The residency is one of the most stressful periods in medical practice and entails different psycopathological disorders. Individual type of adaptation plays an important role in the pychological response to this situations.

The aims are to describe the coping behaviour used during the residency period, and to analyze the factors related to them.

Cross-sectional study in 145 residents, in wich we valued sociodemographic data, psychopatholy (GHQ Goldberg), personality dimensions (16PF-A Cattell), psychic antecedent and coping behaviour (Lazarus and Folkman, 1986). A descriptive, comparative and a Pearson correlation study was performed.

The sociodemographic variables and the frecuency of the coping behaviors used are detailed in table. We described their relation with personality features and sociodemographic variables, and the coping associated with psychic antecedent and psychopathology.

The more used behaviors were those directed towards Planful problem-solving, Seeking social support, Self-controlling, Positive reappraisal, Confrontive coping and Distraction. Coping behaviour are related with various factors that probably caused them, being personality features outstanding. The socio-demographic variables also are related, and in women are more frecuent Seeking social support and Selfaward.

Although this study, due to its transversal structure, can not establish a causal relationship between coping behaviour and the presence of psychopathology, we observed that the latest one was associated with Selfblame, Distancing and Avoidance behaviors and could be considered as inefficient strategies. In those with personal psychic antecedents, Distraction and Selfaward behaviors were outstanding, although this mechanisms were not related to psychopathology.

The prevalence of psychiatric illness among patients attending dermatology clinics is high. Three major categories of disorder exist; Psychosomatic disorders, Primary psychiatric disorders and Secondary psychiatric disorders.

To investigate the relationship between Dermatological conditions, in particular Dermatitis Artefacta and Psychiatric disorders and to discuss course and management of these disorders.

All referrals from Dermatology clinics in South Dublin to the Psychiatry service over a six- month period were reviewed. Psychiatric Diagnosis was noted, the prevalence of each of these and their management.

90% of referrals had a psychiatric diagnosis. I focused on one particular case of a 22 year old woman referred by her dermatologist, presenting with bizarre, well-demarcated, linear lesions that appeared to develop "overnight". In joint consultation with the dermatology team, a diagnosis of Dermatitis Artefacta was made. In this review I discuss the features, associated psychopathology, epidemiology, aetiology and management of this rare condition.

Psychiatric illness should be considered in all patients attending dermatology clinics. If a psychiatric disorder is diagnosed, close collaboration between dermatologists and psychiatrists is essential if a favourable outcome is to be achieved.

We recruited n=15 SAD subjects and n=11 NC. We have utilized TMS on Primary Motor Cortex (M1) in order to study neuronal excitability and cortical inhibitory mechanisms. These has been achieved by examining EMG recording Motor Evoked Potentials (MEP). We measured MEP, Motor threshold, Cortical Silent Period (CSP), paired pulse inhibition both in patients and healthy controls. Clinical assessment was conducted with the MINI interview, Liebowitz Social Phobia Scale, TPQ

neurophysiological variables are not significantly different between groups. Patients with SAD showed a significantly higher Harm Avoidance and lower Novelty Seeking. There was a positive correlation between CSP and Novelty seeking and a negative correlation between LICI and Novelty Seeking among patients but not among HCs

To explore different longitudinal patterns of social functioning before onset of psychotic illness and how they relate to clinical presentation, substance use and acute treatment response.

Inclusion criteria: Drug-naïve first-episode psychosis, 18-50 yo, criteria for Schizophrenia or Other Psychotic Disorders (DSM-IV), excluding Psychotic Disorder due to a General Medical Condition and Substance-Induced Psychotic Disorder.

Mental Retardation, neurological disease, brain injury or drug dependence.

Premorbid Adjustment Scale (PAS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS).

Ward cluster analyses were carried out to differentiate three longitudinal patterns of social premorbid adjustment from childhood to late adolescence: stable good (N=75), stable bad (N=44) and deteriorating (N=35). Chi-square and ANOVA tests were used.

154 subjects (64.5% male, mean age 26.81, SD=6.98) participated in the study.

At baseline the socially stable good group had more positive symptoms, SAPS 13.85 (3.99), than the stable bad group, SAPS 11.82 (3.93) (p=0.023).

At six weeks post-treatment the socially deteriorating group had more negative symptoms, SANS 8 (4.89), than the stable good, SANS 3.85 (4.11), and the stable bad, SANS 5.23 (5.45) (p=0.000).

The stable good group had the highest rates of substance use, followed by the deteriorating group.

A good premorbid social life was related to higher substance use and more positive symptoms at presentation. A social deteriorating pattern was associated with more negative symptoms at baseline and six weeks post-treatment. These differences would argue for different pathogeneses of psychosis.

Benzodiazepine (BDZ) abuse highly prevalent among former heroin addicts, currently in methadone maintenance treatment. Discontinuation of BDZ abuse is accompanied by sleep disturbances. We evaluated the effectiveness of melatonin in attenuating sleep difficulties in a BDZ withdrawal program.

Patients in a managed BDZ withdrawal program entered a double blind crossover control study with melatonin or placebo: 6 weeks one arm, one week washout, 6 weeks other arm. Urine BDZ, the self reported Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies Depression (CES-D, mood) questionnaire were administered at baseline, and after 6, 8 and 13 weeks.

Eighty patients were randomly assigned into two arms. Both groups (n=40) had similar baseline PSQI (13.8±3.8) and CES-D (1.5±0.6) scores, which correlated (R=0.4, p=0.001). Sixty one patients (77.5% in "melatonin-first" and 75% in "placebo first") finished 6 weeks, showing similar BDZ discontinuation rate 11/31 and 11/30 respectively. PSQI scores were significantly lower (better sleep) in the 22 patients who discontinued BDZ (8.9±4.4) than in 39 with urine BDZ (11.2±4.2 p=0.04). Interaction between study groups and BDZ groups showed that sleep quality in patients who continued abusing BDZ improved more in the "melatonin first" group than in the "placebo first" group, with no differences in sleep quality improvement in patients who stopped BDZ (F=4.3, p=0.04).

Most improvement in sleep quality was attributed to BDZ discontinuation. Although melatonin did not enhance BDZ discontinuation, it improved sleep quality, especially in patients who did not stop BDZ.

Burnout syndrome is psychological experience that produces physical,emotional and mental symptoms and signs,which is commonly observed in health care professionals. The stress is considered as the key factor in development of this syndrome.

To assesses the burnout syndrome in general practitioners and anesthesiologists in Belgrade,Serbia,regarding that both occupations are considered as highly stressful.

The sample consisted of 50 primare care physicians working in primary health care and 50 anesthesiologists at a University hospital in Belgrade.The burnout was assessed using Maslach Burnout Inventory,which addresses thre general scales-emotional exhaustion,depersonalization and reduced personal accomplishment.

The findings supported our hypothesis that this syndrome is highly prevalent among health care workers,espacially among anesthesiologists.

The burnout syndrome is a frequent disorder among health care workers, especially among with high work demand,susc as general practitioners and anesthesiologists.Therefore,prevention strategies should be planned and carefully implemented.

The goal of our study was to identify brain structures in patients with panic disorder (PD) that show changes in 18FDG PET during the treatment with cognitive behavioral therapy (CBT) or antidepressants.

Twelve patients with panic disorder were studied with [18F]-2-fluoro-deoxyglucose positron emission tomography (18FDG PET) during resting state (condition of random episodic silent thinking, REST). After PET examination patients were randomly assigned to either cognitive behavioral treatment group (6 patients) or antidepressants treatment group (6 patients). After 3 month 18FDG PET examination was repeated in both groups.

Scores of psychopathology rating scales (CGI, HAMA, PDSS) decreased in both groups. Changes of 18FDG uptake in pharmacotherapy group: decreases were found in a priori hypothesized regions in right hemisphere, in superior, middle, medial and inferior frontal gyrus, superior and middle temporal gyrus, and increases were detected in a priori hypothesized regions, mainly in left hemisphere in medial and middle frontal gyrus, superior, middle and transverse temporal gyrus. Changes of 18FDG uptake in CBT group: decreases were found in a priori hypothesized regions of right hemisphere in inferior temporal gyrus, superior and inferior frontal gyrus, and increases were detected in a priori hypothesized region, mostly in left hemisphere: inferior frontal gyrus, middle temporal gyrus and insula.

Changes in brain metabolism after treatment either with CBT or with antidepressants were similar in number of brain areas, with prominent right-left difference.

Supported by the project 1M0517 MZCR.

Nocturnal panic attacks are considered in PD patients a severe subtype of the illness. Recent studies failed at identifying more severe psychopathology in these patients. We analyzed this issue in a sample in the earlier phases of PD.

A sample of 153 patients (107 women and 46 men) with a recent onset of a PD established with the MINI was included. Patients were free of treatment and had never received effective treatment for their disorder. Data were obtained both from the clinical interview and from specific questionnaires concerning severity (PDSS, CGI), agoraphobia (MIA), anxiety (STAI) and depression (BDI). The presence of nocturnal attacks was assessed during the clinical interview.

The median time of evolution of the PD was 8 months. The mean age of the sample was 30 years old. Agoraphobia was diagnosed in 66% of the cases and the mean CGI was 4.22 (moderate). More than half of the patients (52.9%) reported nocturnal panic attacks. A positive relationship was found between rate of panic attacks and nocturnal attacks (PDSS frequency: p=0.002; number of attacks in the last month: p=0.02). A positive relationship appeared with agoraphobia (PDSS agoraphobic avoidance: p=0.05; MIA alone: p=0.02). No relationship appeared regarding CGI and scales concerning psychopathology.

Half of the patients in first stages of PD reports nocturnal panic attacks, which are related both to an increased rate of panic attacks and an increased agoraphobic avoidance. However, nocturnal attacks are not related with the whole clinical severity of PD.

The Wender-Utah Rating Scale (WURS) was developed for the retrospective diagnosis of childhood attention-deficit/hyperactivity disorder (ADHD). It consists of a list of childhood behaviours and symptoms suggestive of ADHD. Our objective was to study correlations of WURS scores with different impulsivity, personality, anxiety and depression psychometric scales.

A group of 110 healthy university students were evaluated using the WURS. Four subjects scored higher than the cut-off value of 37 (compatible with childhood ADHD) and were excluded. The Barratt Impulsivity Scale (BIS-11), the Big Five Questionarie (BFQ), the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) were administered. Partial bivariate correlation analyses were performed.

WURS scores were correlated with total scores on the BIS-11 (r=0.430; p<0.001), as well as with the motor (r=0.410; p<0.001), attentional (r=0.328; p=0.001), and improvisation subscales (r=0.289; p=0.003). Regarding the BFQ, a correlation was found between WURS scores and the “emotional stability” factor (r=-0.379; p<0.001) as well as with the subfactors “emotion control” (r=-0.310; p=0.001) and “impulse control” (r=-0.354; p<0.001). Finally, significant correlations were also found between WURS scores and scores on the STAI-trait (r=0.366; p<0.001), STAI-state (r=0.200; p=0.039), and the BDI (r=0.350; p<0.001).

Correlations between the WURS and other impulsivity-related psychometric scales such as the BIS-11, or the “emotional stability” factor and the “emotion control” and “impulse control” subfactors of the BFQ, provides evidence for the concurrent validity of the WURS. The correlation of this instrument with anxiety and depression scales points to possible clinical implications.

The association between headache and psychiatric disorders is formally acknowledged. Although the majority of headaches represent comorbidity (perhaps reflecting a common biological substrate) there is increasing evidence of a bi-directional relationship linking somatic conditions and psychopathology.

The International Headache Society (IHS) classifies in the International Classification of Headache Disorders – ICDH-2 (2004) two main types of Headache Attributed to Psychiatric Disorder, distinguishing between headaches associated with Somatisation Disorders and Psychotic Disorders.

Headache attributed to psychiatric disorder is a diagnosis reserved for when it occurs not as a primary disorder, but as a symptom, or as causally related to the psychiatric disorder.

The authors intend to study the distribution os headaches in a psychiatric population.

To a population of hospitalized psychiatric patients, able to communicate verbally and consenting to be interviewed, was applied a questionnaire used and validated by the Portuguese Headache Society for population studies. Medical records were also revised in order to access tne mental diagnosis ICD-10.

In this population, headaches are a frequent complaint, mainly in females. Regardless of the mental diagnosis, the prevailing are tension-type headache. In Schizophrenic patients, we did not find migraine and there was a higher percentage of patients without headache. Despite the high prevalence of headache in the psychiatric population, headaches attributed to Psychiatric disorders are rare.

A significant number of war veterans from Military Forces of Serbia have participated in wars in former Yugoslavia, since 1991. This paper deals with analysis of war traumatic stressors and after-war psychosocial stressors resulting in mental disorders.

A retrospective study of the disease history in 50 war veterans who were hospitalized during 2006.

Over 80% of the veterans have participated in combat. The most frequent was the posttraumatic stress disorder, followed by a high percentage of comorbidity with depressive disorders, with a lesser presence of alcohol abuse. In majority of veterans, somatic syndromes and diseases were registered as well. During the after-war period, majority of veterans has been exposed to chronic psychosocial stressors and non-adequate psychosocial support which was followed by consequential low motivation and a poorer professional functioning.

There is a significant connection between war posttraumatic disorders and the extent of the undergone war stressors and non-adequate psychosocial support after the war.