Suicide risk assessment is an essential part of general and forensic psychiatric practice. Psychiatrists must be able to evaluate specific clinical, demographic, and psychosocial risk factors in this process. Age represents an important demographic riskfactor for suicide. In the United States, suicide rates among adolescents and young adults have been increasing, with rates that are almost three times higher than in the 1950s.

Recent reports show an increase in suiciderates in middle aged populations as well. Suicide rates remain highest for older adults. The relationship between age and suiciderisk is complex, and psychiatrists need to recognize the psychosocial andbiological risk factors associated with different age groups.

The presenter will review suicide risk assessment in the context of different stages of life: adolescence and young adulthood, mid-adulthood, and advanced age, outlining the risk factors unique to the different stages. The presentation will also address how cultural factors and gender may affect risk assessment across different age groups.

The presenter will discuss the management of suicidal risk as it pertains to the different age groups.

Does the restriction of the links between the imprisoned parents and their children constitute the warranty of the safeguarding of the construction of personality of the children?

It ostruct the symbolization of the taboo and support the emergence of the risk of depression, sometimes leading to suicidal behaviours.

To elaborate in the clinical care of patients in detention methods allowing to prevent suicidal risks.

clinical observation and psychoanalytical clinical talks

population in prison and their immediate entourage

In progress.

The purpose of this study was to evaluate the occurrence of the suicidal ideation and associated factors with self-reported suicidal ideation within the last 12 months among Korean adolescents.

A total of 1533 adolescents were recruited from middle schools (age range: 13-14 years) in Korea. According to existence of suicidal ideation, they were divided 2 group – suicidal ideation group and non-suicidal ideation group, and the differences between groups in terms of various characteristics, including depression (Kovacs’ Children’s Depression Inventory), school and family factors, and health related conditions.

A total of 501 (32.7%) middle school students reported suicidal ideation, and the rate of suicidal attempt was 6.9% (n=106). The associated factors of suicidal ideation were female (OR= 2.42, p<0.001), below average academic achievement (OR=1.43, p=0.007), perceived low parental support (OR=2.09, p=0.001), depression (OR=3.25, p<0.001), current alcohol use (OR=2.37, p=0.003), self reported poor health (OR=1.54, p =0.043), and school bullying (OR=1.91, p =0.005).

These results may have important implications for the strategies and specified intervention in preventing suicidal ideation in Korean adolescents.

Within the population of patients hospitalized in the past 7 years,36.3% (N = 452) confirmed SA. In the SA group the sex ratio girls:boys was 3:1, where 45% girls and 23% boys (p = 0.000) had the history of SA. Highest percentage of SA occurred in patients with a diagnosis of depressive disorders: 52%, then in the following groups – conduct disorders 45%, reactive depression 43%, personality disorders 33%, substance abuse 27%, eating disorders 21% and psychoses 21% (p = 0.000). In all selected groups of psychiatric diagnoses the risk of suicide was highest in case of coexistence with NSSI (odds ratio, OR> 5). In addition, in the group of patients diagnosed with depression, a significant risk factor was the experience of physical violence (OR = 2.96) and in the group of psychoses – the number of hospitalizations (OR = 1.22).

NSSI are major risk factor for suicidal behavior among psychiatrically hospitalized youth irrespective of diagnosis.

Mental disorders constitute the most important risk factor for suicidal behaviour. Studies have found that LGBT (lesbian, gay, bisexual, and transgender) individuals are at increased risk for mental health problems, as a consequence of a hostile stressful environment.

There as been a historical pathologisation of sexual orientation and gender identity, however, lately there have been significant changes in medical understanding about this theme.

The authors aim to determine the possibility of increased suicidal ideation/suicidal behaviour among LGBT individuals.

Review of the literature using the terms LGBT, lesbian, gay, bissexual, transgender, sexual orientation, gender identity, suicide, suicidal ideation, suicidal behaviour.

Studies provide evidence that individuals in a sexual or gender minority are at greater risk for suicidal thoughts and behaviours. There is evidence of elevated rates of reported suicide attempts in LGBT compared to heterosexual adolescents and adults, worldwide. Individuals reporting a bisexual orientation had an increased risk of suicide attempts and ideation compared with their homosexual and heterosexual peers. Mental disorders do not appear to entirely explain elevated rates of suicide attempts in these individuals. Social stigma, prejudice and discrimination associated with this individual are important factors.

Health professionals should be alert to the higher risk of suicidal behaviour in lesbian, gay, bisexual and transgender people. Further research is needed in order to prevent suicide in these populations.

Suicidal behaviors are increasing in our country and they can be influenced by several factors such as social and cultural factors. It is important for physicians to better elucidate the risk factors in order to develop better strategies for prevention and management.

To determine socio-demographic and clinical features in Tunisian patients who committed suicide attempts.

Retrospective and descriptive study using medical files of patients referred to the outpatients clinic of Razi hospital. Included patients have made a suicide attempt in the period from january to september 2014. Socio-démographic and clinical features were collected.

Thirty-three patients were included (19 men and 14 women). The mean age was 30.6 years.

Most of these patients were single (n=20; 60.6%), unemployed (n=19; 57.6%), with a low education level (n=19; 57.6%) and a low financial income (n=18; 54.5%).

Nine of our patients went to jail (27.3%) and 8 had a personal history of suicide attempt (24.2%).

Eighteen patients had addictive behavior (54.5%) and 7 of them were addicted to many substances (21.2%).

Most prevalent psychiatric disorders in our population were adjustment disorder (57.6%) and depression (39.4%).

Personality disorders were found in 18 patients (54.5%).

57.6% of patients used drugs for their suicide attempts

Four patients were hospitalized and 82.2% of patients were lost afterward.

Suicidal attempts were associated with a disturbed and unsettled social and familial life leading to personality disorders. Furthermore, we noticed the high prevalence of addiction behaviors and bad treatment compliance.

Previous findings suggested that electrodermal hyporeactivity has a high sensitivity (up to 97%) and high raw specificity (up to 98%) for suicide.

To evaluate prevalence, sensitivity and specificity of electrodermal hyporeactivity for suicide and suicide attempt, with and without death intent and with violent method or not, in adult patients with a primary diagnosis of depression.

At each study site at least 100 patients with a primary diagnosis of depression, also in remission, will be recruited. Depressive symptomatology will be evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts will be registered and the death intent of the worst attempt will be rated according to the first eight items of the Beck Suicide Intent Scale. The risk of suicide will be assessed according to rules and traditions at the centre. The EDOR Test (ElectroDermal Orienting Reactivity) will be performed. Two fingers are put on gold electrodes. Through headphones a moderately strong tone is presented now and then during the test. Sensors located within the electrodes are able to register the electrodermal response to those tones, measuring the skin conductance (i.e. electrodermal activity from sweat gland activity). Each patient will be followed up for one year for actions of intentional self-harm that require medical care and for suicide. The death intent will also be rated.

It is expected that the EDOR test detects a previously unknown neuropsychological dysfunction that is independent of the depressive state and can predict suicidality with a high sensitivity and specificity.

Recent studies demonstrated the effectiveness of Telemental Health in the management of several psychiatric disorders. In our previous work we described a new model of Day-Hospital for Severe Mental Illness (SMI) defined Institutional Psychiatric Open Light Treatment.

According to our model, we test the effectiveness of a dedicated website, with several different functions, in organize a better monitoring and cooperation with SMI patients, affected by psychosis and personality disorder.

A pilot, observational study, for a group of twenty five patients admitted to a day hospital, in which we have analyzed whether and how patients use the website, what functions they use easily or in a greater extent and if it’s possible to correlate the use of these functions with clinical evolution of treatment.

The patients using more the website give a better outcome results, depending from a good compliance to the integrated treatment and a better link to the teamwork.

There is no evidence of a correlation between the way of use the website and diagnostic categories, but there is a significant correlation with age, interests and personal resources of patients.

Generally, it ‘s possible to measure a support in empowerment, autonomy activation and cooperation with treatment.

A dedicated website offers new useful tools for operators and patients, in a recovery process adding lightness, autonomy activation and better compliance to treatment.

Improve these tools and build a functioning closer to the needs of a recovery process, it’ll be object of further studies.

Human trafficking is a worldwide problem, that deeply affects the lifes of those involved. Victims of trafficking are confronted with a broad range of problems (unsafety, social isolation, financial problems, legal insecurities, stigmatization). Poor mental health is a dominant and persistent adverse health effect associated with human trafficking.

The (Mental) Health needs of victims have received limited attention, particularly when compared with law- enforcement and immigration responses to trafficking (WHO, 2012). Collaboration between the Justice-, welfare- and Mental Healthcare system is needed to develop solutions that can lead to a breakthrough to improve the Mental health and overall wellbeing of these women. The Centre against child and humantrafficking (CKM, the Netherlands:www.ckm-fier.nl) integrates the services needed by offering a safehouse setting combined with an inpatient MHtreatment facility. The centre closely collaborates with the justice system to be able to advocate the needs and legal rights not only on an individual, but also on a group level. The centre aims to improve the MH and overall wellbeing of the women (and children) admitted to the centre.

All women admitted to the centre have severe MH problems (often untreated before admission), mainly caused by a complex, chronic PTSS. The severe sleeping problems caused by the PTSS are experienced as most disabling for daily functioning. A sudden increase in MH problems is often related to legal insecurities and trials against the perpetrators.

More research is needed to identify the MH needs of the women to be able to improve the MH services needed for this group. The population of the CKM offers great oppurtunities to develop treatment modules for the victims of trafficking.

Although the relationship between personality and depressive illness is complex, there is empirical evidence that some personality features such as neuroticism, harm avoidance, introversion, are related to depressive illness risk among postpartum women.

The aim of this study is to estimate the prevalence of postpartum depression and to evaluate its relationship with neuroticism.

This is a descriptive cross-sectional study regarding 100 parturients during the first week of postpartum recruited in Obstetrics department, Sfax, Tunisia.

The EPDS was used to assess depressive symptoms at early postpartum.

Neuroticism was assessed by using the neuroticism scale of the NEO PI-R.

The total sample (n=100) had a mean age of 29 years.

4% had a family psychiatric history and 6% had a personal psychiatric history.

The current pregnancy was undesired in 13% of cases.

Sympathetic signs of pregnancy were reported by 69% of women.

The prevalence of postpartum depression in the first week was 9%.

The occurrence of depression was associated with the existence of mood personal background, a difficulty to accept the pregnancy and an irregular pregnancy monitoring.

Women with depressive symptoms obtained higher scores on neuroticism, depression and angry hostility than women from healthy groups.

Sympathetic signs of pregnancy were significantly related to neuroticism and anxiety.

Understanding the effect of neuroticism allows clinicians to detect subgroups of women with an increased vulnerability to postpartum depression who might receive early psychological and psychiatric care.

History of psychiatry can provide us with a map of the evolution of our practice and identify its major figures and their contributions.

to identify significant figures in the history of psychiatry

a historiometric approach was taken to nine available general histories of psychiatry texts and a historical dictionary of the discipline. Reliability was tested against data from the journal History of Psychiatry. Those cited in at least 60% of the sources are considered significant figures. An index of eminence is calculated for each significant figure.

The Cronbach’s alpha for the included nine sources was .89. There was significant correlation across the included sources. Seventy-four significant figures were identified. Among these, Sigmund Freud, Philippe Pinel, and Emil Kraepelin have the highest eminence in the field – in this order. Nineteen (25.7%) came from Germany, followed by nine (12.2%) from the US, eight (10.8%) from France, seven (9.5%) from Austria as well as England. Three (4.05%) of the significant figures in the histories of psychiatry are women: Dorothea Dix, Anna Freud, and Melanie Klein.

The history of psychiatry has evolved into five distinct periods, with the most eminent figures – Pinel, Kraepelin, and Freud – each representing the first three epochs – the asylum era, the first biological psychiatry, and the psychoanalytical period, respectively. The two most recent historical periods are not well represented yet and the contribution of women are underrepresented in the available histories of psychiatry.

Violence against women in marriage is greatly affects the mental health of women; it is associated with an alteration of the quality of life of victims and with a high incidence of mental disorders. However, a few studies were conducted in Arabic countries.

to estimate the prevalence of the violence against women in the marriage and to explore the relationship between the violence against women in the marriage and anxiety and depression symptoms.

It was a descriptive and analytical cross-sectional study carried on 197 married women (mean age: 32.32 ± 5.94 years; range: 19 and 50 years) recruited in family planning center of Monastir (Tunisia), which were assessed by the Woman Abuse Screening Tool questionnaire and the Hospital Anxiety Depression questionnaire.

The lifetime prevalence of violence against women in the marriage was 56.9%. The most common form of violence was psychological (56.9%), followed by economic violence (41.1%), physical violence (32%) and sexual violence (10.6). The frequency of anxiety and depressive symptoms was three times higher among women victims of violence: 33.9% versus 10.5% (P< 0.0001) for anxiety symptoms and 17.8% versus 5.9% (P = 0.012) for depressive symptoms.

Our study has demonstrated the association between violence against women in marriage and anxiety and depression symptoms. These results justify the implement of screening and support programs for Tunisian women victims of violence in marriage.

Prevention, screening and effective management are possible. There is a need for increased screening and clinician awarness.

In women, mentalillness is often associated with social burden and inadequate compliance.

Social burden, distress tolerance and medicationadherence among female withmental illness in remission.

Toknow the level of social burden, distresstolerance and its relationship with medicationadherence among Indian female with mental illness in remission.

Fiftyone consecutive asymptomatic female patients were assessed using socio-demographicproforma, The Zarit Burden Interview(ZBI), Distress Tolerance Scale(DTS) and Medication adherence scale(MAS). Seventy five percent of patientsexperienced different levels of burden and 25 %has poor medication adherence. Significant correlationwas observed between social burden and occupation (p<. 05); distress tolerancewith decision making (p<. 05) and knowledge about treatment (p <. 05), andmedication adherence with knowledge about treatment(p<.01). Thetotal scores of ZBI had a significant correlation with DTS scores (p. >01) andMAS score (p<.05).

Social burden is common, and interrelatedwith distress tolerance and medicationadherence in women with mental illness in remission.

Abuse and health consumerbehavior in women with mental illness in remission.

To know the level of abuse, effective consumer behavior and itsrelationship in female with mental illness in remission.

Fifty one consecutive females wereassessed using socio-demographic pro forma, Composite AbuseScale (CAS), Effective Consumer Scale(ECS) and Indian Disability Assessment Scale (IDEAS).

Eighty nine percent patients experiencedabuse (physical or psychological). Correlation analysis revealed a significantcorrelation between harassment andknowledge of treatment (p<. 01); physical abuse with religion (p<.05) andattitude of others (p<.05); emotional abuse with knowledge of treatment(p<.01) and severe abuse withreligion (p<.05). Socioeconomic status has astatistically significant correlation with domain of consumer behavior such as communications(p<05), negotiation(p<01) and decision – taking action (p<05). Other statistically significant correlation found were between family type and negotiation (p<05), diagnosis and uses of health information (p<05) & priorities (p<05). Marital status has a negative correlation withcommunications (p<05). Total scoreon CASis negatively correlated with scores on ECS, but statistically notsignificant.

Abuse and effective consumer behaviormay vary with socio-demographic variables.

Females who lost tzheir husbands during the war sufer from the different psychic problems.

to investigate the association of severity of traumatization and level of somatization, obsessive-compulsive symptoms, sensibility, depressiveness, anxiety, hostility, phobic, paranoia, psychotic symptoms of the females who lost husbands during the 1992-1995 war in Bosnia-Herzegovina (BH).

The sample was consisted from 50 females who lost and 50 females who did not lost their husbands in the BH war 1992-1995, of age from 35-60 years. We used The Harvard Trauma Questionnaire and Brief Symptoms Inventory.

The obtained results indicate that the level of traumatization was significantely positively associated with the level of the somatization (Pearson’s 'r”=0,682; P<0,001), obsessive-compulsive symptoms (r=0,759; P<0,001), sensibility (r=0,698; P<0,001), depressiveness (r=0,743; P<0,001), anxiety (r=0,780; P<0,001), hostility (r=0, 765; P<0,001), phobic (r=0,605; P<0,001), paranoia (r=0,678; P<0,001), and psychotic symptoms (r=0,622; P<0,001) of tested females in the postwar BH.

The severity of traumatization of the females who experienced the loss of their husbands during the war 1992.-1995 in Bosnia-Herzegovina significantly positively associated with the level of the somatization, obsessive-compulsive symptoms, sensibility, depressiveness, anxiety, hostility, phobic, paranoia, psychotic symptoms.

To determine the effect of Red Clover on postmenopausal psychological symptoms.

A triple blind randomized placebo- controlled clinical trial was conducted to assess the effect of Red Clover on postmenopausal psychological symptoms in 72 volunteer healthy women, whom had been visited in one of menopausal clinic in west of Tehran. (Year 2012-2013). The intervention group received daily 2 capsules containing 40 mg dried leaves of Red Clover for three months; the control group received 2 capsules containing 40 mg Starch in the same way. Tools have two main parts; 1) Personal characteristics, 2) Psychological symptoms scale, as obtained through psychological sub scale of Menopause Rating Scale (MRS). Data analyzed by using descriptive and inferential statistic and all ethical points were considered.

Equality of demographic characteristics and menopause psychological symptoms scale before intervention had been. The average score of the psychological symptoms scale before intervention was 7.50 ± 4.24, and after first, second and third month was 5.11 ± 2.76, 4.13 ± 2.62, and 2.69 ± 1.69. There was significant difference between intervention and placebo group, also there were significant decrease during three months. (P-value: 0.001)

40 mg daily use of dried leaves of Red clover for three months had been effective in reducing menopause psychological symptoms. No side effects had been seen during study and one month later.

Received grants from Research department of Tehran University of Medical Sciences. (Year 2012- 2013)

To compromise effect of massage therapy applied by midwife and trained clients on menopausal symptoms.

This is the Randomized Controlled Clinical Trial, which was conducted at one of menopausal clinics of referral gynecology hospitals in Tehran (Year 2012). In this Study 90 healthy volunteer menopausal women were assigned to the group of massage therapy applied by midwife, applied by trained clients, and control group. Each subject in two intervention groups received 30-minutes massage sessions, twice a week for four weeks applied by professional midwife or study subjects, whom received two session training, and no treatment was provided to subjects in the control group. Study questioner had two main parts of Personal characteristics also Menopause Rating Scale (MRS). The results were analyzed by using SPSS version 14 software. All ethical points were considered.

Significant difference was found between the participants' pre-application and post-application of MRS score in two intervention groups (p<0.05), whereas the score in the control group did not differ significantly. Also massage therapy group applied by professional midwife have higher significant effect than massage therapy group, applied by study subjects (p<0.05).

The results of the study have demonstrated that massage therapy were effective in reducing menopausal symptoms during menopause. But, the effectiveness of massage therapy applied by midwife had more significant effect than educated clients' apply.

This study was supported by Tehran University of Medical Sciences, year 2011-2012.