A higher SE is suggested by a reduced difference between ideal and real self. The present pilot study was designed to investigate if a brief eight-session individual person-centered therapy (PCT) intervention on older adults can promote their self-esteem (SE), as compared with a control group (waiting list). We hypothesized that participants randomized to PCT would report improvements in SE from pre- to post-intervention compared tocontrol group.

We recruited 81 persons aged between 65-82 years (M=71.9 SD=4.77) and randomized 40 to PCT and 41 to control group. Measures were completed, including demographics and the Self-esteem Scale (SES) at the baseline, post-treatment and at the 12-month follow-up.

Findings indicated that individual PCT with older adults may improve their SE. The difference between ideal self and real self, evidenced at follow-up (M=1.251, SD=.524) by the participants who had undergone PCT, was significantly lower (41.3%) in comparison to the baseline score (M=2.131, SD=.799). Significant differences between the intervention group and the control group were found in the post- intervention (F(1) = 34.939, p < 0.01) and follow-up (F(1) = 34.595, p < 0.01). During these three assessments there were no significant differences in the waiting list participants. In addition, results revealed no significant between group differences in any socio-demographic variable (P's>.05) in t1, t2 and t3.

Results suggest that PCT is beneficial for improving SE. Clinical practice and health care context may benefit from including PCT as an important component for reducing health disparities and for aging well.

Older adults’ sense of coherence (SOC) is often challenged by changes in later adulthood. Therefore, this study aims to explore if a brief eight-session individual person-centered therapy (PCT) intervention on older adults can promote their SOC, as compared with a control group (waiting list). We posited that participants and randomized to PCT would report improvements in SOC from pre- to post-intervention compared to those in waiting list.

The Sense of Coherence Scale (SOCS).and demographics were assessed at the baseline (t1), post-treatment (t2) and at the 12-month follow-up (t3), in a group of 87 participants between 65-86 years (M=71.9 SD=4.77).

Results indicated that participants in PCT evidenced greater improvements as to their SOC (31.4%) than those in waiting list (2.3%). Both at the post-intervention, and at follow-up, participants who underwent PCT had a significantly higher SOC (M=4.76, SD=.524). In addition, results revealed no significant between group differences in any socio-demographic variable (P's>.05) in t1, t2 and t3.

Changes in SOC were positive and maintained, thus, findings suggest that PCT is favorable to enhancing SOC. In this context, PCT is also a personal resource to promote SOC. Moreover, since SOC is shown to be associated with healthrelated well-being among older populations, SOC development in old age should be focused.

To analyze the indicators of adjustment to aging (AtA) and to investigate the latent constructs that can work as major determinants in spirituality for a cross-national older community-dwelling population.

Questionnaires were completed, assessing participants’ background information. Interviews were performed, addressing one core area: indicators of AtA. Complete data were available for 154 older adults, aged between 75-103 years (M = 86.6, SD = 6.98) from two different nationalities. Data was subjected to content analysis. Representation of the associations and latent constructs were analyzed by a Multiple Correspondence Analysis (MCA).

The most prevalent response of the interviewed participants for indicators of AtA was ‘spirituality’ (43.2%) whereas ‘financial stability’ was the least referred indicator of AtA (10.3%). ‘Spiritual activities’ was the most reported response regarding ‘spirituality’ (20.0%). Spirituality for older adults was explained by a three-factor overall model: ‘spiritual and existential meaning’, ‘limit-related awareness’ and ‘community embeddedness’.

The findings presented in this paper emphasized the need to explore the potential of spirituality to AtA and the need for improving the spiritual dimension of health care for the older population.

To analyze subjective age (SA) and the contributors to adjustment to aging (AtA) identified by older adults and to investigate the latent constructs that can work as major determinants in SA and AtA in an older population.

Measures were completed, using a variety of appropriate methods, including demographics and interviews. Complete data were available for 108 older adults aged between 75-99 years (M=81.1; SD = 6.43). Data was subjected to content analysis. Representation of the associations and latent constructs were analyzed by a Multiple Correspondence Analysis (MCA).

The most prevalent response of the interviewed participants for contributors to AtA was ‘sense of limit and existential issues’ (20.2%). ‘With congruence’ (29.3%) was identified as the most frequent SA response. AtA and SA for Portuguese elderly were explained by a three-factor model: ‘integrated’, ‘involved’ and ‘young-at-heart’. A three-dimension model formed by ‘attentive’, ‘driven’ and ‘connected’ was indicated as a best-fit solution for English elderly.

AtA is related to SA in older adults in both samples. The results presented in this paper stressed the underdeveloped potential of an adjustment and age overall model for this population.

Our aim was to investigate is there association between level of cogmitive funtionings and severity of PTSD symptoms, depression symptoms, amd anxiety symptos.

We tested 104 war veterans on presence of PTSD, depression symptoms, anxiety, and level of cognitive functionongs.We used Harvard trauma questionnaire (HTQ) for assessment of severity of PTSD symptoms, Hopkins Check Scale (SBCL 25) for severity of depressiveness and anxiety, mini mental status (MINI) for severity of cognitive impairs.

Mean age of tested subjects was 50.6 (SD=5.2) years. The score of the cognitive functionings negatively correlated to severity of trauma experiences (Pearson's r -0.310, p= 0.001), to PTSD symptom severity and depressiveness (Pearson's r=-0.649, p< 0.001; r=-0.606, p< 0.001, respectively). Besides that the score of cognitive functioning negatively correlated with presented anxiety (Pearson's r=-0.566,p< 0.001).

Trauma experiences severity, PTSD symptoms severity, depressiveness and anxiety symptoms severity decreised cognitive functiongs in war veterans seventeen years asfter war 1992-1995 quited in Bosnia-Herzegovina.

TEACCH program (Treatment and Education of Autistic and related Communication Handicapped Children) represents a model for management of five major autistic behavioral problems:

1. (1) Self abuse,

2. (2) Aggression,

3. (3) Disruptive behaviors,

4. (4) Repetitive Behaviors,

5. (5) Other behavioral deficits.

Present study introduces TEACCH based model for behavioral intervention of autistic preschoolers in school setting.

Studying effectiveness of usage of (TEACCH) program in decreasing commonly experienced behavioral disorders among autistic preschool children according to Parent/Teacher assessment and follow up.

5 autistic children aged (2-6) years (4 boys and 1 girl) were selected according to the study inclusion criteria and legal guardian consent. They were subjected to psychiatric assessment (psychiatric interview sheet and DSM IV criteria for autistic disorder), psychological assessment using:

1. (1) Childhood Autism Rating Scale” (CARS)(2000) (Arabic version),

2. (2) Vineland Adaptive Behavior Scale(2004)(Arabic version), as well as

3. (3) Autistic Behavioral Checklist for preschool children and

4. (4) Disordered Behavior Intervention Program (3 and 4 were made by researchers).

Study subjects were assessed by their mothers and teachers for their behavioral problems. Pre- intervention assessment were arranged for each child and commonly experienced behaviors both at home and school as regard both severity and frequency were listed for intervention. Mother/Teacher Post-intervention and follow up assessment were also arranged for each child.

Both Pre/post and Post /follow up assessment and comparison were statistically significant both for mother and teacher ratings. Behavioral problems were significantly decreased using TEACCH model for behavioral intervention of disordered behaviors among study subjects.

Early identification, Individualized intervention and follow up of significant behavioral problems using study model helps reducing them.

Violent behavior of patients is a common problem in emergency psychiatry and evaluation, diagnosis, management and treatment of which is very difficult.The absence of a test that could be used to predict violent behavior hampers proper decision in the case of emergency admissions, as well as discharge from the hospital. The application of such a test would upgrade assessment offering solve this problem.

To identify risk and protective factors of violent behaviors : to establish the degree to which the HCR-20 predicts the frequency and severity of violent behavior; to examine the predictive validity of the scales of the HCR-20.

Improve assessment, management and treatment of patients with violent behaviors in the psychiatric ward.

Prospective cohort study, during 24 weeks. Psychiatric evaluation based on structural clinical interviews and questionnaires related to violent behaviors and risk factors were conducted to patients admitted in psychiatric hospital on UHC “Mother Tereza” Tirana.

According to our data, the relationship between violence and mental illness vary considerably across different diagnoses.

The highest rate of violence is reported in subjects with substance abuse disorder and antisocial personality disorder followed by Bipolar disorder and psychotic patients.

Among the risk factors verified so far, the past violence behaviors reported show the highest predictive value.

HCR-20 tool has currently shown good results to roughly estimate probability of future violence and taking appropriate measures in order to prevent unwanted consequences.

Dandy-Walker syndrome is a congenital brain malformation. The major presentations are mental disorder, cerebellar ataxia and symptoms related to hydrocephaly. It can be associated with psychiatric symptoms. Although, since this presentation is less prevalent, it has been insufficiently discussed

The subject is a 17 year old girl suffering from mental retardation. Her signs started 3 months ago when she was considered as having decreased need to sleep and walking during the night mostly. Her appetite increased as well. she was found to be getting more talkative than past; especially she talked to herself more.

She was admitted to hospital with the diagnosis of bipolar I disorder (the most recent episode: mania) in axis I and deep MR in axis II. In her brain MRI, enlargement of fourth ventricle and cisterna magna and atrophy cerebellar vermis were seen. EEG showed unspecific changes and there was no positive finding in her blood count, electrolytes,renal and liver function tests and blood sugar.

Despite two weeks of treatment with risperidone 3 mg/day and biperidine 4 mg/day and partial control of some symptoms, irritability and anger remained consistently. So, valproic acid (VPA) 400 mg/ day was added to treatment and after one month the patient was discharged from hospital with complete remission of newlypresented symptoms.

This report indicates the importance of taking psychiatric symptoms into consideration while evaluating organic brain disorders. With respect to treatment, the same treatment as primary mood disorders was indicated effective.

Propranolol prescribed by physicians in various fields. The extensive use of beta adrenergic antagonists are their various side effects such as nausea, vomiting, diarrhea, constipation, agitation and confusion, Sleep disorders, nightmares, depression and anxiety auditory hallucination. Also a case of induction of mania phase due to discontinuing propranolol has been reported.

A 11 year old boy was admitted with the diagnosis of Bipolar I disorder. Patient was started on 200 milligrams of Sodium Valproate twice daily and 1 miligram of Respridone twice daily. During the next 2-3 weeks his symptoms were gradually relieving and after 1 month patient left the psychiatric ward symptom free. At the one-month follow-up patient was still without any symptoms but had developed mild tremor and 10 milligrams of Propranolol was prescribed.

A week later patient accompanied by euphoria, restlessness, insomnia and increased energy after discontinuing it the symptoms had waned. He toke propranolol again but in a lower dose of 10 milligrams. Interestingly after taking a single dose of 10 milligrams propranolol patient developed the same symptoms. The symptoms were relieved by discontinuing the medication. Low doses of potent benzodiazepines were used to control tremor, which was a successful strategy.

The patient with the diagnosis of BMD, who contrary to our expectations developed symptoms of manic episode after taking low doses of Propranolol.

We propose that clinicians take into consideration proper percussions before prescribing this drug to patients with mood disorders.

Major depressive disorder (MDD) is associated with abnormal functional connectivity (FC) of amygdala and decreased function of cortico-limibic circuit, which play important roles in the pathogenesis of MDD. However, little is known about the connectivity alterations in late-onset depression (LOD), and whether such disrupted function is correlated with cognitive impairment is unclear.

A total of twenty-three LOD patients and thirty-seven controls underwent neuropsychological tests and resting-state functional magnetic resonance imaging (RS-fMRI). Regional homogeneity (ReHo) and FC of bilateral amygdala seed were used to analyze blood oxygen level-dependent fMRI data between groups.

Compared to controls, LOD groups showed weaker functional activity in bilateral middle frontal gyrus and left medial orbitofrontal gyrus, moreover, the decreased ReHo was positively correlated with Trail making test-B score (TMTB, r= 0.462,P= 0.04). In aspects of FC, left amygdala has reduced FC with right fusiform gyrus, right superior temporal gyrus and right putamen, while right amygdala has reduced FC with left cerebellum. Further correlative analysis found that the decreased FC between amygdala and right putamen was positively correlated with Verbal fluency test-verb score (VFT-verb, r= 0.513,P= 0.021) and the decreased FC between amygdala and superior temporal gyrus was positively correlated with Auditory Verbal Memory Test-delayed recall score (AVLT-delayed recall, r= 0.446,P= 0.049).

Our finding of reduced activation of prefrontal gyrus as well as decreased connection of bilateral amygdala may be key factors of impaired cognitive function in LOD patients and these changes could be early indicator for cognitive deficits.

Prospective studies have supported the validity of Vochs and colleagues’ three-factor interactive etiologic model of bulimic symptomatology (BS) among female undergraduates.

Given the comparable rate of binge eating between young adult men and women, we sought to examine for the first time the validity and sensitivity of the interactive model of BS in men.

We examined whether the interaction between Perfectionism x Male Body Dissatisfaction x Low Self-Esteem predicted increases in BS over 1-year (Study 1) and over 6-weeks (Study 2). Two different samples of college men were used. Time-1 BS scores as well as Time-1 and Time-2 Body Mass Index, Depression and Social Desirability scores were controlled for.

Data from college men (Study 1: N = 308, Mage = 21.04; Study 2: N = 344; Mage = 20.87) were analysed using hierarchical multiple regression/correlation procedure on participants’ Time-2 BS scores.

Both studies revealed that an increase of BS in men was predicted by the Perfectionism x Male Body Dissatisfaction x Low Self-Esteem interaction. BS increased in men who initially had high levels of BS and perfectionism, low levels of selfesteem, and were dissatisfied with their body. However, men with initially low or average levels of BS did not have an increase in BS even if they were perfectionistic, body dissatisfied and had low self-esteem.

The results support the interactive model's ability to predict increases of BS; however, the support is in regard to the maintenance of BS, not the onset of BS.

Schizophrenia is a worldwide public health problem that exacts enormous personal and economic costs. Schizophrenic patients often have difficulties to care by themselves and need from family and community support, including invalidity benefits.

Determine clinical and neuropsychological factors which predict global functioning and incapacity in paranoid schizophrenia.

40 paranoid schizophrenic outpatients (DSM-IV TR) were evaluated. Global functioning and incapacity was assessed with the DAS (Disability Assessment Schedule). Sociodemographic and clinical data were collected using a questionnaire including: age, gender, years of education and premorbid IQ (National Adult Reading Test), illness onset and triggers, admissions, adherence (Compliance Rating Scale), pharmacological treatment and drug abuse. In addition, psychopathology was assessed with PANSS, depressive symptoms’ with the Beck Inventory, insight with SUMD and cognitive functioning with a wide neuropsychological battery of tests which assessed attention, executive functions, verbal and working memory and social cognition.

T-tests and chi-square analyses were used to explore binary or categorical variables and Pearson correlation coefficient for quantitative scales. A stepwise multiple regression analysis was used to predict DAS.

DAS was correlated to positive (χ2 = .415; p = .008) and negative symptoms’ (χ2 = .530; p = .000), insight (χ2 = .519; p = .000) and executive functioning (χ2 = -.335; p = .035).The multiple regression analysis revealed that insight and negative symptoms’ predicted disability (R2 = .417).

Psychological and psychosocial interventions that increase insight and improve negative symptoms’ should be included in a comprehensive treatment of schizophrenia to prevent disability. Future research on antipsychotics should be addressed to improve negative symptoms’.

Recent estimates suggest Bipolar disorder (BD) affects approximately 1% of the population, with diagnosis often made during late adolescence and early adulthood, and that it is lower in the elderly (up to 0.1%). The initial onset of BD generally presents with depressive episode, but an initial maniac episode is not uncommon, although it becomes less likely with increasing age. In spite of the fact that elderly is a growing population in developed countries there are only few studies on late-onset BD (LOBD). Its etiopathogenesis and heterogeneity are complex, sharing several commonalities with organic brain diseases, which is denoted on frequent neuroimaging white matter hyperintensities, and involves higher medical and neurological burden.

To provide a comprehensive review reporting prevalence, features, course and comorbidity on LOBD. Additionally to report one selected case, intending to better understand this patient's subgroup.

The literature was systematically reviewed by searching on PubMed and reference psychogeriatric textbooks. We have selected one case of an elderly woman with LOBD with inaugural acute mania episode associated with previous diagnosis of Parkinson disease.

Distinguishing older adults with BD by early or late age at onset have limited clinical usefulness, although LOBD patients are more likely to have an organic mental disorder superimposed and more extensive and severe cognitive impairments, as well as vulnerability to extrapyramidal symptoms.

This case-report and literature review suggests that LOBD as a distinct diagnostic entity by its different presentation and etiology, and consequently different treatment, needs further investigation.

An association between low levels of serum cholesterol and violent or suicidal behaviour has frequently been reported. However the role of serum cholesterol in the cycle of violence (Widom 1989) has not been studied. The aim of this study was to investigate association between exposure to violence during childhood and expressed violent behaviour in suicide attempters with low and high serum cholesterol levels.

A total of 81 suicide attempters were assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6–14 years of age) and during adult life (15 years or older). We used median split to dichotomise groups below and above median serum cholesterol.

In patients with serum cholesterol below median, the correlation between exposure to violence as a child and violent behaviour as an adult was significant (rho = 0.52, p = 0.0024), while in patients with serum cholesterol above median, the correlation between exposure to violence as a child and expressed violent behaviour as an adult was not significant (rho = 0.23, p = 0.23).Comorbid substance abuse predicted violent behaviour as an adult only in patients with serum cholesterol above median.

Cycle of violence hypothesis is modified by serum cholesterol.

This study was aimed at evaluating the effect of the new, centralised (regional) referral system on the local Primary Mental Health Care (PMHC) Service, two years after inception.

Prior to the Single Point of Entry (SPOE) system, which is also known as triage, referrals were sent directly to each Consultant Psychiatrist and Community Mental Health Team by General practitioners (GPs). Theoretically, the new referral system should streamline referrals using resources efficiently, make access to mental health easier and reduce the time patients wait to be seen after referral.

Via user-satisfaction questionnaires, we conducted an on-line survey of GPs and the PMHC team in the Newry and Mourne area over a period of three months, asking for their views on the SPOE system.

The response rate for GPs was 28.3% (17), and 68.4% (13) for PMHC team. 65% of GPs and 85% of the PMHC team felt the new referral system was moderately or very effective overall. Both groups agreed that the time patients wait to be seen after routine referrals should be shortened. Emerging themes from qualitative analysis include the need to improve communication, training of staff and access to patient records during triage.

The low GP response rate suggests that Mental Health services should obtain more effective ways of engaging GPs in service development. This study indicates that the single point of entry system is effective overall but needs improvement in terms of accessibility and adequate communication between GPs, PMHC team and triage staff.

Analysis of characteristics of adaptation based on authors’ many-level model of family functioning.

Identification of quality of life of mental health care users, FACES-3, scales of prognosis of compliance in psychiatry (Lutova N. B. et al., 2007) and MARS. We have examined 152 schizophrenic patients (ICD-10 F2.0) and 38 their relatives.

Quality of life of patients and relatives is affected; family are characterized by schizophrenic patients as a whole as balanced and middle-balanced in 82,35% of cases, as imbalanced - in 17,65%. Relatives of patients define families as balanced in 27,3%, as middle-balanced - in 54,5%, as imbalanced - in 18,2%. There are more middle-balanced families according to rating of probands and lesser balanced than relatives’ ratings. Imbalanced families are found almost with equal frequency. During the first hospitalization the insight of necessity of maintenance therapy, in opinion of patients, was found only in 27,6%; there was insight but they did not adhere recommendations of the doctor - 49,0%; there was not insight regarding meaning of doctor's prescription and they did not adhere doctor's recommendations - 23,4%. In the first year after the first hospitalization to psychiatric institution 55,0% persons have been re-hospitalized, out of them with non-compliance - 42,0%.

Traits of adaptive behavior of families in schizophrenia have been revealed.

Anorexia Nervosa (AN) is a serious psychiatric disorder associated with high mortality.

To examine mortality patterns in patients with anorexia nervosa and psychiatric comorbidity.

6009 women who received in-patient treatment for AN between 1973-2003 were followed up retrospectively using Swedish registers. SMR were calculated on the basis of 74 523 person-years for natural causes of death and 80 388 personyears for unnatural causes of death. SMR was calculated for the group as a whole but also for patients with comorbid inpatient-treated psychiatric disorders, defined by respective ICD-codes from the Swedish patient discharge register.

Nearly half of the patients (44.9%) received in-patient treatment for a psychiatric disorder other than AN during the follow-up time. The overall SMR for anorexia nervosa with psychiatric comorbidity was 6.5 (95% CI: 5.2–7.9) for natural causes and 17.6 (95% CI:14.3–21.4) for unnatural causes of death. Comorbid psychiatric disorders yielded very high SMR for unnatural causes of death. The highest SMR for natural causes was estimated for anorexia nervosa with comorbid alcohol use disorder (16.8; 95% CI: 11.7–23.3).

Anorexia nervosa is a disorder with high mortality for natural and unnatural causes of death, especially when psychiatric comorbidity is involved. To correctly diagnose psychiatric comorbidity, particularly alcohol use disorder, and initiate early treatment could be a way to decrease mortality.