiatry service was established between Denmark and Sweden in order to increase access to cross-cultural expertise. Patient acceptability study was conducted to assess the patients’ attitudes toward the quality, advantages and disadvantages of telepsychiatry service.

Over a period January 2005-December 2007, 61 patients were treated via telepsychiatry by clinicians that speak patientsrespective mother tongues. Video-conferencing equipment connected the Little Prince Psychiatric Centre in Copenhagen with two hospitals, one asylum seekers’ centre and one social institution in Denmark. These stations were also connected to the Swedish department of the Centre. Number of languages spoken was 9 while the number of nationalities treated was 11. No interpreter assistance has been used.

After the end of the telepsychiatry contact all patients were asked to complete a satisfaction questionnaire.

Patients reported a high level of acceptance and satisfaction with telepsychiatry. They expressed a wish to use telepsychiatry via their mother tongue, rather than interpreter-assisted mental health care in the future.

The restricted physical contact and non-verbal communication of telepsychiatry was compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. The results of the survey may contribute to further development of, primarily, European Telepsychiatry Network. However, this model may be used for conducting of larger international telepsychiatry service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue worldwide.