Find out are exist significance and link between infection of CNS (duration, type bacterial or viral, seizures if had happen) and psychiatric problems 20 years after?

Study-Follow up 30 patients during one year treated in day care hospital. eeg controlled. Ct brain if necessary. To measure depression used Beck, Montgomery A scales.

To measure panic used Pais 3 scales.

20 years after severe infection CNS noticed that just 20% visible eeg abnormalities. No seizures, but 10 % got AE.

50% dg as panic, felt better on clonazepam.

20%depression mild, recovered on escitalopram.

10% personae disorders on therapy.

Evaluated study showed that duration of CNS infection and seizers in anamnesis after 20 years consequence in irritability eeg as well as behavior problems so needed drugs.

Bacterial infection (pneumoccoc, enteroccoc) linked in depression. As difference, viral infection linked in anxiety, panic and personal disorders.

Beck and Montgomery A scales significant improvement after therapy. Panic scales also.

The defining features of Type D personality, that is, tendencies to experience negative emotions and inability to express emotions, are the known risk factors of somatization tendencies.

Many depressive patients express their mental distress through somatic symptoms. Therefore, it may be worthwhile to investigate the relationship between Type D personality and complaints of somatic symptoms in depressive patients.

The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients.

Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with 14- item Type D personality Scale (DS14). Patient Health Questionnaire 9 and 15 were used to measure depression severity and somatization tendencies.

Two-thirds of the subjects were classified as Type D personality (63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects (12.7 vs. 7.2, p=8.2E-6). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age (p=0.0015)and NA score (p=1.5E-7) was found to be statistically significant.

The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore (r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia.

Theory of Mind (ToM) is the ability to assign a set of mental states to yourself and others. in bipolar disorders, alteration of social relationship can be explained by the impairment of the functioning of ToM. Deficit in ToM can be a trait marker of bipolar disorder and people in general population who has high score of hypomanic personality will be more likely to develop bipolar disorders.

The goal of this study is to study abilities in a ToM task in general population with different level of hypomanic personality.

This study examines 323 participants (23.25 ±7.74 years). Measures of hypomanic personality were evaluated by the Hypomanic Personality Scale (HPS) (Eckblad & Chapman, 1986). It is a self-report scale subdivided in 3 factors: social vitality, mood vitality and excitement. ToM was explored using Yoni task (Shamay-Tsoory & Aahron-Peretz, 2007) French adaptation. This test permits to distinguish the affective and the cognitive components of ToM.

Forward multiple regression analyses were performed to examine the effect of components of the HPS on the total score of ToM task. in women’s group, no subscales of the HPS have been included in the model. Conversely, the analyses performed on men revealed that the mood vitality subscale was a significant predictor of ToM abilities.

The ToM task’s score is linked to the hypomanic score but only in men sample and only for the Mood vitality subscale. This result supports that deficits in ToM can be a trait marker of bipolar disorder in healthy men population.

Regarding the increasing number of elderly people, their quality of life.

Becomes more important. Spiritual health is one of the important aspects of health status that is often neglected. This study aims to identify the relationship between spiritual well-being and quality of life among elderly people residing in Kahrizak Senior House.

It was a descriptive, correlational study. The sample included 141 elderly people residing in Kahrizak Senior House who recruited by convenience sampling. Data was collected by Spiritual Well-Being Index (SWBI) and Short Form Quality of Life (SF36) and analyzed by Pearson correlation coefficients, ANOVA, and t-test using SPSS-PC (v-16).

The mean score of quality of life was (50.36±11.3). Women’s quality of life was Significantly lower than men (P=0.000). The mean score of spiritual well-being was (96.26±17.93). There was a positive correlation between spiritual well-being and quality of life (P=0.008).

Regarding the lower levels of quality of life especially in women elderly, more.

Attention should be paid to this group of society. Awareness of the importance of spiritual well-being in caring of these people is recommended.

Comorbidity is common among adults with ADHD, including substance abuse. To our knowledge relation between ADHD and SUD has not been studied in Arab countries.

Assessment of scope of comorbidity between ADHD and SUD in Egyptian patients.

Estimating prevalence rate of adult ADHD among substance use inpatients and to compare substance use inpatients with and without adult ADHD regarding onset, and severity of SUD.

This cross-sectional comparative study was conducted in addiction treatment center at El Maamoura psychiatric hospital. One Hundred and two adult males were assessed using Arabic version of Wender Utah Rating Scale (WURS) for retrospective assessment of symptoms of childhood ADHD. Arabic version of Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. DSM IV TR criteria were used for final diagnosis.

36 patients were diagnosed as having adult ADHD (35.3%) according to DSM-IV TR criteria. Presence of adult ADHD was associated with an earlier mean age of onset of SUD (15.58 vs. 13.22 years) and larger number of hospital admissions, (6.83 vs. 3.39 times). ADHD subjects achieved a shorter mean period of abstinence (124.53 vs. 209.82 days). Data were fed to the computer using the Predictive Analytics Software (PASW Statistics 18). Significance of the obtained results was judged at the 5% level.

The results of this study confirm the high rates of adult ADHD among substance use patients mentioned in other studies. Presence of adult ADHD was associated with a more complicated course of SUD.

PTSD patients display abnormal emotional processing and bias towards negative emotion. Long latency eventrelated potentials (ERP’s) are composed of the P300 and subsequent slow wave activity. These ERP’s are hypothesized to be relevant for attentional and initial memory storage events as well as emotional processing. objectives: This study tested the hypothesis that abnormal emotional processing in PTSD is reflected in altered brain activity, as measured via ERP’s.

Detect differences in cortical activity and emotional processing in PTSD patients as compared to controls.

ERP’s were recorded from 14 PTSD and 14 control subjects while viewing emotion-laden pictures. Subjects were instructed to press a button depending on the presence of a person or human part in the picture and response time was recorded.

Long latency ERP data (300-1035 msec) showed valence dependent activity in control subjects distinguishing negative vs. positive and neutral pictures. PTSD patients, however, lacked differential activation and had similar brain activity across all picture valances, which resembled the pattern observed in controls only for negative stimuli.

[Late ERP’s 980-1035msec]

PTSD patients also exhibited longer response time.

Our results demonstrate abnormal cognitive-emotional processing in PTSD patients and may underlie overgeneralization processes that are part of this disorder.

INTERMED is a patient-centered method designed to assess bio-psycho-social case complexity in general health care. It consists in a structured interview leading to definition of 20 variables by focusing on past, present and future health needs and risks of patients. The total score supports professional decision and guides to patient-oriented care.

To describe the training process on INTERMED interview and to assess its effectiveness.

A training group of 4 doctors and 4 6th-year medical students attended two-hour meetings twice a month (December 2011– March 2012). After introductory sessions on theoretical aspects and inter-trainee simulations on interviewing and scoring techniques, students were assigned the task of producing recorded clinical material, which was used to comment on interviewing skills and practice on scoring. Individual and consensus scores were collected at the end of every session and compared statistically by means of Cohen’s kappa.

Agreement between individual and consensus scores was already considerable at the beginning of the training and improved during the course (Cohen’s kappa raised from 0.39 to 0.65). The participants were interested and motivated. They expressed satisfaction for the skills acquired during the training.

A five months 20-hour training period is a reasonable time not only for learning how to master the instrument, but also for gaining the basic skills required to build a structured interview. These skills would be useful in the whole participants’ career and allowed the implementation of INTERMED as a clinical and research tool in the Modena General Hospital.

Narcolepsy is a disorder characterized by diurnal somnolence and episodes of short duration sleep. It can occur in 0.02–0.16% of adults, generally before the age of 30.

The aim of this work is to present tolerability and treatment response of Concerta in one adult suffering from narcolepsy.

We report the case of a 28 years adult female with narcolepsy. One year ago, after a strong social stress, she manifested some symptoms of narcolepsy: excessive daytime sleepiness, cataplexy, and visual hypnogogic hallucinations. There was no family history of sleep disorders and not experienced premorbid seizure or sleep disorder. Diagnosis of narcolepsy is based on DSM-IV criteria, polysomnography and Multiple Sleep Latency Test. Sleep latency, rapid eye movement sleep latency, and mean multiple sleep latency were 2.9, 70.1 and 1.5 min, respectively. Twenty-four hour EEG monitoring, MRI imaging of the brain and serum chemistries were normal. At the beginning because of the misdiagnosis the patient was treated with lithium and olanzapine. Patient started Concerta treatment after 1 year with 9 mg/day at the morning. Dose was increased maximum to 18 mg twice daily over a 2-weeks period.

Treatment of narcolepsy with Concerta lasted 6 month. Visual hypnogogic hallucinations and cataplexy started to improve 3 weeks after adjustments in methylphenidate dosing. Three months after the initiation of therapy, the patient is completely asymptomatic. Side effects included faster heart rate and nervousness.

This case support results from recent studies that methylphenidate is well tolerated and effective in narcolepsy.

Treatment of atypical depression (AD) modern antidepressants poorly understood, whereas the study of AD in the context of chronobiological disorders necessitates selection pathogenetically substantiated therapy.

To determine the effectiveness of agomelatine in the treatment of AD.

To compare the efficacy of agomelatine in patients with AD and melancholic depression (MD), the impact of the drug on the separate atypical symptoms, and the effect on AD in the first depressive episode (FDE), bipolar disorder (BD) and recurrent depressive disorder (RDD).

6 week monotherapy agomelatine patients with AD (n=60, main group) and MD (n=30, control group) at a dose of 25 mg/day with the possibility of increasing to 50 mg/day. Used rating scales ADDS, BDI, HDRS-17, LSEQ, GAF.

Response rate of onset in the treatment of AD was higher (third week) than in the MD (fifth week). Reduction on a scale HDRS-17 was significant at the first week of treatment in both groups (p< 0,001). of atypical symptoms better than others were reduced hypersomnia and hyperphagia. Treatment of patients with AD at FDE, BD and RDD showed a higher percentage of responders at BD (82%) than in the RDD (64.2%) and especially (p < 0,01) for FDE (40%).

Agomelatine has shown high efficacy in the treatment of AD (88.3%) and MD (83.3%), despite the opposite nature of the symptoms (insomnia and hypersomnia, decreased and increased appetite), as well as comparable efficacy in the treatment of AD in the structure as RDD and BD.

Psychiatrist write reports for a variety of judicial processes; employment law, family law, and personal injury. For a variety of reasons the commissioning agents may object to the report and seek to undermine its utility or validity. Attacks can take a range of forms from impugning an experts expertise, their competence, impartiality, the validity of the material used, the tests used, or via proxies such as another expert. After the event a refusal to pay for services provided is not unusual.

To familiarise psychiatrists with some of the common tactics used, illustrated by real case.

Analysis of papers submitted to Court and in the public domain

Results, by order of frequency:

• Allegations of substandard work, or even negligence are common, a feature being a lack of specifics in the assertions made in the pre-action protocols and witness statements.

• Threats to report the expert to a governing body, a feature being a lack of specific details.

• Threat of counter-claim for financial loss due to an unfavourable report.

• Refusal to pay for the report, up to including until court proceedings for debt recovery have been issued.

Outright attacks on the report are rarely successful, particularly where experts for each side meet to discuss the differences. However a refusal to pay fees is far more likely. Psychiatrists need to adopt a robust approach to Lawyers and learn which intimidatory techniques are probably hot air, and devoid of substance.

Raising a child with an autism spectrum disorder (ASD) is a daily stressful experience implying changes in family functioning [1]. Parents are more likely to experience psychological and educational difficulties and their vulnerability is clearly described [2, 3]. Most studies deal with parental difficulties (medical, psychological…) whereas those focusing on parental self-reported support needs, related to ASD are lacking.

The aim of this study was to investigate parents’ needs and their support expectations in order to investigate needs priority.

Two parents groups of children aged between 3 and 10 years are compared (ASD or control group). Mothers and fathers were interviewed about unmet needs using The Parental Needs Questionnaire, developed for this study and semistructured interview used to evaluate parents’ needs in terms of quality.

141 parents were included, 57 with an ASD child and 84 with TD children. There are 6 need areas for ASD child parents as well as controls: materials, time management, information, education, psychological support and relational difficulties. Parents of ASD child describe priority information needs (89.5%), psychological (73.5%), material needs (71%) and education (58.5%). These needs are listed last in the control group (respectively 10.5%, 26.5%, 29%, and 41.5%).

Providing parental assistance should be based on three key dimensions to receive specific information, to have psychological and social support and to manage child disorder. in practice today only the third axis is often considered in programs [4]. So, we make relevant recommendations about support for parents of ASD child.

The purposes of this study were to estimate the prevalence rates of subtypes of late life depression (LLD) including (vascular depression and non-vascular depression) in the baseline study, to examine the natural course of LLD and to investigate influence of white matter hyperintensities (WMH) volume on depression and neurocognitive function in the 3-year follow-up study.

WMH was rated by the modified Fazekas scale and the volume of WMH was also calculated by an automated quantification method. Patients were classified as having vascular depression if they suffered from any type of depressive disorders and had a score of 2 or more on either deep white matter hyperintensity or subcortical gray matter ratings. in the 3- year follow-up study, the participants of the in the baseline were follow-uped with the same methodology of the baseline study.

The prevalence rates of vascular major depressive disorder (MDD) and vascular non-major depressive disorder (nMDD) were 2.39% (53.6% of MDD) and 4.24% (34.0% of nMDD), respectively, in the baseline study. Among non-depressive group in the baseline study, subjects with WMH(+) had 13.5 times (OR=13.5, 95% CI=1.10-165.97) risk of developing depressive disorder in the 3-year follow-up study, as compared to those without WMH(+). Log WMH volume (OR=5.78, 95 CI=1.04-31.72) in the baseline study was an independent predictor for depressive disorder in the 3-year follow-up study

WMH is a crucial predictor for future depressive disorder, which supports the previous vascular depression hypothesis. Vascular depression is a useful construct accounting for clinical characteristics of LLD.

Different questionnaires were formulated in order to assess the severity of gambling. The most used questionnaire is the South Oaks Gambling Screen (SOGS), based on DSM-III criteria for gambling, even though it has poor specificity, because overestimates the prevalence of the disorder when used in general population.

Try to overcome SOGS limits using a questionnaire based on DSM-IV criteria for gambling.

Validate the questionnaire based on DSM-IV criteria, using as gold standard the clinical interview developed through the SOGS.

The sample used is formed by 71 subjects, 58 men (81.7%) and 13 women (18.3%), recruited from the Psychiatric Department of Gemelli General Hospital in Rome, who were asked to fill out both questionnaires.

The sensitivity of our questionnaire was 93% (compared to 100% in the SOGS); the specificity was 100% (97.1% in the SOGS). False negatives were 7%, while they were absent in the SOGS ; false positives were absent in the DSM-IV questionnaire, while they were 2.9% in the SOGS.

We also determined the prevalence of each item of DSM-IV questionnaire in all gamblers identified (66 subjects): the most relevant item was “chasing one's losses”(item6), instead the least one was “committing illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling”(item8).

Our data confirm the greater specificity of the questionnaire of DSM-IV criteria for gambling compared to the SOGS. We suggest its use for the identification of gamblers in a sample formed by general population.

Frequent and increasing relations among psychiatric and substance dependence disorders, have made, to date, more complex the treatment of this dependence, especially when the patient is facing the difficult task of maintaining abstinence, which requires a work of self-awareness, motivation to change and active modification of dysfunctional lifestyles.

Our study has the aim to detect patients’ changes in personality between the beginning of the rehabilitative therapy and its end, trying to get information on aspects of addiction on which the treatment affects the most.

Our sample was formed by 153 patients, recruited at the Department of Psychiatry of Gemelli General Hospital, who were subjected to an integrated approach of treatment, both pharmacological and rehabilitative group-therapy, according to Minnesota rehabilitation model, that considers addiction as a bio-psycho-social problem.

Patients, after a first psychiatric evaluation, were asked to fill out two psychometric tests, the SymptomCheckList-90 R and the Structural Clinical Interview for DSM-IV, in two times, at the first meeting and at the last one, after 20 meetings of group therapy.

At the end of the group therapy 39 patients dropped-out, 114 patients had a significant improvement in depressive symptoms (DEP item), greater responsibility perseverance and attention in their activities and habitual contexts (GSI, DIS, W/S items), as well as better management of compulsion and impulsivity (OC item) and a lower sense of inferiority, inadequacy and discomfort in interpersonal relationships (PAR, ANX, IS, SOC. A., PSY. A. items).

Clinical observations indicate that atypical antipsychotics, especially clozapine, induce obsessive-compulsive (OC) symptoms in schizophrenic patients. Recent data from neuroimaging and clinical trials suggest a role for altered glutamate neurotransmission in the etiology of OCD. It has been reported that SLC1A1, GRIN2B and GRIK2 regulate glutamate transmission and affect OCD pathophysiology. This study aimed to determine whether SLC1A1, GRIN2B and GRIK2 are associated with clozapine-induced OC symptoms.

A total of 250 clinically stable schizophrenic patients receiving clozapine treatment and 261 sex- and age-matched controls were recruited. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the severity of OC symptoms. Based on the Y-BOCS score, 250 patients were divided into OC group and non-OC group (patients with and without OC symptoms, respectively). Three reported OCD susceptibility polymorphisms SLC1A1 (rs2228622), GRIN2B (rs890) and GRIK2 (rs1556995) were genotyped.

Trends of association with OC symptoms were observed in rs2228622A and rs890T alleles. SLC1A1 and GRIN2B interaction was found in the significant 2-locus, gene-gene interaction model (P=0.0021), using a MDR method. Further analysis showed a significant interaction between SLC1A1 and GRIN2B on the Y-BOCS score (F6, 137=7.650, P 0.001), and individuals with AA/TT genotypes had a significantly higher mean Y-BOCS score than those with other genotypes, except AG/TT.

These results suggest that SLC1A1, GRIN2B and interactions between the two might confer a susceptibility to OC symptoms in schizophrenic patients receiving clozapine.

Reports about medication adherence in Arab patients with schizophrenia and the possible confounding factors are lacking. The aim of this study was to determine whether insight, spirituality and patient beliefs about the necessity and concerns about medication were associated with adherence among those presenting with schizophrenia in an outpatient facility.

At the end of a routine follow up with their psychiatrist, patients completed questionnaires including the Schedule for the Assessment of Insight (SAI- E), Morisky Medication Adherence Scale (MMAS), Arabic Daily Spiritual Experience Scale (DSES) and Beliefs about Medicines Questionnaire (BMQ) in addition to demographic and clinical information from patients and their medical files.

A convenience sample of 92 patients with schizophrenia was studied .On the basis of the MMAS results, 33 (14.7%) patients were categorized as medication adherent and 59 (49.3%) as medication nonadherent. Regression analysis showed that the BMQ concern subscale and DSES scores were negative predictors of adherence whereas the SAI score was a positive predictor of adherence. The most important predictor of adherence was DSES and SAI, followed by BMQ concern subscale

This study extended prior research on the role of insight, spirituality and patient beliefs in medication adherence in a sample of Arab patients with schizophrenia which is consistent with previous research conducted in western cultures.