The Driver and Vehicle Licensing Agency in UK have published guidelines on driving for mentally ill patients. An earlier audit done in 2008 showed that none of the 25 patients included in the audit received advice on driving.

A re-audit was done in terms of documentation of

1. 1) the driving status of patients,

2. 2) advice on driving at time of discharge.

Retrospective audit was done by retrieving 25 case notes and discharge summaries of patients admitted. Demographic details, driving status and driving advice given were collected using a pre-defined proforma.

25 patients admitted to adult wards were included (16 males, 9 females, and mean age 46). 15 patients were admitted as informal while 5 each were on section 2 and 3 of Mental Health Act (MHA). The following were the diagnoses; mental disorders due to alcohol (2), Schizophrenia (8), manic episode (1), bipolar affective disorder (5), depressive episode (8) and personality disorder (1). 16 patients (64%) were documented to have current driving licence and this information was not recorded in 9 cases (36%). 12 (48%) patients were current drivers and 4 of them were professional drivers. 13 (52%) patients were given documented advice regarding driving at the time of discharge.

52% of patients admitted to general adult mental health wards were given advice regarding driving at the time of discharge and compared to previous audit data, there has been a significant improvement. However this needs to be improved by increasing the awareness among healthcare professionals.

In order to promote the harmonisation of training in psychiatry and facilitate mobility of psychiatrists across Europe, the European Board of Psychiatry is developing appropriate training recommendations. In a recently conducted European survey, Greece was partly under-represented and there is lack of recent data regarding national psychiatric training.

The present survey aimed to investigate, from a trainee's point of view, the degree of compliance of Greek training centres to what the European Board of Psychiatry recommends.

An on-line survey, accessible only to invited trainees, was constructed in close adherence to previous questionnaires and guidelines set by the European Board of Psychiatry. Training centres in psychiatry were identified and trainees were invited by e-mail to complete the survey in autumn 2010. All responses were tracked and only valid completed questionnaires were included in the final results.

Preliminary results from the first quarter of the sample clearly indicate that the overwhelming majority of Greek psychiatric trainees do not have individualized training programs (88%) and logbooks (99%). There is no auditing experience (90%) and no exposure to internal (90%) or external (93%) evaluation. On the other hand, structured theoretical training is available to the majority of trainees (94%) although psychotherapeutic supervision is offered to only 25% of trainees.

Much improvement had been observed over the last decade in psychiatric training in Greece. However, results of the present survey show that there is still inadequate compliance to some of the recommendations developed by the European Board of Psychiatry.

The DASS is a self administered questionnaire which principally measures anxiety stress and depression as a feature of the general population with 42 items.

To create an easy to use and valid measurement, for primary care and during treatment assessment in patients with anxiety or depression disorders.

Translation was performed using the multiple forward and backward translation protocol. STAI state and trait along with BDI were also administered to check construct validity of DASS.

537 adults participated, 178 (33.6%) male, 349 (64.6%) female. The total scale of the DASS-42 had a coefficient alpha of .968. Subscale coefficient alphas also were high (αdepression = ,941; αanxiety = ,906 ; αstress = ,942). Mean score for stress was 12,46 (SD = 9,82), for anxiety 7,19 (SD = 7,7) and for depression 8,05 (SD 9,6). Both subscales and total score were significantly correlated with STAI and BDI (r = .60 to.73, p < .01).Principal Components Analysis revealed the presence of 3 factors explaining 56% of the total variance. 14 items loaded in the stress subscale, 14 in the depression factor, but only 12 in the anxiety factor. ANOVAs found significant differences in all subscales between healthy adults and psychiatric outpatients. (p < ,001).

The results of the current validation study suggest that the Greek translation of the DASS is both reliable and valid, with psychometric properties close to those reported in the international literature.

Delusional disorder, also known as paranoia, is a low prevalence psychotic disorder in our environement. Usually, patients who have this disorder are very difficult to treat adequately besides its poor adherence to medical treatment, and the ineffectiveness of some therapies are well documented.

The aims of this study were to describe clinical, socio-demographic and pharmacological variables among a large stable sample in the community, and quantify the association between these variables and mental health care adherence.

Hospital Clinico San Carlos Hospital covers three local health areas; the sample was taken from one of them, wich provides health care to 268,000 people, approximately.We identified 130 out-patients with delusional disorder, but only 90 of these fulfilled DSM IV criteria. We recorded socio-demographic, clinical, pharmacological and legal data from 71 medical history patients. We also included number of visits and number of times patients didn't attend to an appointment among the total in one year. We defined mental health care adherence as good, irregular, or abandoned, in relation to missed appointments.

Delusional disorder incidence was 1,6 per 100,000 habitants, with a prevalence of 36 per 100,000 habitants, according to other studies results. Among all treatments, risperidone was the most prescribes neuroleptic. We found association almost significant between tratment with benzodiacepinesn and good adherence (x2 = 0,059).

These results give as a more realistic view of delusional disorder in our enviroment, and let us to reconsider aspects of mental health care adherence and a posible association with benzodiazepine treatment.

Reports in the medical literature describe several cases of acute onset psychosis as a result of hypothyroidism, and a small number related to radioactive iodine treatment (RAIT). The effectiveness of RAIT in the therapy of differentiated thyroid cancer depends on a sufficient TSH level elevation obtained by discontinuing thyroid hormone replacement therapy.

Describing a case of new-onset psychotic disorder in a 42-year-old woman following a RAIT session, one year after total thyroidectomy for papillary thyroid carcinoma developed on multinodular goiter.

Identifying a relation between the psychosis onset and the therapeutic protocol the patient underwent for the thyroid disease treatment.

We present the case of a patient with a medical history of thyroid disease, secondary posttraumatic epilepsy and minor thalassemia; the clinical and paraclinical evaluations; the psychiatric presentation, treatment and evolution.

The overt psychotic symptomatology developed in this case a few days after RAIT and led to an emergency psychiatric hospitalization, the laboratory findings showed a TSH value of 75 microunits/ml. The psychotic episode remitted after a month of antypsichotic medication and levothyroxinum replacement therapy. The patient has been receiving psychotropic medication for a year, during which she was readmitted for a depressive episode (6 months after first discharge).

The patient's psychotic disorder developed after a period of thyroid hormone replacement therapy discontinuation and consecutive to the RAIT session, which indicates that in susceptible individuals there is a risk for psychosis with this therapeutical strategy.

The pathological gambling (PG) is an impulse control disorder with clinical features common to other psychiatric disorders such as addictions and obsessive-compulsive disorder (OCD). The pathophysiology of PG is still unclear, but it is hypothesized that it might include environmental factors coupled with a genetic vulnerability and dysfunctions of different neurotransmitters such as norepinephrine, dopamine, glutamate and serotonin. The serotoninergic system seems to be primarily involved, as has been shown to regulate the impulsivity and aggression.

With this study we aim to assess the impulsivity in 26 PG as compared with a matched group of healthy controls (HC).

Twenty-six outpatients, with a diagnosis of PG according to DSM-IV criteria, and 26 HC were included in the study. The severity of symptoms was evaluated by the South Oaks Gambling Screen (SOGS) and the impulsivity was assessed by Barratt Impulsivity Scale, version 11 (BIS-11).

The results showed that the PG patients had a higher BIS-11 total score, as compared with HC, and higher scores of two factors of the same scale: the motor and attentional impulsivity. Even the motor and non-planning impulsivity subscales scores were higher in patients than in HC.

These results suggest that PG patients are more impulsive than control subjects. This feature could lead to a loss of control typical of PG.

Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.

A case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).

From the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.

Skin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.

Was remarqued the insufficient representation of psychiatrists in the physician workforce throughout the world (Rao, 2003) and the increasing number of unoccupied vacancies in psychiatry (Brokington, 2002). Most developing countries need to increase and improve training of mental health professionals. Once trained, these professionals should be encouraged to remain in their country in positions that make the best use of their skills.

Recruitment in psychiatry remain a problem, strongly related with definition of identity of psychiatrists and with community view regarding this need of taking care for this category of patients.

Neuroticism is one of the five fundamental dimensions of personality based on the model of the Big Five. It is defined as the general tendency to experience unpleasant emotions such as hostile emotions, feelings of anxiety or depression.

The objective of this work is to validate the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) among Tunisian students.

Neuroticism among students was evaluated using the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985). This scale provides an overall score of Neuroticism Lire phonétiquement Dictionnaire - Afficher le dictionnaire and also different scores for each of the six Neuroticism facets are: anxiety, depression, anger / hostility, impulsivity, social shyness and vulnerability to stress.

The validation was made on a representative sample of university students (n = 500) randomly selected.

The main properties studied were: acceptability, reliability (Pearson’s coefficient ‘r’), face validity and content validity (Cronbach’s alpha).

The acceptability of the questionnaire was good, less than 10% of students were unable or unwilling to complete the questionnaire. The Pearson coefficient showed good reliability for this scale r = 0.96, p < 0.05. The Cronbach’s alpha was acceptable for all items of the scale α = 0.73.

The Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) is valid in Tunisian students. It is now available for clinicians to measure the level of neuroticism among students.

Religious themes commonly feature in religious with Obsessive-compulsive disorder (OCD). OCD which includes cognitive, emotional, and behavioral components, is a debilitating chronic disorder and can affects on patient’ marital satisfaction. The aim of us was to evaluate efficacy of Religious Cognitive- Behavior therapy (RCBT) on religious oriented Obsessive-Compulsive disorder and marital satisfaction.

This is a randomized controlled clinical trial. This study conducted on 90 OCD outpatients with 17 and more Yale Brown obsessive compulsive scale(Y-BOCS) and religious content OCD. Intervention consists of 10 weekly RCBT. We used Enrich scale for asses’ marital satisfaction and Y-BOCS scale before and after treatment.Data were analyzed by ANCOVA/ANOVA repeated measure test using SPSS version ver.15.

In our study duration of OCD was 11.5 ± 8.6 years & 11.5 ± 8.8 years and duration of marriage was 16.88 ± 11.6 & 13.51 ± 10.9 years Yale Brown scores after intervention decreased with significant difference (p = 0.001). There were significant difference between mean scores of two groups (p = 0.001). Comparison of obsession subscale and compulsion subscale of Yale Brown scale showed decreasing trend in both of obsession subscale and compulsion either within or between group is statistically significant (p = 0.001).Also marital satisfaction significantly improved in case group (p = 0.001).

In religious patients with religious contents, religious based interventions like religious CBT could significantly increase clinical responses. Also theses interventions could improve marital status. These results suggest that Religious Cognitive-Behavior Therapy can be effective for religious oriented OCD patients.

Catatonia refers to a broad group of movement abnormalities usually associated with mood disorders and schizophrenia. Periodic catatonia is characterized by catatonic episodes occurring in a cyclical pattern with clinical features of combined stupor and excitement, remissions to an interval state and an autosomal dominant pattern of transmission (Meyer et al, 2001; Stober, 1995). The role of benzodiazepines, antipsychotics and Lithium in the prevention of recurrence in periodic catatonia has been documented. We present two cases of periodic catatonia treated with Lithium and carbamazepine. Also, we want to discuss the salient features of periodic catatonia cases reported so far in the literature, to the best of our knowledge. Can we consider periodic catatonia as a different nosological status? Or it is early or it is late?

To describe two cases of periodic catatonia and their treatment with mood lithium/carbamazepine

To discuss the cases of periodic catatonia in the literature

To examine the nosological status of this entity

Medline search will be made using appropriate key words

Total number of cases of periodic catatonia is more from asian countries, other case characteristics will be descriptive.

Catatonia less prevalent in European countries unlike in developing countries including India. Recurrent catatonia, as expected, is still less common. Sometimes treatment of periodic catatonia is beyond Benzodiazepines / ECT /antipsychotics. In such cases Lithium and Carbamazepine may be helpful. Weather periodic catatonia needs a different nosological status is to be debated.

Patients with factitious disorder intentionally produce or feign signs of medical or mental disorders. The only apparent objective of this behavior is to assume the role of a patient without an external incentive. The high rate of comorbidity with other psychiatric disorders together with the knowledge that factitious disorder lies on a continuum between somatoform disorders and malingering renders the early detection and diagnosis of cases with feigned psychological signs and symptoms more demanding.

Poor documentation of factitious disorder with predominant psychological signs and symptoms in the current literature reveals a blind spot in the diagnostic approach. With this in mind three cases were followed and reviewed to illustrate the elusive character of this clinical entity and demonstrate the importance of its early consideration in the differential diagnosis.

Three patients presented to our acute psychiatric department with an extensive constellation of mood and psychotic symptoms. All patients underwent a thorough neuropsychological and medical evaluation. The diagnosis of factitious disorder was mainly based on their inconclusive mental status examination which could not definitively support the presence of another psychiatric or medical disorder, on the observation that their behavior on the psychiatric unit proved inconsistent with their chief complaints and on the past history from collateral sources which confirmed a pattern of multiple hospitalizations.

Factitious disorder should be considered in patients with inconsistent psychiatric presentations and negative diagnostic results who are high utilizers of acute care facilities such as the emergency room and inpatient services.