The study aims to investigate the recognition of patients with Obsessive-Compulsive Disorder (OCD) in psychiatric outpatients.

A total of 2282 outpatients seen at 14 different psychiatric clinics in South Germany were asked to participate in the study. Five hundred and eighty-nine (30%) of the original 2282 patients met screening criteria for OCD, and of those, 237 (42%) participated in the final interview including DSM-IV diagnosis, and comorbidity.

Sixty-nine of 589 participating patients who screened positively for obsessive symptoms actually had an Obsessive-Compulsive Disorder. Only 19 (28%) of the outpatients diagnosed with OCD according to DSM-IV criteria were also given this diagnosis by their consultant. The psychopathology scores indicated that the OCD patients had clinically relevant OCD with a mean Yale-Brown Obsessive Compulsive Score (Y-BOCS) of 17.5 (± 5.4), and a mean Clinical Global Impression Score (CGI) of 5.2 (± 1.2).

In outpatient clinics over 70% of OCD patients remain unrecognised and thus untreated by consultants. Screening questions provide a rapid way of identifying those who may have OCD and should be incorporated into every mental state examination by consultants.

To investigate the frequency of bradykinesia in patients with obsessive-compulsive disorder (OCD) and to see whether patients with OCD who also have bradykinesia display distinctive neuropsychological and neuropsychiatric features.

We studied 23 antipsychotic-free patients with OCD and 13 healthy controls. Bradykinesia was assessed with section III of the Unified Parkinson Disease Rating Scale. The Wechsler Adult Intelligent Scales-Revised (WAIS-R) was used to assess the Full Scale IQ and to measure visuospatial, visuoconstructional ability and psychomotor speed/mental slowness.

Of the 23 patients with OCD studied, 8 (34%) had mild symptoms of bradykinesia. No relationship was found between bradykinesia and the sociodemographic variables assessed but this motor symptom was significantly associated with the severity of compulsions. Patients with bradykinesia differed from those without: they had a higher frequency of repeating compulsions, and lower IQ scores, performance scores, and WAIS-R subtest scores for similarities and picture completion. No significant differences were found between patients without bradykinesia and healthy controls in any test.

Clinical assessment of motor symptoms in adult patients with OCD often discloses mild bradykinesia sometimes associated with repeating compulsions and poor WAIS-R performance scores.

Only a few studies have examined the putative association between substance use and bullying others, and to our knowledge none of the previous studies have investigated substance abuse among victims or those who are both bullies and victims. The aim of our study was to investigate substance use among all of these three bullying subgroups and to examine the putative association between substance use and bullying behaviour.

The study sample consisted of 508 Finnish adolescents (age 12–17) admitted to psychiatric inpatient care between April 2001 and March 2006. We used the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) to obtain DSM-IV psychiatric diagnoses, information about bullying behaviour and substance abuse of the adolescents. The level of nicotine dependence (ND) was assessed by using the modified Fagerström Tolerance Questionnaire (mFTQ).

Our study showed that both among boys and girls, regular daily smoking and alcohol use among boys were statistically significantly associated with bullying behaviour. Further, among girls, but not among boys, there was also an association between bullying behaviour and more severe substance use, such as ND, use of cannabis and hard drugs.

Since an association between bullying and severe substance use was found in this study, our novel finding needs replication in adolescent general population samples.

The purpose of this study was to examine psychometric properties of the Czech language version of the Adolescent Dissociative Experiences Scale (A-DES) [2].

653 non-clinical participants and 162 adolescent psychiatric inpatients completed Czech versions of the A-DES and the Somatoform Dissociation Questionnaire (SDQ-20), and provided further information (data regarding demographic variables, diagnoses, further psychopathology).

The Czech A-DES has very good internal consistency, test-retest reliability and a good validity, though its predictive power is limited. The ADES scores significantly correlate with the measure of somatoform dissociation, a presence of clinician-observed dissociative symptoms, reported traumatic experiences, self injurious behavior, and polysymptomatic diagnostic picture. A-DES scores were significantly higher in ADHD group, but not in a group with a diagnosis of a dissociative disorder.

The authors stress that all adolescent psychiatric patients who show more complex behavioral disturbances, have histories of trauma, show self-injurious behaviors or have ADHD diagnosis should be screened for dissociation.

Adolescent depression has been shown to have a range of adverse outcomes. We used longitudinal data to investigate subsequent higher education in former depressed adolescents.

A Swedish population-based investigation of depression in 16–17-year-olds was followed up in national registers 15 years later. Adolescents with depression (n = 361, 78% females) were compared to a group of non-depressed peers of the same age (n = 248, 77% females). The main outcome was graduation from higher education by age 30.

The adolescent with depression were less likely than their non-depressed peers to have graduated from higher education by age 30, both regarding females (27.7% vs. 36.4%, p < .05) and males (12.7% vs. 28.6%, p < .05). After adjustment for early school performance, socioeconomic status and maternal education, the decreased likelihood of subsequent graduation from higher education remained for depressed males (OR, 0.27; 95% CI, 0.08–0.93) but not for depressed females (OR, 0.93; 95% CI, 0.58–1.49).

Contrary to what previous research has suggested, adolescent depression and its consequences might be particularly destructive to subsequent higher education in males.

To examine the link between symptoms of hyperactivity-inattention and conduct disorder in childhood, and the initiation of tobacco and cannabis use, controlling for other behavioral symptoms, temperament and environmental risk factors.

The sample (N = 1107 participants, aged 4 to 18 years at baseline) was recruited from the population-based longitudinal Gazel Youth study with a follow-up assessment 8 years later. Psychopathology, temperament, environmental variables, and initiation of tobacco and cannabis use were self-reported. Event time analyses were performed to assess the effects of childhood disruptive symptoms on age at first use of tobacco and cannabis.

Proportional hazard models revealed that participants with high levels of childhood symptoms of both hyperactivity-inattention and conduct disorder were at highest risk of early tobacco initiation (in males: hazard ratio [HR] = 2.05; confidence interval [CI]: 1.24–3.38; in females: HR = 2.01; CI: 1.31–3.09), and, in males, of early cannabis initiation (HR = 1.95; CI: 1.04–3.64). Temperament, through activity in both males and females and negative emotionality in females, was also associated to early substance use initiation.

Children who simultaneously have high levels of symptoms of hyperactivity-inattention and conduct disorder are at increased risk for early substance initiation. These associations may guide childhood health professionals to consider the liability for early substance initiation in high-risk groups.

The objective of this study was to explore factors associated with hara-kiri as a method of suicide and suicidal behavior in contemporary Japan.

A retrospective study was conducted on medical records of 421 patients (174 male; 247 female) who were considered suicidal and treated at the Kitasato University Hospital Emergency Medical Center in Japan between January 2006 and March 2008. We compared hara-kiri and all other methods regarding sociodemographics and clinical features of all suicidal patients.

Instances of hara-kiri suicide attempt had the highest proportion of males (63%) among all suicide and suicidal behavior. One-way analysis of variance revealed significant differences between hara-kiri and other suicide attempt methods in the age of the suicidal patients. Result of multiple logistic regression analysis indicated that those who attempted hara-kiri suicide were likely to be male, be diagnosed with schizophrenia, survive, and be married.

Our findings indicate that hara-kiri as a method of suicide and suicidal behavior remain prevalent in Japan, and the study findings also suggest that both clinical and cultural factors might play a role in hara-kiri as a method of suicide and suicidal behavior.

It is not known how characteristics of suicide attempts vary with different forms of alcohol involvement. The aim of this study is to clarify the role of alcohol use disorder and acute alcohol consumption in suicide attempts.

Data on 1921 suicide attempts was gathered in a major German city over a 5-year period. Suicide attempts were categorised according to a diagnosis of alcohol use disorder and acute alcohol consumption at the time of the attempt. Group comparisons and multinomial logistic regression were used for statistical analysis.

In 331 suicide attempts (17%) an alcohol use disorder was diagnosed. Six hundred and twenty-two suicide attempts (32%) were committed with acute alcohol consumption. Suicide attempts by individuals with alcohol use disorder were more often committed by men, older individuals and as a recurrent attempt, independently of alcohol consumption at the time of the attempt. When alcohol was consumed in suicide attempts by individuals with alcohol use disorder, low-risk methods were used most often.

Individuals with a diagnosis of alcohol use disorder are a high-risk group for multiple suicide attempts and should be a target group for suicide prevention. Screening for suicidality should be a regular part of the clinical assessment in individuals with alcohol use disorder.

To determine whether the modified version of the Suicide Assessment Scale (SUAS) can be utilised to predict risk of repeat suicidal behaviour.

Hundred and sixty-five patients aged 18 to 68 years who were admitted to emergency wards after a suicide attempt were interviewed. Follow-up interviews (n = 96) were carried out after 2 months. Associations between SUAS scores and repeat attempt (fatal/non-fatal) during the following 3 years were analysed and the instrument's ability to predict repetition was assessed.

High SUAS score (>30) was associated with repetition. The ability of the SUAS to correctly predict repeat suicidal behaviour in the entire study group was low (AUC = 0.65, 95% CI = 0.56–0.74) but better for those (n = 42) who reported ongoing psychiatric treatment at follow-up (AUC = 0.78, 95% CI 0.63–0.94). Among the latter group, all with baseline SUAS scores >30 made repeats.

The modified SUAS performed well as a screening instrument in psychiatric patients.

To examine relationships between suicidal ideation, self-harm, and suicide attempts, including the timing of the phenomena.

The British National Psychiatric Morbidity Survey (NPMS) 2000, a randomised cross-sectional survey of the British population (n = 8,580), included detailed questions about suicidal phenomena.

Suicidal phenomena were common in the survey population: a fifth had experienced tedium vitae, and nearly one in six had had death wishes or considered suicide. 4.4% of the study population had attempted suicide at some time. The relationships between individual elements of suicidality, though not absolute, were strong. The relationships tended to be hierarchical. The results suggested that suicidal thinking represents a strong indicator of vulnerability to suicidal acts, less so to self-harm. Although suicidal phenomena were more common in women, the relationship of the different elements were not affected by gender.

Studies in non clinical populations allow full appreciation of the nature and burden of suicidality. The topic of suicide is sensitive, so there may have been under-reporting, although the level of missing data was around 0.1%. Nevertheless, the sample was large and closely representative of the whole British populace.

Suicidality is common in the British population. The strong relationships between elements of suicidality are clinically important.