It is known that psychiatric disorders often lead to unhealthy life styles and reduced quality of life, which can lead to weight gain, possibly enhanced by psychotropic treatment.

Solutions for Wellness (SfW) is an educational program for life style changes for psychiatric patients. This observational study evaluated the effectiveness of SfW.

30 psychiatric clinics collected data for the study. Quality of life was measured by the Subjective Wellbeing under Neuroleptics scale (SWN), at baseline and at the end of SfW participation at 3 months. Demographic, disease and treatment data were also collected. A control group consisted of patients from centers that did not offer the SfW program.

314 patients were enrolled in SfW group, 59 in the control group. 54% of the total group had schizophrenia, 67% received atypical antipsychotics. The baseline mean BMI in the SfW group was 31.7 kg/m2.

SWN scores for the SfW group improved significantly from baseline to the end of the program (mean increase 3.3 ± 12.2), but not significantly more than for the control group (mean difference 1.4, p = 0.4158 (t-test)). The SfW group demonstrated a significant decrease in BMI, weight and waist circumference from baseline. The decreases were significantly larger compared to the control group for BMI (p = 0.0018) and weight (p = 0.0027) (t-tests).

Patients in the SfW program improved in BMI, weight, waist circumference and SWN total score. Changes in weight and BMI were significantly larger in the SfW group compared to the control group.

To examine the perceived needs by patients and radiotherapists using a modified by us version of the Camberwell Assessment of Need (CAN).

We eliminated 4/22 areas of the CAN scale -ideated for psychotic patients- in order to adapt it to oncological subjects (naming it CANo). Each of the scale areas values: the existence of a specific need; the help received from care-givers; the help coming from social services; the completeness of the help received. CANo was administrated to 30 solid cancer subjects consecutively admitted in 2007 to the Radiotherapy Department of Novara Hospital (Italy), and to their respective treating radiotherapists. Patients with cognitive impairment were excluded. Patients were also administrated the following protocol: HADS (Hospital anxiety and depression scale); Paykel's list of stressful events; MBTI (Mayer-Briggs Type Indicator); EORTC QLQ-C30.

Anxiety and depression occurred at any level in 15/30 of cases. There was a significant correlation (Spearman coefficient: SC) between the numbers of needs on CANo scale and anxiety (SC:0.4; p=0.002) or depression (SC:0.48; p=0.006) levels. Higher scores in all functional EORTC scales corresponded to lower needs detected by CANo. Patient needs were perceived less important by patients themselves than their physicians (mean satisfied need scores: 1.87 vs. 3; unsatisfied need scores: 0.63 vs. 1.03). The staff overestimated patient physical health needs (7/30 vs 3/30), psychological distress (20/30 vs 5/30), relationship difficulties (9/30 vs 2/30), received information correctness (7/30 vs 2/30).

The CANo scale may be useful to detect oncological patient needs and to improve the quality of care.

A deficit in the theory of mind has been identified, although without univocal results, in various pathologies, such as schizophrenia, bipolar disorder and some personality disorders. Aim of the study was to evaluate, in a non- psychiatric population, the correlation of personological characteristics and symptoms with theory of mind and emotion recognition tasks.

The following protocol was administrated to 130 voluntary students from Novara (Italy) School of Medicine: EPQ-R test for personality analysis; an intention-inferencing task for theory of mind (adapted from Happè's version); the emotion recognition test (adapted from Blair's version); and SCL-90 for symptoms evaluation. Spearman correlation coefficient (SC) was calculated; p< 0.05 was considered statistically significant.

No statistically significant correlations were found between the EPQ-R (psychoticism, estroversion and nevroticism) and theory of mind test scores. Better performances in the theory of mind test corresponded to lower scores in SCL-90 subscales: obsessive-compulsive disorder (SC:-0.248; p=0.004); depression (SC:-0.280; p=0.001); anxiety (SC:-0.276; p=0.001); hostility (SC:-0.178; p=0.042); phobic anxiety (SC:-0.197;p=0.025); paranoid ideation (SC:-0.191;p=0.03); and psychoticism (SC:-0.189; p=0.032). A lower capacity in the recognition of the happiness emotion corresponded to higher scores in the hostility (CS:-0.194; p=0.027) and phobic anxiety (CS:-0.211; p=0.016) SCL-90 subscales, while higher scores in the EPQ-R subscale psychoticism and somatisation SCL-90 subscales were respectively related to lower skills in the recognition of fear (CS:-0.226; p=0.01) and envy (CS:-0.193; p=0.028) emotions.

Theory of mind skills seem independent from personological traits, but are inversely correlated to various symptomatological subscale scores. The recognition of specific emotions correlates selectively with various personological traits and symptomatological subscales.

Homocysteine (Hcy) is studied in relation to gender dependent schizophrenia in young males and to affective disorders in females. In relation with Hcy also the level of Vit.B12 and folic acid is investigated as they have ability to decrease the level of Hcy essentially.

The aim of our study is to get information about serum level of Hcy, Vit.B12 and folic acid in patients with schizophrenia's spectrum, autism, mood disorders and mental retardation and their possible link.

In the study 91 patients of Children's Psychiatric Hospital with above-mentioned diagnosis were involved, 37 of them with schizophrenia's spectrum disorders. Patients were selected according to their diagnosis (in line with ICD-10) and current clinical state. Each diagnosis and clinical state was coded depending on its severity and course of disease.The level of Hcy was stated by isocratic HPLC system with fluorometric detection (Shimadzu LC-20, model RF-10AxL).

Correlation among diagnosis, severity of disease and level of Hcy was r = -0.401 (p < 0.01). It was found out that the level of Hcy was the highest in 14 schizophrenic patients with acute condition and adverse course of disease.

First obtained data are indicative of potential link among the level of Hcy and schizophrenia and its severity, thereby it allows advancing hypothesis that Hcy can be as one of risk factors of schizophrenia.

Ensuring standards of section 58 documentation and associated communication complies with the code of practice of the Mental Health Act 1983 UK.

Case note review of detained patients under section 3 of Mental Health Act (MHA) 1983, requiring either a certificate of consent to treatment (form 38) or a certificate of second opinion authorising treatment (form 39), beyond first three months of medication. A standard checklist was devised, based on recommendations of MHA commission and code of practice.

Form 38 (5 Patients), 100% completion of names, dosage, route of adminstration of medication and proposed number of ECT treatments. Only 60% completion of documentation regarding treatment plan explanation and stating whether clozapine was included excluded.

Form 39 (7 patients) completed correctly in 100% cases with recommendation by second opinion appointed doctor (SOAD) in 85% cases. No documentation by SOAD in case notes and contact with the responsible medical officer (RMO) was only by phone (should have face to face contact). Only in 28% of cases RMO documented the SOAD visit and outcome.

This audit has highlighted wide range of implications from the medico-legal perspective. The statutory documents, form 38 and 39, were completed correctly in majority of cases except for minor omissions. Adequate documentation was lacking with regards to discussion about the care plan and outcome of the SOAD visit. SOAD contact with the RMO was only on the phone (should only be in emergency) and no documentation of the second opinion in the case notes apart from filling the form 39.

Evaluate the attitudes of non psychiatrist doctors and residents working in Hôtel-Dieu de France hospital towards mental illness and medical students of Saint Joseph University.

A 25-question-questionnaire about the perception of severe mental illness, of psychiatric treatments, of psychiatrists, and of psychiatry as a future career, which was distributed to Saint Joseph University medical students over the 7 years via the delegates of each class, to the doctors via their secretaries in their clinics, and personally to the residents between the period of November 27 and December 28, 2007.

We have found negative attitudes towards mental illness in the studied population but positive attitudes towards psychiatric treatments, psychiatry, and psychiatrists with higher scores among doctors than students towards mental illness (p = 0.0073) and towards psychiatric treatments (p = 0.0016) but no significant difference between different groups in the scores of perception of psychiatry (p = 0.78) and psychiatrists (p = 0.42). No difference was found between males and females for none of the scores.

This study is the first of its kind to demonstrate that medical students’ attitudes are negative towards mental illness but positive towards psychiatric treatments, psychiatry, and psychiatrists during their first years of medical studies and stay the same after receiving a theoretical psychiatry course and after a clinical training in a psychiatric hospital and even when they become residents and that these attitudes become more positive when they become doctors.

To assess the prevalence of depression during IFN therapy; to test whether a computerized version of the Minnesota Multiphasic Personality Inventory (MMPI) is a sensitive and reliable test for the early identification of patients at risk of depression before IFN therapy is started; and whether and how the depression can be cured. Patients. 185 patients treated with IFN.

Before therapy, all patients underwent an MMPI and a clinical examination for identification of depressive symptoms.

Thirty-one patients developed a psychiatric disorder, 11 of them requiring treatment. Among the 18 patients with MMPI positive tests, 16 developed a psychiatric disorder (sensitivity of 0.58). Among the 154 who did not develop psychiatric side effects, 152 had a negative MMPI (specificity: 0.99). Severe psychiatric disorders (8 patients) were successfully treated with antidepressant drugs.

Psychiatric side effects are easy to see during IFN therapy. An accurate psychiatric evaluation should be considered on all patients before treatment. However, as this specific examination cannot always be performed because of the lack of psychiatrists in liver units, it is necessary to identify tests, that are easy to carry out, reproducible, self-administered and inexpensive in order to screen all patients. If depression develops, it should be treated aggressively, and selective serotonin re-uptake inhibitors are the anti-depressant of choice.

The authors’ aim is to approach the different psychiatric manifestations in HD, and Psychiatry's role in afflicted families.

The authors undertake a revision of this topic in the literature.

Familiar history is underestimated, and in the course of the disease, antidepressive treatments are underutilized. Atypical antipsychotic with minimal extrapyramidal side effects are welcome on motor as well as behavioural symptoms. Family counselling and psychological support is key.

The attitudes of medical students toward psychiatry have been studied extensively in other countries. A positive attitude to psychiatry may make future doctors more responsive to the psychological needs and comorbidity of patients in all branches of medicine.

The purpose of this study was to examine whether attitudes toward psychiatry improved during psychiatric attachment as well as the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career.

On the first and last day of their psychiatric attachment 109 fifth year medical students of SBMU were asked to participate in the study. They completed a demographic form and “Attitude toward Psychiatry Questionnaire”. They also responded to two questions which measured their intention to pursue psychiatry as a prospective career.

Students had favorable attitude toward psychiatry before the attachment with mean score of 84.14 on Attitude to Psychiatry Questionnaire (neutral score 72). These attitudes become more positive after attachment. Students’ intention to pursue psychiatry as a career increased during attachment (t=-4.85 df =107 p=0.000). Improvement in attitudes was related to an increased intention to pursue psychiatry as a career (rho=0.170 n=109 p=0.032).

The study confirms earlier reports of a significant positive impact of undergraduate psychiatric attachment on medical students’ attitudes toward psychiatry and their intention to pursue psychiatry. Thus, teaching psychiatry at an undergraduate level may well have important implications.

This study was done to determine the quality of life in medicine students according to the sex, residence, being native, marital status, being scholar, entrance share to the university, educational level and entrance year to the university in the second half of 2006.

It is a descriptive study that was done among medicine students of Zanjan"s medical university. Necessary data were extracted by distribution of QLQ questionnaire among the students. In this study, sample volume was 200 cases and sampling method was total sampling. The data were analyzed with SPSS statistical software.

In this research 200 medicine students, whose, entrance year to the university was 1999-2006, were studied. The highest quality of life was seen in students entered to the university in 2004 (105.1), married students (104.67), students in basic science level (99.7), scholar students (98.81), students residing outside of dormitory (96.95 (female students (94.81), students with free entrance share (93.35), and non-native students, respectively.

According, to the analyzed data, the quality of life in medicine students of Zanjan medical university was in ‘intermediate level (93.19). The mean of quality of life in married students (104.67), scholar students (98.81) students residing outside of dormitory (96.95), female students (94.82), students with free entrance share (93.35) and non-native students was more than mean of other students. The most and least mean of score in scale fragments of QLQ questionnaire were related to the body health and parent - child relations, respectively.

The association between tics, epilepsy and obsessive-compulsive symptoms, is still little explored in literature.

The authors describe case of a male patient, 25 years old, with some obsessive personality traits and with the appearance of simple multiple tics, at 7-8 years old. The tics were vocal and motor, particularly facial and worsen with anxiety. Of the personal history is highlighted the existence of repetitive tonsilitis and in the family history the presence of tics in 3 paternal first cousins. This patient started only consultation of Neurology in 2003 and was medicated with haloperidol 1 mg / day. Already in 2007 it was triggered absence crisis, so that after additional study (EEG and MRI) and detection of focal paroxysmal activity in the left fronto-temporal region, the patient was medicated with levetiracetam 1000 mg / day. Currently holds the following therapy: levetiracetam 1500 mg / day, clonidine 0225 mg / day and buspirone 30 mg / day, with clinical improvement occurred.

This patient on one hand, presents DSM-IV-TR (2001) diagnostic criteria for Gilles de la Tourette syndrome and on the other hand, criteria for the diagnosis of fronto-temporal epilepsy. It is also relevant the patient"s family history, that is consistent with the high risk of Tourette Syndrome in the first degree relatives.

Characterize the profile of suicidal behavior in a sample of patients followed in a general psychiatric consultation.

It was done an analytical observational study of a random sample of 100 patients followed in a general psychiatric consultation. A survey was conducted with the collection of socio-economic, religious aspects and clinical data, and it was consulted the patient"s clinical process. Data analysis was done in Excel 2003.

The sample was consisted mostly by women (74%), being the most representative age group between 40 and 50 years (27%), mostly married (61%), 24% had 2 children and 65% lived in the rural area. The clinical diagnosis (ICD-9) was in 46% of cases, neurotic depression. 52% consider themselves religious not practitioners, being 90% catholics. History of suicide attempts/parasuicide occurred in 32% of patients, in the form of drug intoxication (31%) or with another method (11%). Most of the individuals said to have already thought about suicide at least once in their lifetime (74%). Only 8% had current suicidal ideation. Family history of suicide occurred in 27%, particularly in first degree family members, mainly by drowning (7%) and hanging (7%).

Our results suggest that exists a high prevalence of suicidal behavior in this patients. For that reason, it should be done a systematic screening for suicidal ideation in this risk population.

Although probably undereported, musical hallucinosis is very rare and usually bilateral. It refers to auditory complex hallucinations, for which the patient has full insight, and includes melodies, tunes, rhythms and timbres.

A 71-year-old women was seen for a history of hearing music in the right ear. She had mild hypertension and auricular fibrillation, being chronically medicated with aspirine, bisoprolol and hydroclorothiazide. Three months previously she started hearing some popular folk Portuguese songs in the right ear. She could identify the lyrics and sing the songs she heard. Weeks later fado and classical music were added to the repertoire, and later on she started hearing less well-formed sounds like “dlam... dlam” or “uhh... uhh”. There were no other auditory or visual hallucinations. She was seen by an otorhinolaryngologist, and made an audiogram showing bilateral, right-predominant, pre-coclear deafness with normal evoked brainstem auditory potentials. An MRI showed small deep subcortical lacunar lesions. EEG was normal. PET scan showed left temporal hypometabolism. On benzodiazepines she had discrete improvement.

Musical hallucinosis has been found mainly in deaf patients, and a similar mechanism to that of Charles-Bonnet syndrome has been proposed. Sensory deprivation of primary auditory cortex would “release” the secondary auditory cortex, to produce complex auditory hallucinations with full insight. In our patient we were able to demonstrate the integrity of the brainstem pathway, supporting a direct link between diminished right ear sound transmission and left temporal lobe diminished activation as ascertained by the pet scan.

Attachment research has provided useful concepts towards an interpersonal approach to psychopathology. Although it suggests that psychological processes are defined by three relational dichotomies (self vs. other, relatedness vs. autonomy, and dependent vs. dependent-on positions), it has not yet assessed separately and simultaneously the eight components generated by the intersection of these dichotomies (e.g. self requesting relatedness, self providing relatedness etc). The aim of the present research was to investigate the validity and potential clinical usefulness of such a neglected approach.

In Study 1, thirty Cognitive Analytic Therapy outpatients at Guy's Hospital, London, were interviewed before treatment on their couple relationships and filled out the Brief Symptom Inventory (BSI) and Inventory of Interpersonal Problems (IIP). A content-analytic method was applied to the transcripts. In Study 2, a new attachment questionnaire was completed by 400 undergraduates, along with the BSI and IIP.

In Study 1, at a six-month follow-up, BSI scores were predicted by the Self Requests Autonomy [R Sq = .29, F(1,23) = 10.84, p = .003] and the Other Provides Closeness [R Sq = .23, F(1,23) = 9.72, p=.001] attachment dimensions, while IIP scores were predicted by Self Provides Support [R Sq = .11, F(1,23) = 7.87, p=.003]. In Study 2, factor analysis yielded eight components matching the theoretical expectations and correlating with BSI and IIP scores (rs ranging from .18 to.41).

The present findings provide some preliminary support for the validity and potential clinical relevance of the method.

Attention Deficit Hyperactivity Disorder (ADHD) is relatively common in children and has many co morbidities. Some studies have shown that co morbidities especially anxiety disorders may affect the response to stimulant medication. The object of this study was to investigate the relation of children's response to methyl-phenidate with their co morbid psychiatric disorders.

The sample included fifty 6 to 12 years old children with ADHD referred to Dr.Sheikh clinic of child psychiatry in Mashhad (north-east of Iran). The diagnoses were made by a child psychiatrist based on the DSM-IV -TR criteria, using clinical interview and K-SADS. ADHD children received methyl-phenidate for 4 weeks. ADHD- rating scales were completed by mothers and teachers of children before the treatment and after 4 weeks. Data were analyzed by SPSS -16 and statistical tests including chi-square and t-test.

The mean age of ADHD children was 8.7 years old. Most of the patients (74%) were boys. In 32 patients (64%) at least one co morbid psychiatric disorder was found. Anxiety disorders were the most common co morbidity of ADHD (in 56% of patients). Co morbid disorders did not have a significant affect on response to medication in ADHD children (P>0.05).

In the present study disruptive behavior and anxiety disorders were the most common co morbidities in ADHD children. Presence of co morbid disorders including anxiety disorders did not change the response to methyl -phenidate.