To explore the parents’ representations of te wheight problem after one year To evaluate if this changement of the representations has un effect in the well being of the adolescents, their parents and their family relations.

Two focus groups were conducted at the end of a one year Family-Based Behavioural Treatment (FBBT) for obese teenagers (12–18 years), involving 16 parents. Four Open-ended questions were used.

Parents reported that the participation in a group program allowed them to reduce their sense of isolation. It helped them to decrease their sense of guilt and also in the transition from childhood to adolescence. Less attention was payed to the diet.

The process-outcome studies present ambiguous results concerning the fluctuations of psychopathological symptoms during psychotherapy. We also know that self-concept clarity is connected with the level of psychological functioning (Campbell et al, 1996), but no research is available exploring the dynamics of this variable in psychotherapy.

The study was designed to find if the intensity of fluctuation of the self-concept clarity and symptoms of neurosis during psychotherapy was connected with positive outcome.

All participants were in a program of 8–12 week intensive eclectic group psychotherapy. 85 patients with a diagnosis of neurosis and/or personality disorders filled in questionnaires measuring the self-concept clarity and symptoms of neurosis every 2 weeks. Additionally the features of neurotic personality were measured. The root mean square error (RMSE) of log-linear regression for each participant is the indicator of fluctuations.

There is a positive correlation between the fluctuation of the self-concept clarity during psychotherapy and the symptom reduction at the end of the therapy for all patients (r = 0,24). Among the subgroup of patients with high initial self-concept clarity and high intensity of neurotic personality features this correlation was notably high (r = 0,53). No statistically significant correlations were found concerning the fluctuation of neurosis symptoms.

Fluctuations of the self-concept clarity during psychotherapy are thought to be beneficial for patients with neurosis and personality disorders - particularly for those integrated around their disturbed personality. This observation is discussed in the perspective of the integrated dynamic systems model of change in psychotherapy (Hayes, Strauss, 1998).

The relationship between health beliefs regarding formal mental health services, practical variables (time, affordability, transportation), stigma, and use of internet support groups in lieu of formal treatment has received little empirical attention.

The study examines the relationship between health beliefs, practical variables, stigma, and engagement in internet support groups among adults.

The study addresses whether beliefs regarding formal mental health services, having the time, finances, and transportation to use them, and the social consequences of being identified as having a mental health problem influence the use of internet support groups.

Data were analyzed from 2,532 respondents who endorsed perceiving the need for but not receiving formal mental health treatment in the National Survey on Drug Use and Health (2008). Binary logistic regression was used to examine the relationships between health beliefs, practical variables, stigma, and the use of internet support groups.

The strongest positive predictors of internet support group use were fear of being hospitalized/taking medications (AOR = 8.252, CI = 8.170–8.334), lack of transportation (AOR = 2.313, CI = 2.271–2.357), and insufficient insurance coverage (AOR = 2.640, CI = 2.610–2.670). The strongest negative predictors of internet support group use were lack of belief in the efficacy of formal treatment (AOR = .629, CI = .618–.641), fearing that others would find out (AOR = .660, CI = .645–.675), and not thinking formal treatment was needed at the time (AOR = .681, CI = .665–.696).

Using the internet for relief from mental health symptoms has proliferated, yet has received little empirical attention. Research is needed to examine the implications of using internet technology rather than formal mental health treatment.

The aim of the study was to assess the impact of several psychological and/or biological variables in the recovery from surgery.

The selected sample was composed of 42 patients (age range: 25–70) admited for surgical treatment to a University Hospital. The patients who presented impaired cognitive functioning were excluded from the study. Prior to surgical intervention (48 to 72 hours), patients were administered the Family Adaptability and Cohesion Evaluation Scale (FACES-II). Salivary cortisol was measured 24 hours before surgery. Following surgical intervention, recovery was coded as “good” or “poor” accordingly to Moix et al.’s criteria (1995). Dietary intake, resting and sleeping time, fever, perceived pain and surgery-related complications were assessed on a daily basis.

Significant relationships between better recovery, family cohesion and salivary cortisol level were found. The patients with lower scores in the cohesion dimension of the FACES-II and higher cortisol levels had more complications during the recovery phase (F = 10.96, p = 0.006).

Our results suggest that social support (family cohesion) and the activity of the hypothalamus-pituitary-adrenal axis (cortisol levels) can have a significant influence on postoperatory recovery. Taking these data into account, it would be suitable to assess psychopathology and social support in patients waiting for surgically interventions.

Deployment to conflict areas poses problems for service families. These stressors pose a high cost from increased rates of marital/family break-up and the impact on operational effectiveness, through early recall from combat zones. Soldiers look forward to a mission whilst partners are more ambivalent. The time before deployment is hard on those who stay behind, who experience high levels of anxiety. Those about to be deployed feel guilty, and have to manage their own anxieties about what the mission will bring - hard work, excitement and danger. Most do not talk about this to their partners, who in turn have to manage their own inner turmoil and worst case ‘fantasies’.

The project grew from concerns about the welfare of families of deployed army personnel.

The project aimed to help them develop a greater capacity to manage, contain and function with these worries. The program provided psychodynamic psychoanalytic practices to a previously neglected group that was not wholly army, but is essential to its well-being.

The program gave the families a greater understanding of the emotional difficulties faced by their partners before, during and after deployment and lessened the stress in their relationships; strengthening their own and their partners’ sense of self, resilience, and the marital bond.

Usually 3–5% of a unit would be recalled from combat operations, over the duration of a tour, this was reduced to 1%.

A psychotherapy programme for the families of soldiers reduces attrition rates.

Negative self-esteem is frequently associated with a pessimistic style of explaining events. People experiencing events may see themselves as the cause, moreover they see the situation as unchangeable, and affecting all aspects of life. After experiencing some inability to avoid an adverse situation individual learns to act or behave helplessly.

Working with a depressive patient can lead to the therapist's negative emotions such as frustration caused by the slow improvement, lack of the patient's engagement or escalation of suicidal tendencies. In such situation supervision seems to be essential.

The aims of this case report is analysis of relation between therapist's low self-esteem and patient's learned helplessness.

The studies includes analysis of supervision case report. The supervisee has completed the CBT education and he was a psychiatrist with five years of clinical experience.

This supervision showed the therapist's poor self-esteem as a factor escalating the patient's learned helplessness. The therapist needed to prove himself and his excessive activity unmotivated the patient and decreased his sense of competence. The work on these dysfunctional cognitions was very important and reduced the therapist's anxiety. The increase of the therapist's self-consciousness improved the progress of therapy.

This analysis showed the impact of the therapist's cognitions on the course of therapy. The work on therapist's negative cognitions about himself is very important and can reduce the problems in therapy, e.g. learned helplessness of patient with depression.

Schizophrenic patients have a high incidence of falls and fractures. We evaluated postural stability in schizophrenic patients using computerized static and dynamic posturography (CDP).

To measure normal and perturbed stability in schizophrenics.

To objectively demonstrate postural abnormalities in schizophrenics.

We retrospectively evaluated CDP studies on 54 consecutive schizophrenic patients. CDP was done using FallTrak (R). Patients performed normal stability - eyes open (NS/EO), normal stability- eyes closed (NS/EC), perturbed stability - eyes open (PS/EO), and perturbed stability - eyes closed (PS/EC) for 30 seconds each. Findings were classified as normal or abnormal based on age-matched normative data.

The ages ranged from 31 to 77 years. There were 34 (63.0%) males and 20 (37.0%) females. Of the total 54 patients, 48 (88.9%) exhibited abnormalities on CDP testing. NS-EO was abnormal in 29 (53.7%), NS-EC was abnormal in 37 (68.5%); both NS-EO and NS-EC were abnormal in 25 (46.3%); PS-EO was abnormal in 27 (50.0%) and PS-EC was abnormal in 20 (37.0%). Both PS-EO and PS-EC were abnormal in 14 (25.9%). Both PS and NS were abnormal in 26 (48.1%). NS was normal in 13 (24.1%) and PS was normal in 21 (38.9%). Both NS and PS were normal in 6 (11.1%) patients.

Most schizophrenic patients show abnormalities in both normal and perturbed stability when tested using static and dynamic posturography. Balance was normal in only 11.1 % of the patients. Further studies are needed to evaluate the clinical significance of these findings.

Schizophrenia and smoking are closely linked. Non-instutionalized schizophrenics have a much higher rate of smoking and smoke more cigarettes than the general population. We studied the smoking patterns in institutionalized schizophrenic patients.

Boarding Homes (BH) provide boarding with daily activity and health care supervision. All residents are over 18 years old, ambulatory and do not require skilled nursing care. The objective of the study was to evaluate the smoking patterns in schizophrenics living in these institutions.

The aim was to evaluate the effect of supervision on the smoking habits of institutionalized schizophrenic patients.

Smoking history was obtained from 100 consecutive BH schizophrenics sent to our office for annual physicals. All were under care of psychiatrists.

Of the 100 patients [54 (54%) males; 46 (46%) females], 96 [52 (54%) males; 44 (46%) females] were current smokers. 32 [20 (63%) males; 12 (37%) females] reported smoking up to 10 cigarettes per day, 42 [22 (52%) males; 20 (48%) females] up to 20 cigarettes per day, while 22 [10 (45%) males, 12 (54%) females] 30 or more cigarettes per day.

Schizophrenics living in institutions have extremely high rates of smoking, in spite of being supervised. These rates are higher than that reported with schizophrenics living independently and extremely higher than the general population. They also smoke more cigarettes per day. Strategies to reduce smoking and protect this population from the harmful effects of this addiction need to be established.

It is generally accepted that Clozapine is the gold standard treatment in patients with treatment resistant schizophrenia. Large numbers of patients treated with Clozapine discontinue treatment for various reasons including severe side-effects and insufficient response. There is limited literature supporting the next-step treatment option following the discontinuation of Clozapine.

The atypical antipsychotic Amisulpride as a next-step treatment option beyond Clozapine, is hypothesised to be useful in some patients due to its first pass metabolism which differs from other second generation antipsychotics. The authors present the clinical response from using Amisulpride in three Clozapine-resistant schizophrenic patients.

The authors aim to demonstrate the role of Amisulpride monotherapy in patients with schizophrenia who are resistant to, Clozapine.

Three cases of individuals with residual psychotic symptoms despite Clozapine use and/ or with significant side effects precipitating discontinuation, are presented. They were changed to Amisulpiride and their response was evaluated by clinical assessment.

Positive clinical results were obtained in all three patients, with improvement of psychotic symptoms and of some of the more common side effects of Clozapine.

The findings from these cases suggest that Amisulpride can be of benefit in treating Clozapine-resistant schizophrenic patients. Further, more structured trials are needed to understand these findings.

The goal of this study vas to examine the efficacy of valpoate (depakine-chrono) with combination by haloperidol decanoat in schizophrenia patients with treatment resistant verbal hallucinosis.

46 outpatients (men) diagnosed according to ICD-10. Patients treated haloperidol decoanat (in ampoules) 100 mg intramuscularly over 7 days plus 1500 mg depakine-chrono (in caps.) in day, per os. Treatment duration was 7 to 28 days. The expressiveness of psychopathology was estimated 7 balls system by the positive scale score of PANSS. The significance of differences between baseline and at the termination was assessed by the Wilcoxon Rank Sum Test.

All surveyed patients apparently efficiency of treatment of schizophrenia with verbal hallucinosis after treatment was higher statistically significance.

Haloperidol decanoat with the combination by depakin chrono represents a usefully method for the treatment of patients with treatment resistant verbal hallucinosis.

The role of cerebellum in schizophrenia has been highlighted by Andreasen's hypothesis of “cognitive dysmetria”. Evidence is accumulating that cerebellar dysfunction could underlay some of the clinical psychiatric and neurological symptoms as well as cognitive dysfunctions observed in schizophrenia.

To provide an up-to-date review of the putative role of the cerebellum in schizophrenia.

To inform clinicians of the neurobiological findings involving the cerebellum and schizophrenia and its possible translational applications in clinics.

We conducted a MEDLINE search of all English articles published between 1966 and 2009 using the key words “psychosis” “schizophrenia,” “cerebellum” and “cerebellar”. Priority was given to controlled data; uncontrolled studies were considered if sample size was reasonable (more than 10). Case reports were included if deemed to provide therapeutical insights.

Results from several neuropsychiatric and imagiological studies have documented abnormalities in cerebellar function and structure in schizophrenic patients. Moreover, pharmacologic and psychosocial therapeutic interventions for these patients have been linked with changes in cerebellar function. Some psychopharmacological approaches seem to be preferable in patients with schizophrenia-like symptoms and confirmed cerebellar pathology. Novel experimental therapeutical approaches with cerebellar transcranial magnetic stimulation in treatment-resistant schizophrenia seem promising.

Although different lines of research converge to suggest that a cerebellar dysfunction could exist at least in some patients with schizophrenia, the relationship with cerebellar pathology remains obscure and should be the focus of future research.

Schizophrenia is a chronic disease with devastating consequences for individuals, families and society. Illness is characterized by alternately periods of relapses and remission. It is therefore of particular importance recognition of prodromal symptoms, which announced a new worsening of the disease and act with treatment timely. This is to prevent early deterioration of personality, shorter stays in hospital, better socialization and significant economic effects.

126 female patients who were admitted on Female Admission Department of Special Hospital for Psychiatrics disease during 2009. with already verified schizophrenia. Patients with somatic disease, social and administrative reasons for prolonged hospitalization were excluded from study.

Aim of the study was to investigate effects on admission in prodromal stadium in schizophrenia relapses on hospital treatment length.

Patients were divided in to two groups. First group were patients with prodromal symptoms (anxiety, hostility, irritability, insomnia, inapetitio, aggressive behavior, social withdrawal), and second one were patients with manifest psychotic symptoms (delusions and hallucinations). All data about symptoms were given by heteroanmnesis. In research are used descriptive statistical measures (frequencies, percents and arithmetical mean) and CHI- square test for confirmation statistically significant differences.

Results of study revealed very highly significant differences between two groups (p = .000, p < 0,005).

Recognizing the importance of prodrome and early intervention affect the length of hospital stay showed that the comparative study was made.

Improving adherence in the early stages of illness by means of long-acting antipsychotics can lead to reduced number of readmissions and enhanced remission rates, which could lead to improved performance in the medium-long term.

Assessing clinical remission, number of admissions and personal and social performance in recent-onset schizophrenic patients undergoing LAIR.

Longitudinal retrospective study of a cohort of thirty-one recent-onset schizophrenic patients ( ≤ 2 years) who started LAIR treatment between 2004–2008. Twenty-six (83.9%) were treated for two years. PANSS scale was assessed at baseline; PANSS, Personal and Social Performance scale (PSP) and remission criteria after two years.

Twenty-six patients (83.9%), 61.5% male aged between 16–44 years old, completed two years of treatment. All patients met criteria for schizophrenia (DSM-IV) with an average duration of 0.8 year since diagnosis. The main reason to using LAIR was poor adherence (76.9%). The PANSS total and all its subscale scores improved significantly (p < 0.005) with 80.8% of patients showing a ≥ 50% improvement on the PANSS total. Seventeen patients (65.4%) achieved remission criteria. Five patients (19.2%) were admitted during the follow-up. The average on global functioning (PSP) was 72.4 (IC 95%, 66.4-78.4). LAIR doses at baseline were 25 mg (46.2%), 37.5 mg (30.8%) or 50 mg (23.1%); after two years, 25 mg (34.6%), 37.5 mg (34.6%), 50 mg (23.1%) or 75 mg (7.7%).

Despite the limitation of retrospective observational studies, our data, including the good adherence rate (83.9%), suggest that LAIR could be effective in the treatment of recent-onset schizophrenia.

Earlier studies have shown that candidate gene risk polymorphisms and psychoactive substance abuse influence the frequency and severity of psychosis.

In this study we examined whether the most studied schizophrenia risk polymorphisms and psychoactive substance abuse interact in their influence on symptom severity and neurocognition.

We analyzed the clinical data of 280 schizophrenia patients, including genotyping data of the candidate genes NRG1, DTNBP1, RGS4, G72/G30 and PIP5K2A. Patients were assessed clinically by the Positive and Negative Symptom Scale (PANSS) and information about substance abuse was based on self-report and reviewing patient charts. We tested for possible interactional effects using the General Linear Model (GLM) analysis.

15,8% of patients reported episodic or regular substance abuse, the vast majority (92%) used cannabis or the combination of cannabis and another drug. Substance abuse was associated with higher scores of the PANSS hostility/excitement factor, independent of sex, age, or genetic results (F = 4,02;p = 0,04). We found significant interactional effects of the DTNBP1 gene risk polymorphisms and substance abuse on different PANSS factors: rs2619528 and positive substance abuse interaction were associated with higher scores on the PANSS negative factor (F = 4,6;p = 0,03), and the PANSS depression factor (F = 4,75;p = 0,03). Moreover the rs3213207 - substance abuse interaction was associated with higher scores on the PANSS cognitive factor (F = 7,55;p = 0,006). Carriers of the Val allele of the COMT Val158Met polymorphism demonstrated significantly higher scores on the PANSS depression factor (F = 5,53;p = 0,02).

Our results underscore the importance of gene-environment interactions in the phenotypic heterogeneity of schizophrenia.