Two-year retrospective study included a total of 112 hospital endocrinological patients of both sexes, F-68(60%), M-44(40%), who were referred to psychiatric consultation.

1. The most frequent causes for psychiatric consultation in hospital endocrinological patients were as follows: in diabetic patients (62/112-55%)-depression (34/62-54%), psychoorganic syndrome (24/62-38%), other diagnoses (4/62-16%); in patients with arterial hypertension (26/112-23%)-depression (18/26-69%), psychoorganic syndrome (6/26-31%); in patients with other diagnoses (obesitas, menopause, Cushing disease) (16/112-14%)-depression(12/16-75%), psychoorganic syndrome (3/16-18%), schizophrenia (1/16-6%); in patients with thyroid gland diseases (8/112-7%)- depression (6/8-75%), psychoorganic syndrome (2/8-25%).

Depression and psychoorganic syndrome were the most frequent psychiatric disorders in hospital endocrinological patients with various endocrinological diagnoses, referred to psychiatric consultation.

It is necessary for consultative-liaison (CL) psychiatry to include long-term follow up of somatic patients with psychiatric disorders because of define of course and outcome of psychiatric symptoms and disorders in this patient's population, the interactive relation of somatic and psychiatric disorders as well as the evaluation of the effects of psychopharmacological therapy.

As a symptom, aggression is closely related to antisocial personality disorder (ASP). Prefrontal cortex plays a key role in the regulation of anger and violence and in sleep-wake transitions. The aim of this study is to evaluate the quality of the subjective sleep and to determine its relation to the degree of aggression for the subjects with APD.

Among 155 males who were sent to a pretrial forensic psychiatric examination by the court, 60 were suitable and admitted to the study. All of them were being charged with violent offences (murder or assault). 64 subjects were not involved in crimes involving violence were taken as the control group. All of the subjects met the DSM-IV criteria for ASP. Subjects were interviewed with an assessment battery including a semistructured interview form concerning the sociodemographic factors, SCID-I, SCID-II, Aggression Questionnaire (AQ) and Pittsburgh Sleep Quality Index (PSQI).

AQ total point and physical aggression, verbal aggression and anger subscales were found to be significantly higher in the study group. Between the groups significant differences were found in PSQI total points, sleep latency, sleep disorder, use of sleeping pills and in the points of subscales of loss of functionality during day. There has been found a positive correlation between PSQI global point and AQ total point.

This study can contribute to further support to evidence of brain dysfunction predisposing to severe aggression and sleep disturbances of individuals with APD.

clinical, experimental. PTSD symptoms were assessed according PTSD diagnostic criteria (ICD-10). Statistical calculations (SPSS): descriptive statistics, t-criterion, correlation,Mann-Whitney criterion.

of 70 delinquent adolescent girls (DAG), 97% were exposed to some traumatic event in lifetime, 77% had PTSD symptoms, including 38,5% in severe form. The largest risk of PTSD development in DAG was associated with rape, the death of a parent, long enforced separation from them. Risk factors of PTSD development in DAG depended on personality, cranial-brain injury, sexual-role behavior disturbance, family problems. A high index on the Spilberger test for personality anxiety, hypochondria, affect rigidity, psyshasthenia, autization with a low index on the MMPI correction scale and primary use of immature personality defense mechanisms (regression and projection)- are personality predictors of PTSD development in DAG.

practically all DAG were exposed to single traumatic event in lifetime. Roughly 40% of DAG developed clinically severe PTSD, almost three times more than in girls with socially approved behavior. The largest risk of PTSD development in DAG was associated with rape. The other significant predictive risk factors: low socioeconomic family status; lack of social and psychological support; anxiety tendency in early childhood; unformed mature personality defense mechanisms when adolescent. It is typical for severe PTSD in delinquent girls to be relatively equally represented by reexperience, avoidance, increased arousal; high degree comorbidity with other anxiety disorders (panic attacks, obsessive-compulsive disorder), somatoform and depressive disorders.

Poor sleep quality causes frequently and seriously impairments in older people daily functioning. More than that, inadequate treatment of insomnia side effects further decrease patients quality of life.

We examined whether between nonbenzodiazepine and benzodiazepine hypnotic treatment are significant differences regarding sleep quality, total sleep time, sleep onset latency, number of awakenings during the night, global functioning and side effects.

A group of 40 outpatients, 16 male and 24 female, mean age 67.9, diagnosed with insomnia, was divided in two equally groups, each of them receiving for at least 7 days either zolpidem 5 mg/day or diazepam 10 mg/day, overnight. Inclusion criteria: age over 65. Exclusion criteria: physical illness and psychiatric disorders that disrupt sleep, simultaneous administration of other sedative drugs. An assessment using Clinical Global Impressions (CGI), Global Assessment of Functioning (GAF) and self reports for depth, total perceived time, onset latency of sleep, number of awakenings during night and side effects were realised every day for a week.

The intent-to-treat (ITT) and last-observation-carried-forward (LOCF) analysis reflected statisticaly significant differences from the day 2 in four variables- depth of sleep (+3/+1.2, p<0.01), number of awakenings(+3.2/+4.9, p<0.01), GAF (+7.8/+5.5, p<0.01) and CGI (-1.9/-0.7, p<0.01) in favor of zolpidem treated patients. Also, side effects were significantly more frequent reported in benzodiazepine group (15/10, dropouts 3/1, p<0.01).

Zolpidem is a first choice treatment in older people because it is well tolerated and have a good efficacy profile compared to diazepam.

It's sometimes difficult to choose whether drug therapy or/and psychotherapy for adolescents with anxiety-depressive disorders. An antidepressant's therapy is sometimes complicated by a defensible position of adolescent, because the prolonged course of antidepressants has negative side effects. An early improvement plays an important role when psychotherapy is used. In most cases it helps to achieve prolonged remission and to avoid relapses.

It's necessary to form a rational approach in therapy of anxiety-depressive disorders by combination of drug therapy and psychotherapy.

35 adolescent in the age of 15 – 17 with symptoms of anxiety – depressive disorders were observed. SSRI fluvoxamine maleate and course of cognitive psychotherapy were used. The effectiveness of therapy was valued at once and also in 6 and 12 months after the therapy. The degree of improvement, remission, convalescence and exacerbation were measured by Beck's scale.

Those adolescent who received a complex therapy had an early positive results. Also they had more expressive improvement at once and in 6 and 12 month after course of the therapy and had a lower rate of exacerbation and had prolonged remission.

The complex therapy revealed to be more effective than drug therapy and psychotherapy separately. Combining SSRI antidepressants with cognitive psychotherapy helps clinicians to prolong remissions and to decrease the exacerbation rate at adolescents with anxiety-depressive disorders.

Symptoms of at least mild depression (Beck Depression Inventory [BDI] >/= 10), are associated with mortality in acute coronary syndrome (ACS) patients. The BDI, however, is largely a measure of general distress and does not discriminate well between anxiety and depression. We examined the independent contributions of anxiety and depression, as classified by the self-report version of the PRIME-MD, to mortality 1-year post-ACS.

Prospective observational study of 765 ACS patients assessed with the PRIME-MD and BDI during hospitalization and followed for 1 year. Logistic regression to predict 1-year mortality based on in-hospital assessments.

Based on the PRIME-MD in-hospital, 99 patients (12.9%) screened positive for panic disorder, 58 (7.6%) for general anxiety disorder, and 174 (22.7%) for depression. Of 266 patients (34.8%) with a BDI >/= 10, 100 (37.6%) had no PRIME-MD diagnosis, 70 (26.3%) had only depression, 23 (8.6%) had only an anxiety disorder, and 73 (27.4%) had depression and an anxiety disorder. Controlling for age, gender, Killip class, prior myocardial infarction (MI), and cardiac diagnosis (MI vs. unstable angina) and compared to patients with no PRIME-MD diagnosis, the odds ratio of mortality was 1.75 (95% confidence interval [CI] 0.66 to 4.64, p = .26) for patients with depression alone, 2.97 (CI 0.93 to 9.55, p = .07) for patients with anxiety alone, and 4.43 (CI 1.72 to 11.40, p < .01) for patients with both depression and anxiety.

When assessing the psychosocial status of ACS patients, both depression and anxiety should be considered.

Finding of this study indicated: therapeutic touch caused a reduction in the state of anxiety (p=000), no effect on trait anxiety. In addition, therapeutic touch was effective on systolic blood pressure (p=0.002), pulse rate (p=000) and respiratory rate (p=0.0014) during catheterization and effective on cardiac dysrhythmia only on sinus tachycardia (p=0.005).

Results suggest this method is effective on anxiety in stressful situations.

Excessive gambling touch between 1 and 3% of the adult population (Shaffer et al. 1999).

Studies of treatment-seeking gamblers establish a relationship between gambling and suicide. We investigated clinical characteristics in excessive gamblers of a Swiss University Hospital(CHUV).

The aim of this study is to compare gamblers with prior suicide attempts (GPSA) with gamblers without prior suicide attempts (Non-GPSA) and with the international literature.

Hypothesis:

1. - GPSA are confronted with a higher problem load than Non-GPSA.

2. - GPSA lack social networks and family support as compared to Non-GPSA.

Patients treated for gambling disorders typically show a high level of co-morbidity. Bourget, Data are based on medical files of our treatment center. Among our consecutively admitted patients (2002-2006), we identified pathological gamblers who reported prior suicide attempts directly or not directly linked with gambling.

1. – GPSA were more likely to be women, separated or divorced, referred by the forensic network.

2. – GPSA were more likely to be disabled and had a history of alcohol abuse. GPSA showed no difference with respect to age at intake or employment status as compared to NON-GPSA.

Further research is needed to find out whether the higher proportion of women with prior suicide attempts is due to the fact that men are more likely to complete suicide.

Gambling was included in DSM III since 1980 as a psychiatric disorder. Compared to other forms of (compulsive) behavior for example substance abuse), the gambling problems have hardly solicited public and scientific concern. In particular a new generation of young adults raised in an environment of video and internet games has been neglected by researchers. Our knowledge of this population segment with respect to gambling disorders is wanting.

The present study aims to obtain a clearer description of gambling behavior in this segment of the Swiss population. The present project should allow us to gain a better understanding of problem burden and will help to identify the different forms of games that are used by young adults age 18 to 25 in Switzerland.

In a first step we have been planning an explorational and descriptive pilot study. 120 men age 18 to 25 are recruited from Universities, Technical Colleges, Professional Training Schools, Occupational Centers, and newspaper ads as well as via the Internet.

Participants will be evaluated in terms of the following instruments: socio-demographic questionnaire, structured interviews and tools to identify types and characteristics of gambling behavior and concomitant problems, namely SOGS (South Oaks Gambling Survey), Internet Dependence (YOUNG), the Fagerström scale (tobacco), AUDIT (alcohol), Impulsive Behavior Scale (UPPS), BDI II (Beck), the Hamilton Scale for anxiety assessment.

The present study serves as the basis for a large scale population based study.

Obsessive compulsive disorder (OCD) is a highly heritable neuropsychiatric disorder. Attempts to elucidate contributing genes have met with limited success. Intermediate markers of brain dysfunction (cognitive endophenotypes) may help focus the search for genetic contributions. Such markers should be present in people at risk of developing OCD in the absence of clinical symptoms. In prior work, OCD patients showed impairment on tests of response inhibition and cognitive flexibility (Chamberlain et al., 2005, 2006).

First-degree relatives of OCD patients, patient probands, and matched healthy volunteers without a family history of OCD undertook neuropsychological assessment (n=20 per group).

Compared to matched controls without a family history of OCD, unaffected first-degree relatives of OCD patients showed impaired response inhibition (p<0.05) and cognitive flexibility (p<0.05). These deficits were comparable to those in the patients themselves.

Brain-based cognitive markers of inhibitory functions may be of utility in the search for OCD endophenotypes. Examination of relationships between these abnormalities, genetics, and structural/functional brain changes, will help to elucidate aetiological contributions to OCD and putative spectrum disorders.

To compare the efficacy of escitalopram 10 or 20 mg/day with placebo in preventing relapse during 24 weeks in outpatients with obsessive-compulsive disorder (OCD) who had responded to an initial 16-week open-label treatment with escitalopram.

A multinational, randomised, double blind, placebo-controlled, flexible to fixed dose relapse prevention study with escitalopram in outpatients with OCD. The study consisted of a 16-week open-label period with 10 to 20 mg escitalopram followed by a 24 week double blind, placebo-controlled period, and a 1 week taper period. Patients who had responded to treatment (≥25% decrease in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score) by the end of the 16-week open-label period were eligible for randomisation to either escitalopram or placebo for a further 24 weeks.

468 patients with OCD were treated with open-label escitalopram (10 mg or 20 mg) for 16 weeks. There were 320 responders (68%) who were randomised to change to placebo (n=157) or to continue with escitalopram (at the assigned dose) for further 24 weeks (n=163). The primary analysis (time to relapse) showed a clear beneficial effect of escitalopram relative to placebo (log-rank test, p<0.001). The proportion of patients who relapsed was statistically significantly higher in the placebo group (52%) than in the escitalopram group (23%) (p<0.001, chi-square test). The risk of relapse was 2.74 times higher for placebo- than for escitalopram-treated patients (chi-square test, p<0.001). Escitalopram was well tolerated.

Escitalopram was effective in preventing relapse of OCD and was well tolerated as continuation treatment.

The efficacy and tolerability of escitalopram in obsessive-compulsive disorder (OCD) were investigated in a 24-week, randomised, placebo-controlled, active-referenced, double blind study.

466 adults with OCD were randomised to escitalopram 10mg/day (N=116), escitalopram 20mg/day (N=116), paroxetine 40mg/day (N=119), or placebo (N=115) for 24 weeks. The pre-specified primary efficacy endpoint was the mean change in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score from baseline to Week 12 based on the intent-to-treat population and last observation carried forward (LOCF) using analysis of variance (ANCOVA).

Escitalopram 20mg/day was superior to placebo on the primary endpoint. After 12 weeks, on the primary efficacy endpoint, there was a statistically significant difference from placebo for 20mg escitalopram and paroxetine. In the escitalopram 20mg/day group, the Y-BOCS total score was significantly lower than in the placebo group as early as Week 6. At Week 24, the proportion of remitters (Y-BOCS≤10, LOCF, pre-defined) was significantly greater (p<0.05) for 20mg escitalopram (41.2%) than placebo (27.4%), but not for 10mg escitalopram (36.6%) or paroxetine (37.9%). The response rate (≥25 decrease from baseline Y-BOCS, LOCF, pre-defined) was significantly greater than placebo (50.4%) for 20mg escitalopram (70.2%) and paroxetine (67.2%). Statistically significantly more patients withdrew from the placebo group (18%) due to lack of efficacy, than paroxetine (8%) or escitalopram 20mg/day groups (6%). More paroxetine-treated patients withdrew due to adverse events than escitalopram- or placebo-treated patients.

Escitalopram was efficacious and well tolerated in the treatment of OCD, with 20mg escitalopram showing statistically significant superiority at the primary efficacy endpoint.

Actually, the suicidal risk in people with gambling problems is insufficiently evaluated; this risk is all the more hard to specify within a population which underreports gambling behaviour and associated co-morbidities. Estimations of suicidal behaviour vary between studies, suicide attempts were observed in 4% to 40% of gamblers studied. Suicidal thoughts were reported for 25% to 92% of people with gambling problems. 64% of gamblers that committed suicide did neither inform family or friends nor health professionals about their suicidal intents. In the context of a pilot study, we wish to study suicidal behaviour in people with gambling problems.

The goal of the study consists in the early identification of gambling problems associated with suicidal behaviour. A short intervention, specifically targeted towards the prevention of suicide will be compared with the current treatment for gambling problems. Gambling and suicidal behaviour will be monitored over 6 meetings during 12 months.

On the basis of this study, we wish to develop a blended E-Learning tool for professionals in psychiatry and primary health care that help to detect and treat people with gambling and suicidal behaviour.

Atypical antipsychotics are actually the first-line treatment in schizophrenia. Obsessive–compulsive symptoms (OCS) are common in patients suffering from schizophrenia and seem to worsen prognosis. Whilst atypical antipsychotics can be a useful augmentation strategy in refractory Obsessive Compulsive Disorder (OCD), their efficacy in case of comorbid obsessive compulsive symptoms in schizophrenia remains unclear.

The purpose of this literature review was to examine the relationships between atypical antipsychotics, Obsessive Compulsive Symptoms (OCS) in schizophrenia.

A systematic MEDLINE database was run using the following key-words: atypical antipsychotics, obsessive compulsive symptoms and schizophrenia (27 articles).

Clozapine, risperidone,olanzapine and quietiapine may induce or exacerbate OCS in patients with schizophrenia due to their anti-serotoninergic properties. There was no study with ziprazidone,aripiprazole nor amisulpiride. For schizophrenic patients with comorbid OCS, the first line strategy appears to be combination therapy with clomipramine or an Selective Serotoninergic Reuptake Inhibitors (SSRIs)(fluvoxamine, sertraline, fluoxétine) and an atypical antipsychotic. Moreover, in these cases, cognitive behavioural therapy should also be considered.

Obsessive Compulsive symptoms and schizophrenia are an ongoing matter of debate in terms of comorbidity or constitution of a specific "schizo-obsessive" subtype. Nevertheless, according to the worsening prognosis of this phenomenon, combination therapy (atypical antipsychotics and SSRIs) remains the most relevant therapeutic approach. Moreover, cognitive behavioural therapy studies in this area are required.